不同治疗阶段的多发性骨髓瘤患者焦虑抑郁程度与社会支持状况分析

Anxiety,Depression and Social Support in Patients with Multiple Myeloma at Different Stages of Treatment

目的 通过对处于不同治疗阶段的多发性骨髓瘤患者的焦虑抑郁程度比较,分析与社会支持状况关系,为临床护理心理干预提供数据支持。方法 随机选取2019年4月15日-2021年5月15日某院血液内科住院患者200例进行问卷调查,根据患者治疗阶段分为4组,初治患者50例,难治复发患者50例,移植患者50例,维持治疗患者50例。在住院2周内进行焦虑自评量表、抑郁自评量表、社会支持量表填写,比较4组患者心理及社会支持状况,分析多发性骨髓瘤患者抑郁焦虑情况与社会支持状况关系分析。结果 难治复发患者的焦虑抑郁并存的检出率(15%)高于初治组(19%)及移植组(9%)、维持治疗组(7%),组间比较差异具有统计学意义。200名多发性骨髓瘤患者焦虑抑郁程度高于全国常模。200例患者焦虑评分(-0.521)、抑郁评分(-0.687),与主观支持、客观支持及支持利用均呈负相关,P<0.01;与国内常模相比,200例患者在支持利用的评分为(7.16±2.05)分与客观支持上的评分为(10.21±3.22)分,均低于国内常模的(9.28±2.42)与(12.66±3.40)分,差异有统计学意义;在主观支持和支持总分2项上的评分为(44.68±7.20)分,高于国内常模的(33.56±3.72)分,差异有统计学意义。结论 处于不同治疗阶段的多发性骨髓瘤患者均存在焦虑抑郁现象,病情控制是决定其焦虑抑郁的主要因素,患者病情控制越稳定,其焦虑程度越低;社会支持系统与焦虑抑郁程度呈负相关,社会支持系统越健全,患者焦虑抑郁程度越低。

Objectives To compare the anxiety and depression degree of multiple myeloma patients at different stages of treatment,and analyze the relationship between anxiety and depression and social support status,so as to provide data support for clinical nursing psychological intervention.Methods A total of 200 inpatients in the department of Hematology of a hospital from April 15th,2019 to May 15th,2021 were randomly selected for a questionnaire survey.According to the treatment stage,the patients were divided into 4 groups:50 patients with initial treatment,50patients with refractory recurrence,50 patients with transplantation,and 50 patients with maintenance therapy.Within 2 weeks of hospitalization,self-rating anxiety scale,self-rating depression scale and social support scale were filled out.The psychological and social support status of patients in the 4 groups were compared,and the relationship between depression and anxiety and social support status of multiple myeloma patients was analyzed.Results The detection rate of anxiety and depression in refractory relapse patients(15%) was higher than that in the initial treatment group(19%),transplantation group(9%) and maintenance treatment group(7%),and the difference was statistically significant.The anxiety and depression levels of 200 patients with multiple myeloma were higher than the national norm.The anxiety scores of 200 patients(-0.521) and depression scores(-0.687) were negatively correlated with subjective support,objective support and support utilization,P<0.01.Compared with the domestic norm,the 200patients scored(7.16± 2.05) points in support utilization and(10.21±3.22) points in objective support,both lower than the domestic norm of(9.28±2.42) and(12.66±3.40) points,the difference was statistically significant.The scores of subjective support and total support were(44.68±7.20) points,higher than(33.56±3.72) points of the domestic norm,and the difference was statistically significant.Conclusions All patients with multiple myeloma at different stages of treatment had anxiety and depression,and disease control was the main factor to determine their anxiety and depression.The more stable the patient’s disease control was,the lower the anxiety degree is.The social support system was negatively correlated with the degree of anxiety and depression.The more complete the social support system was,the lower the degree of anxiety and depression was.