原发性青光眼伴视野损害患者反刍性沉思水平及影响因素的调查研究

The level and influencing factors of rumination in patients with primary glaucomatous visual field defect

目的调查原发性青光眼伴视野损害患者反刍性沉思水平并探究其影响因素。方法便利抽样,采用简体中文版事件相关反刍性沉思问卷和青光眼患者自我管理行为问卷,对267例原发性青光眼伴视野损害患者进行横断面调查,比较不同视野情况在侵入性、目的性反刍性沉思及自我管理行为总分上的差异,分析其侵入性、目的性反刍性沉思水平主要影响因素。结果原发性青光眼伴视野损害患者的反刍性沉思总分为(29.90±5.58)分,自我管理行为的条目均分为(2.81±0.31)分。不同视野情况在侵入性反刍性沉思、目的性反刍性沉思、自我管理行为总分上比较差异无统计学意义(P>0.05)。多元线性回归显示,意外伤害、生活调适、家庭人均月收入、受教育水平可解释侵入性反刍性沉思30.7%的变异量,疾病之医疗管理、机能保健、意外伤害可解释目的性反刍性沉思11.1%的变异量。结论原发性青光眼伴视野损害患者反刍性沉思处于中等偏下水平,自我管理行为处于中等水平。医护人员应关注存在意外伤害、生活调适能力差、家庭人均月收入低、受教育水平低的这类原发性青光眼伴视野损害患者的侵入性反刍性沉思评估,减少其负性体验,转变认知,促进患者采取正确的自我管理行为,改善疾病的预后。

Objective To investigate the status of rumination in patients with primary glaucomatous visual field defect and explore the influencing factors.Methods Totally 267 patients with primary glaucomatous visual field defect were selected via convenience sampling method.Invasive rumination,purpose rumination,and self-management behaviors among different visual field were compared.The main influencing factors of invasive rumination and purpose rumination were analyzed.Results Total score of rumination in patients with primary glaucomatous visual field defect was(29.90±5.58)points,average item score of self-management behaviors was(2.81±0.31)points.There were no significant difference in invasive rumination,purpose rumination,self-management behaviors among different visual field(P>0.05).Accidental injury,life adjustment,income of family per mouth and degree of education could explain 30.7%of the total invasive rumination variation;disease management,body function promotion and accidental injury could explain 11.1%of the total purpose rumination variation.Conclusions Rumination and self-management behaviors in patients with primary glaucomatous visual field were at a lower middle level and middle level respectively.Medical staff should attach importance to assess the invasive rumination among these patients with accidental injury,poor ability of life adjustment,low income of family per mouth and low degree of education.Through lowering the negative experience,changing the cognitive and taking correct self-management behaviors,then prognosis of disease would be improved.