重症肝炎、肝衰竭患者疾病认知与心理痛苦状况的相关性

Correlation between disease cognition and psychological distress in patients with severe hepatitis and liver failure

目的观察重症肝炎、肝衰竭患者心理痛苦状况,分析患者疾病认知与心理痛苦的关系。方法选取2019年3月~2020年4月海南省干部疗养院收治的63例重症肝炎、肝衰竭患者,设计一般资料调查问卷,询问患者基线资料情况,采用心理痛苦管理筛查工具(DT评分)评估患者并分为心理痛苦严重组和心理痛苦轻微组;评估并比较两组疾病认知,分析重症肝炎、肝衰竭患者疾病认知与心理痛苦的关系。结果 63例重症肝炎、肝衰竭患者22例心理痛苦严重,占34.92%;心理痛苦严重组年龄<60岁患者例数、疾病感知评分、疾病认知评分低于心理痛苦轻微组,睡眠质量评分高于心理痛苦轻微组,差异有统计学意义(P <0.05)。经二元logistic回归分析后建立多元回归模型,结果显示,年龄<60岁、睡眠质量差、疾病感知低下、疾病认知低下均可能是重症肝炎、肝衰竭患者心理痛苦严重的风险因子(OR> 1,P <0.05),其中疾病认知低下带来的影响较显著,可能作为独立风险因子;经双变量Pearson直线相关性检验结果显示,疾病认知与心理痛苦状况呈负相关(r=-0.420,P <0.05)。结论重症肝炎、肝衰竭患者心理痛苦状况不容乐观,可能与疾病认知低下有关,部分患者心理痛苦严重,临床应重视重症肝炎、肝衰竭患者心理痛苦状况,并早期给予疾病认知低下重症肝炎、肝衰竭患者针对性干预,以改善患者心理痛苦状况。

Objective To observe the psychological distress of patients with severe hepatitis and liver failure,and to analyze the relationship between disease cognition and psychological distress. Methods 63 patients with severe hepatitis and liver failure admitted to the hospital from March 2019 to April 2020 were selected.The psychological distress management screening tool(DT) was used to assess the mental distress of patients and divided them into groups;designed a general information questionnaire to ask about the patient’s baseline information,recorded and compared the baseline data of the two groups,assessed and compared the disease cognition of the two groups,analyzed the relationship between disease cognition and psychological pain in patients with severe hepatitis and liver failure. Results Among 63 patients with severe hepatitis and liver failure,22 had severe psychological pain,accounting for 34.92%;in the severe psychological pain group,cases of patients with age < 60 years old,disease perception score and disease recognition score were lower than those in the mild psychological pain group,and the sleep quality score was higher than that in the mild psychological pain group,the difference was significant statistically(P < 0.05);after binary Logistic regression analysis,a multiple regression model was established,the results showed that age < 60 years old,poor sleep quality,low disease perception and low disease cognition might all be risk factors for severe psychological pain in patients with severe hepatitis and liver failure(OR > 1,P < 0.05),among them,the influence of low disease cognition was more significant,which might be used as an independent risk factor after the bivariate Pearson linear correlation test,the results showed that there was a negative correlation between disease cognition(self-made illness cognition scale)and psychological distress(DT score)(r=-0.420,P < 0.05). Conclusion The psychological distress of patients with severe hepatitis and liver failure is not optimistic,which may be related to low disease cognition,some patients have severe psychological distress.Clinically,we should pay attention to the psychological distress of patients with severe hepatitis and liver failure,and give early targeted interventions to patients with severe hepatitis and liver failure with low disease cognition to improve the psychological distress of patients.