混合性焦虑抑郁障碍青少年孤独感现状及影响因素分析

Loneliness and associated factors among adolescents with mixed anxiety and depressive disorder

目的调查混合性焦虑抑郁障碍(mixed anxiety and depressive disorder,MADD)青少年孤独感现状及其影响因素,为制定有针对性的干预方案提供参考。方法采用方便抽样法,于2020年9月—2021年6月选取大庆市第三医院12~18岁265名MADD青少年为研究对象,采用一般资料调查表、儿童青少年同伴关系量表、匹兹堡睡眠质量指数问卷(PSQI)、青少年心理韧性量表(RSCA)、UCLA孤独感量表调查MADD青少年孤独感现状及影响因素。结果MADD青少年孤独感平均得分为(56.49±10.83)分,处于中等水平。学段、性别、医疗费用负担、父母外出务工情况及患者饮酒情况在MADD青少年孤独感得分上差异均有统计学意义(F/t值分别为57.65,-60.62,21.92,8.52,16.22,P值均<0.01)。MADD青少年孤独感与心理弹性呈负相关,与睡眠质量、人际困扰均呈正相关(r值分别为-0.69,0.76,0.50,P值均<0.01)。多元逐步线性回归分析结果显示,初中生、女生、重度医疗费用负担、人际困扰、睡眠质量和心理弹性为MADD青少年孤独感的影响因素(B值分别为0.11,0.13,0.09,0.46,0.10,-0.24,P值均<0.01)。结论MADD青少年存在中等程度孤独感,护理人员应注重MADD青少年孤独感等负性情绪体验,从提高睡眠质量、减轻人际困扰及提升心理弹性等方面减轻其孤独感。

Objective To investigate loneliness and associated factors among adolescents with mixed anxiety and depressive disorder(MADD),and to provide reference for drawing up effective and targeted interventions.Methods Using convenience sampling method,265 adolescents with MADD in Daqing Third Hospital were selected from September 2020 to June 2021.General information questionnaire,Pittsburgh sleep quality index(PSQI),Resilience Scale for Chinese Adolescents(RSCA),Child and Adolescent Peer Relationship Scale and UCLA Loneliness Scale were used to investigate the status and influencing factors of loneliness among adolescents with MADD.Results The average score of UCLA among 265 adolescents with MADD was(56.49±10.83).The results of univariate analysis showed that age,gender,burden of medical expenses,drinking behavior and parents'migrant work had statistically significant differences in the UCLA scores.The results of Pearson correlation analysis showed that loneliness in MADD adolescents was negatively correlated with psychological resilience(F/t=57.65,-60.62,21.92,8.52,16.22,P<0.01),and positively correlated with sleep quality and interpersonal distress(F/t=-0.69,0.76,0.50,P<0.01).The results of multiple stepwise regression analysis showed that phase of study,sex,burden of medical expenses,interpersonal distress,sleep quality and resilience were the influencing factors of loneliness among adolescents with MADD(B=0.11,0.13,0.09,0.46,0.10,-0.24,P<0.01).Conclusion Adolescents with MADD have moderate loneliness,which needs to be improved.Nursing staff should pay attention to the negative emotional experience such as loneliness among adolescents with MADD,and reduce their loneliness by improving sleep quality and resilience,reducing interpersonal distress.