获知职业病诊断结果后患者心理健康状况及其影响因素分析

Investigation on mental health status and affecting factors of patients after knowing results of occupational disease diagnosis

[目的]探讨申请职业病诊断人群在完成职业病诊断后的心理健康状况及可能影响因素。[方法] 2016年6月-12月,对在某职业病诊断机构完成职业病诊断并领取职业病诊断证明书后1~2个月的患者进行调查。采用12项一般健康问卷(GHQ-12)及自编相关因素调查表进行心理健康状况及可能影响因素调查。[结果]本次共随访调查完成职业病诊断人员129例,最后纳入研究94例,71例被诊断为职业病。申请职业病诊断人员GHQ-12平均得分为(7.23±4.61)分,心理障碍高危人群(总分≥4分者)占74.5%。logistic逐步回归分析结果显示:在性别、文化程度、病种、疾病严重程度、职业病诊断结果、对疾病认知、职业病诊断预期与结果一致性、单位客观支持评分、单位主观支持评分、月收入减少和家庭经济状况等各潜在的影响因素中,诊断为职业病的患者成为心理障碍高危人群的危险性是不能诊断为职业病患者的8.767倍(P <0.01);家庭经济状况越好、用人单位主观支持评分越高,越不容易成为心理障碍高危人群(OR=0.144、0.740,P <0.05)。[结论]申请职业病诊断人群在职业病诊断后心理健康状况不佳,尤其是已确诊为职业病的患者。家庭经济状况较好且生活有结余、用人单位主观支持度高可能是保护因素。这些因素在诊治过程中应得到高度重视,以促进患者心理健康。

[Objective] To investigate the mental health status and possible influencing factors of patients after they knew the results of occupational disease diagnosis. [Methods] The patients,who applied for occupational disease diagnosis in a hospital for occupational disease and knew the results of diagnosis for 1-2 months,were surveyed with 12-item general health questionnaire(GHQ-12)plus self-designed questionnaire. [Results] A total of 129 patients were surveyed and 94 of them were included in this study. Among them 71 cases were diagnosed as occupational disease. The survey showed that the average scores of GHQ-12 was(7.23 ± 4.61),and the percentage of cases with high risk of mental health(total scores ≥4) was 74.5%.Logistic regression showed that diagnosis result( yes or no),employers’ subjective support,and family economic condition were major affecting factors among those potential influencing factors. It seemed that the patients diagnosed as occupational disease had high risk of mental disorders(8.767 times higher than the non-diagnosed patients,P < 0.01). The good family economic condition and the employers’ subjective support were protective factors(the risk odds, 0.144 and 0.740, P < 0.01).[Conclusion] The mental health status of those patients were not fine,especially the patients diagnosed as occupational disease.The good family economic condition and the employers’ subjective support are the protective factors. We should pay more attention to mental health status of such patients.