VA-ECMO治疗患者的负性情绪、希望水平及相关性

Negative emotion,level of hope of patients treated with VA-ECMO and their correlation

目的分析静脉-动脉体外膜肺氧合(VA-ECMO)治疗患者的负性情绪与希望水平情况,分析其相关性。方法采用简单随机抽样法抽取应用VA-ECMO治疗后意识清醒的患者80例,自制一般资料问卷对患者进行基本资料调查,采用贝克焦虑量表(BAI)评估患者治疗第2天至第4天、第5天及以后焦虑情绪,贝克抑郁自评量表13项(BDI-13)评估患者抑郁负性情绪,Herth希望量表(HHI)评估患者希望水平;采用单因素分析法和多因素Logistic回归分析法对患者焦虑、抑郁产生的可能影响因素进行分析;采用Pearson相关性分析法分析VA-ECMO治疗患者负性情绪与希望水平的相关性。结果应用VA-ECMO治疗后,患者焦虑总人数57例、焦虑率为71.25%,以轻中度焦虑为主、各占32.50%,VA-ECMO治疗第5天及以后BAI评分较治疗第2天至第4天升高(P<0.05);抑郁人数61例、抑郁率76.25%,以中度抑郁为主(51.25%),且治疗第5天及以后BDI-13评分较治疗第2天至第4天升高(P<0.05);VA-ECMO治疗后患者HHI得分升高(P<0.05),86.25%患者处于中等及以上水平;多因素Logistic回归分析提示自费、发生VA-ECMO治疗并发症是影响VA-ECMO治疗患者焦虑发生的独立危险因素(P<0.05),自费是影响VA-ECMO治疗患者抑郁发生的独立危险因素(P<0.05);经Pearson相关分析显示VA-ECMO治疗患者HHI量表评分与BAI及BDI量表评分均具有负相关性(r=-0.595、-0.542,P<0.05)。结论应用VA-ECMO治疗后患者均存在一定程度的焦虑及抑郁情绪,这些情绪与治疗费用支付、并发症及希望水平呈负相关。

Objective To analyze negative emotion and level of hope of patients treated with venous-arterial extracorporeal membrane oxygenation(VA-ECMO),and analyze the correlation between negative emotion and level of hope.Methods A simple random sampling method was used to select 80 conscious patients after VA-ECMO.A self-made general information questionnaire was applied to investigate the basic data of the patients.Beck Anxiety Inventory(BAI)was used to evaluate the patients'anxiety from the second day to the fourth day,the fifth and later days of treatment,and Beck Depression Inventory(BDI,the 13-item short form of BDI,i.e.,BDI-13)to assess the patients’depression and negative emotions,Herth Hope Index(HHI)to examine level of hope of the patients.Univariate and multivariate Logistic regression analyses were used to assess the possible influencing factors of the patients'anxiety and depression.Pearson correlation was used to analyze the correlation between negative emotion and level of hope in the patients treated with VA-ECMO.Results After treatment,the total number of the patients with anxiety was 57,and the anxiety rate was 71.25%,including mild(32.50%)and moderate anxiety(32.50%).On the fifth and later days of treatment,the BAI score was higher than that from the second day to the fourth day(P<0.05).The total number of the patients with depression was 61,and the depression rate was 76.25%,among which,moderate depression accounted for 51.25%.On the fifth and later days of treatment,BDI-13 score,and HHI score were higher than that from the second day to the fourth day(P<0.05),and 86.25%of the patients were at the middle or above level.Multivariate Logistic regression analysis suggested that self-pay and complications after treatment were independent risk factors that affect anxiety in the patients treated with VA-ECMO(P<0.05).Self-pay was an independent risk factor that affects the occurrence of depression in patients treated with VA-ECMO(P<0.05).Pearson correlation analysis showed that HHI scores were negatively associated with BAI and BDI of the patients treated with VA-ECMO(r=-0.595,-0.542,P<0.05).Conclusion After VA-ECMO treatment,the patients have a certain degree of anxiety and depression.These emotions are negatively correlated with payment of treatment costs,complications,and level of hope.