神经内科认知障碍患者生活质量现状及影响因素分析

Status quo and influencing factors of quality of life in neurological patients with cognitive disorder

目的了解认知障碍患者生活质量,探讨认知障碍患者生活质量的影响因素,以期为认知障碍患者生活质量的改善提供参考依据。方法2017年1—12月,整群抽取南京市某神经精神病专科医院1 398例神经内科患者,得到125例认知障碍研究对象,对其进行横断面调查。调查工具采用老年性痴呆生活质量(QOL-AD)量表、蒙特利尔认知评估表(MoCA)、日常生活自理能力量表(ADL)、SAS、SDS和一般资料问卷,应用方差分析、Pearson相关分析及多元线性回归进行统计分析。结果本医院神经内科认知障碍的患病率为9.3%。患者QOL-AD评分为(31.88±6.54)分,性别、受教育程度、工作性质、家庭收入、睡眠以及较差的社会关系均影响研究对象的生活质量(P<0.05)。多元线性逐步回归分析显示:MOCA、SAS、SDS为认知障碍患者生活质量的主要影响因素(P<0.05)。结论男性、受教育程度低、体力劳动、社会关系差为生活质量低的高危患者,认知障碍、焦虑、抑郁是影响认知障碍患者生活质量的主要危险因素,应促进和维持此类患者认知能力,丰富其文体生活和社会活动,增进心理健康,从而提高认知障碍患者的生活质量。

Objective To explore the quality of life in patients with cognitive disorder and to discuss its influencing factors so as to provide a reference for improving the quality of life in patients with cognitive disorder. Methods Totally 1 398 neurological patients from a neuropsychiatric hospital in Nanjing were screened using cluster sampling and 125 patients with cognitive disorder were selected as subjects between January and December 2017. The subjects received a cross-sectional study with Quality of Life in Alzheimer's Disease (QOL-AD), Montreal Cognitive Assessment Scale (MoCA), Activities of Daily Living Scale (ADL), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and the general information questionnaire. Variance analysis, Pearson correlation analysis and multivariate linear regression analysis were used for statistical analysis. Results The morbidity of cognitive disorder in neurological patients from our hospital was 9.3%. Their QOL-AD score was (31.88±6.54). Sex, educational background, nature of work, household income, sleep and bad social relations are factors affecting the quality of life of the subjects (P<0.05). According to multivariate linear regression analysis, MoCA, SAS and SDS were main factors affecting the quality of life of the subjects (P<0.05). Conclusions Male patients with lower education, physical work and bad social relations are high-risk patients with lower quality of life. Cognitive disorder, anxiety and depression are main risk factors affecting the quality of life in patients with cognitive disorder. Nursing workers should improve and maintain the patients' cognitive ability, enrich their cultural life and social activities, and enhance their mental health, thereby improving their quality of life.