我国9个县(区)慢性病患者焦虑、抑郁状况及心理健康需求评估结果分析

Condition of anxiety and depression and assessment of mental health needs of chronic patients in nine pilot counties/districts in China

目的了解慢性病患者的焦虑、抑郁状况并掌握慢性病患者对心理健康促进的需求。方法采用整群抽样的方法,在9个县/区各随机抽取6个社区,每个社区各抽取不少于190名慢性病患者,对其焦虑、抑郁状况及心理健康需求进行问卷调查。同时,对慢性病患者进行小组访谈,对医生进行一对一的深入访谈,从患者和医生两个视角获得慢性病患者焦虑、抑郁状况、心理问题的应对及需求等信息。结果焦虑、抑郁状况调查结果显示,慢性病患者中焦虑症状者比例占16.1%,抑郁症状者比例占24.7%。需求评估结果显示,慢性病患者迫切需要改善的心理状况前3位依次是:失眠(30.6%)、紧张/不能放松(25.4%)以及易怒/急躁(22.5%)。大部分慢性病患者希望能够开展以社区为基础、以心理健康为主题的专家讲座;社区能够提供心理健康咨询服务,对有需求的个体进行一对一的辅导。结论女性慢性病患者伴有焦虑和抑郁症状的比例高于男性。慢性病患者在促进自身心理健康方面有改善失眠、紧张、易怒等状况的需求。对于慢性病患者的心理干预应与躯体疾病干预相结合,在慢性病管理活动中融入心理健康的知识和技能,以促进慢性病患者的身心健康。

Objective To understand the anxiety and depression condition of chronic disease patients and master the needs of chronic disease patients in mental health promotion.Methods In 9 counties/districts,6 communities were randomly selected from each county and district by cluster random sampling,and no less than 190 patients with chronic diseases were selected from each community.Questionnaire survey was conducted on their anxiety and depression condition and mental health needs.At the same time,we have a group discussion on patients with chronic diseases and a one-to-one in-depth interview with doctors.From the perspective of patients and doctors,we can get the information of anxiety and depression condition,coping with psychological problems and needs of patients with chronic diseases.Results According to the results of anxiety and depression condition survey,most of the patients with chronic diseases think that they have a good mentality.The results of the requirements assessment show that the top three mental states of patients with chronic diseases urgently need to be solved are insomnia(30.6%),tension/inability to relax(25.4%)and irritability/impatience(22.5%).Most of the patients with chronic diseases hope to carry out expert lectures based on community and with mental health as the theme;the community can provide mental health consulting services and one-to-one counseling for individuals in need.Conclusion The proportion of female patients with chronic diseases accompanied with anxiety and depression is higher than male patients.Patients with chronic diseases need to improve their mental health,such as insomnia,tension,irritability and so on.The psychological intervention for chronic patients should be combined with the physical disease intervention,and the knowledge and skills of mental health should be integrated into the chronic disease management activities to promote the physical and mental health of chronic patients.