全科病房慢性阻塞性肺疾病患者焦虑抑郁状况调查及影响因素分析

Investigation and analysis of factors affecting anxiety and depression in patients with chronic obstructive pulmonary disease in general wards

目的调查全科病房慢性阻塞性肺疾病患者焦虑抑郁现状及影响因素,为对患者实施针对性的护理干预措施提供科学依据。方法选用四川大学华西医院心理卫生中心编制的“华西心晴指数”量表(HEI)及研究组自行设计的一般情况调查表,对2017年10月—2020年10月期间收入四川大学华西医院全科病房的慢性阻塞性肺疾病患者178例进行焦虑抑郁现状调查。以HEI>8分为存在焦虑抑郁情绪,对调查对象人口学特征与HEI得分进行分析,并采用多因素logistic回归分析住院慢性阻塞性肺疾病患者焦虑抑郁的影响因素。结果178例慢性阻塞性肺疾病患者中,80例(44.94%)患者存在焦虑抑郁情绪。年龄、疾病分期、并发症、体重指数、营养风险得分、自理能力得分、文化程度及婚姻状况与其焦虑抑郁相关(均P<0.05),而性别、费用与其焦虑抑郁无明显相关性(均P>0.05)。多因素logistic回归分析提示,患者自理能力得分低、营养风险得分高是慢性阻塞性肺疾病患者焦虑抑郁的主要危险因素(均P<0.05)。结论全科病房住院的慢性阻塞性肺疾病患者普遍存在焦虑抑郁情绪,自理能力低及营养风险高的慢性阻塞性肺疾病患者更易发生焦虑抑郁,建议临床医务人员应多关注这部分人群,早期识别并筛查其影响因素,从而采取针对性的干预措施,改善患者疾病预后,提高其生活质量。

Objective To investigate the current situation and factors of anxiety and depression in patients with chronic obstructive pulmonary disease in general wards and to provide scientific basis for targeted nursing interventions.Methods Participants were 178 chronic obstructive pulmonary disease patients who were included from the general ward of West China Hospital of Sichuan University during October 2017 to October 2020.The"Huaxi Emotional-distress Index"(HEI)scale developed by the Mental Health Center in West China Hospital of Sichuan University and the general situation questionnaire designed by the research team were used to screen the prevalence of anxiety and depression.HEI>8 points was determined as anxiety and depression.Demographic characteristics and HEI scores of the respondents were analysed,and multivariate logistic regression was adopted to analyse the influencing factors of anxiety and depression.Results Amongst 178 patients with chronic obstructive pulmonary disease,80 cases(44.94%)had anxiety and depression.Age,disease stage,complications,body mass index,nutritional risk score,activity of daily living(ADL)score,education level and marital status were related to anxiety and depression(all P<0.05),whereas gender and cost were not significantly correlated with anxiety and depression(all P>0.05).Multivariate logistic regression analysis suggested that ADL score and nutritional risk score were the main risk factors for anxiety and depression in these patients(all P<0.05).Conclusion Anxiety and depression are common in patients with chronic obstructive pulmonary disease in the general ward.Low ADL and high nutritional risk are associated with higher risk of developing anxiety and depression.We suggest that clinical medical staff should pay more attention to these patients and identify and screen their influence factors early,so that targeted interventions can be taken to improve their prognosis and quality of life.