老年帕金森病DBS术后程控病人疾病感知能力的影响因素研究

Study on the influencing factors of illness perception in elderly patients with Parkinson’s disease after deep brain stimulation surgery program control

目的探索老年帕金森病脑深部电刺激术(DBS)术后程控的病人疾病感知能力的影响因素。方法对2020年1月至2021年1月80例DBS术后程控的老年帕金森病病人进行现场调查,选用疾病知觉问卷修订版(IPQ-R)、维克森林医师信任量表(WFPTS)和艾森克个性问卷(EPQ)分别测量病人的疾病感知水平、对医师信任度以及病人的个性特征。比较不同学历、病程、性别病人疾病感知差异,并分析病人疾病感知能力与对医师信任度及个性特征之间的相关性。结果不同学历、病程、性别病人总体疾病感知能力差异无统计学意义,个人控制性维度中男性明显低于女性(t=-2.03,P=0.045)。Pearson相关分析显示,对医师信任度与疾病感知后果、治疗控制、疾病周期、情绪陈述评分呈显著负相关(r=-0.23,-0.22,-0.24,-0.34,P<0.05);个性评价总分、内外向、情绪性、自身隐蔽得分与疾病感知后果维度得分呈正相关(r=0.25,0.27,0.25,0.24,P<0.05);个性评价总分、内外向、精神质、自身隐蔽得分与疾病感知个人控制性维度得分呈负相关(r=-0.24,-0.26,-0.24,-0.25,P<0.05)。结论术后程控老年帕金森病病人学历、病程对病人的疾病感知能力无显著性影响,不同性别的病人个人控制能力不同。病人对医生的信任度及自身的个性对其疾病感知能力具有显著影响。

Objective To explore the influencing factors of illness perception in the elderly patients with Parkinson’s disease(PD)after deep brain stimulation surgery(DBS).Methods A cross-sectional study was conducted in 80 patients with PD aged>65 years old from January 2020 to January 2021.The illness perception,physician trust and personality characteristics of the patients were measured by Illness Perception Questionnaire Revised Edition(IPQ-R),the Wake Forest Physician Trust Scale(WFPTS)and Eysenck Personality Questionaire(EPQ),respectively.The illness perception score among the patients with different educational background,disease course and gender was compared,and the correlation of the patients’illness perception with physician trust and personality characteristics was analyzed.Results There were no significant difference in overall illness perception scores among the patients with different educational background,disease course and gender.The individual control of males was significantly lower than that of females(t=-2.03,P=0.045).Pearson correlation analysis showed a significant negative correlation between perceive disease outcome,treatment control,disease cycle,emotional statement score and physician trust,respectively(r=-0.23,-0.22,-0.24,-0.34,all P<0.05).The total score of personality evaluation,internal and external orientation,emotionality,self-concealment scores were positively correlated with the score of illness perceived consequences dimension(r=0.25,0.27,0.25,0.24,all P<0.05);The total score of personality evaluation,internal and external orientation,psychoticism and self-concealed were negatively correlated with the score of individual control dimension of illness perception(r=-0.24,-0.26,-0.24,-0.25,all P<0.05).Conclusions Education background and course of the disease have no significant influence on patients’illness perception,and the individual control ability of patients with different genders is different.Physician trust and their personalities significantly influence the illness perception of the elderly patients with PD after DBS.