类风湿关节炎患者疲劳现况及其与疾病不确定感、心理弹性的相关性

Investigation on fatigue status of patients with rheumatoid arthritis and its correlation with disease uncertainty and mental resilience

目的:调查类风湿关节炎(RA)患者疲劳现状,采用分层线性回归模型筛选其影响因素,分析疲劳程度与疾病不确定感、心理弹性的相关性。方法:便利抽样法,选取2019年7月-2020年9月某院风湿科就诊的180例RA患者进行横断面研究,采用Bristol类风湿关节炎患者疲劳多维度问卷(BRAF-MDQ)、一般资料调查表、Mishel疾病不确定感量表、心理弹性量表(CD-RISC)进行问卷调查,分层线性回归模型分析影响RA患者疲劳水平的相关因素。结果:RA患者BRAF-MDQ得分(39.75±12.42)分,标准化得分率为56.73%,疲劳处于较高水平;Pearson相关性分析显示,疲劳水平与疾病不确定感呈正相关(r=0.409,P<0.05),与心理弹性水平呈负相关(r=-0.415,P<0.05);分层线性回归分析显示疼痛程度、抑郁、家庭人均月收入、疾病不确定感、心理弹性水平是RA患者疲劳的主要影响因素(P<0.05)。结论:RA患者疲劳水平较高,疼痛程度、抑郁、家庭人均月收入是其主要影响因素,降低疾病不确定与提高心理弹性有助于减轻疲劳。临床护理人员可通过提高患者疾病相关知识水平,改善心理状态,减轻临床症状,增强治疗依从性以缓解疲劳。

Objective:To investigate the fatigue status of patients with rheumatoid arthritis(RA),and use a hierarchical linear regression model to screen its influencing factors, and analyze the correlation between fatigue level, illness uncertainty and mental resilience.Methods:Convenient sampling method was used to select 180 RA patients in the rheumatology department of Huashan Hospital Affiliated to Fudan University from July 2019 to September 2020.They were investigated using the Bristol Rheumatoid Arthritis Patient Fatigue Multidimensional Questionnaire(BRAF-MDQ),General Information Questionnaire, Mishel Disease Uncertainty Scale, and Psychological Resilience Scale(CD-RISC)to conduct questionnaire surveys, and the related factors affecting the fatigue level of RA patients were analyed by using hierarchical linear regression model.Results:The BRAF-MDQ score of RA patients was(39.75±12.42),the standardized score rate was 56.73%,and the fatigue level was at a moderate level.Pearson correlation analysis showed that fatigue level and disease uncertainty were positively correlated(r=0.409,P<0.05),and negatively correlated with mental resilience level(r=-0.415,P<0.05);Hierarchical linear regression analysis showed that pain degree, depression, family monthly income per capita, illness uncertainty, and psychological resilience were the main influencing factors of fatigue in RA patients(P<0.05).Conclusion:The fatigue level of RA patients is relatively high.The main influencing factors are the degree of pain, depression, and family monthly income per capita.To reduce illness uncertainty and improve mental flexibility can help patients relief fatigue.Clinical nursing staff can improve the patient’s disease-related knowledge level, improve their mental state, reduce clinical symptoms, and enhance treatment compliance to relieve fatigue.