上消化道出血患者疾病不确定感及其影响因素分析

Uncertainty of Disease and its Influencing Factors in Patients with Upper Gastrointestinal Bleeding

目的:对上消化道出血患者进行疾病不确定感测评,分析可能影响患者疾病不确定感的相关因素及危险因素,探讨降低患者疾病不确定感对策。方法:选取2019年2月—2020年1月赣州市第五人民医院收治的上消化道出血患者60例作为调查对象,所有患者均由同一位经过培训的精神科医师对其确诊后实施疾病不确定感测评。参照文献资料及临床经验制定可能影响上消化道出血患者疾病不确定感相关因素调查指标方案,对不同因素不同水平行单因素分析,将不同水平存在统计学意义差异的因素作为可能影响上消化道出血患者疾病不确定感的相关因素,并将相关因素纳入到多因素logistic系统分析可能影响上消化道出血患者疾病不确定感的危险因素。根据数据结果探讨降低上消化带出血患者疾病不确定感因素的对策。结果:60例上消化道出血患者疾病不确定感平均得分为(101.38±7.23)分,说明上消化道出血患者疾病不确定感处于较高水平;经单因素分析显示,年龄、家庭经济收入、医疗费用承担、出血部位、出血量、临床症状、既往病史可能影响上消化道出血患者疾病不确定感的相关因素(P<0.05);经多因素logistic分析,自费医疗费用、出血量超过50ml、文化程度初中以下可能为影响上消化道出血患者疾病不确定感的危险因素。结论:上消化道出血患者疾病不确定感普遍较高,病情危重、患者认知水平差、负性情绪重等为影响患者疾病不确定感的危险因素,临床应加强对上消化道出血患者健康教育及心理干预,使患者在充分了解疾病相关知识,促使其客观科学认知疾病,降低疾病不确定感及其带来的负面影响,提升患者治疗期间身心健康。

Objective:To evaluate the uncertainty of disease in patients with upper gastrointestinal bleeding,and to analyze the related factors and risk factors that may affect the uncertainty of disease,and to explore the countermeasures to reduce the uncertainty of disease.Methods:60 patients with upper gastrointestinal bleeding admitted to the hospital from February 2019 to January 2020 were selected as the investigation objects.All patients were diagnosed by the same trained psychiatrist,and the uncertainty of illness was evaluated.According to the literature and clinical experience,the related factors of uncertainty of disease in patients with upper gastrointestinal bleeding were investigated.The single factor analysis was carried out on different factors and different levels.The factors with statistically significant differences at different levels were taken as the related factors that might affect the uncertainty of disease in patients with upper gastrointestinal bleeding,and the related factors were included in the multi factor Logistic model Systematic analysis of the risk factors that might affect the uncertainty of disease in patients with upper gastrointestinal bleeding.Based on the data results,the countermeasures to reduce the uncertainty of the disease in patients with upper gastrointestinal bleeding were discussed.Results:The average score of uncertainty in illness of 60 patients with upper gastrointestinal hemorrhage was(101.38±7.23)points,indicating that the uncertainty of disease was at a high level.A univariate analysis showed that age,family income,medical expenses,bleeding site,bleeding volume,clinical symptoms,and past medical history might be related factors that affected the uncertainty of disease in patients with upper gastrointestinal bleeding(P<0.05).According to multi-variate logistic analysis,self-funded medical expenses,bleeding volume exceeding 50 ml,and education level below junior high school might be risk factors that affected the uncertainty of the disease in patients with upper gastrointestinal bleeding.Conclusion:Patients with upper gastrointestinal hemorrhage generally have a higher sense of disease uncertainty.Critical illness,poor cognition of patients,and heavy negative emotions are risk factors that affect patients’sense of disease uncertainty.Clinically,health education and psychological intervention for patients with upper gastrointestinal bleeding should be strengthened,so that patients can fully understand disease-related knowledge,promote their objective and scientific understanding of disease,reduce disease uncertainty and its negative effects,and improve patients’body and mind health during treatment.