甲状腺术后患者应激与社会支持水平的影响因素及相关性分析

Analysis of the Influencing Factors and Correlation between Stress and Social Support Level in Patients after Thyroid Surgery

目的:探讨甲状腺术后患者斯坦福急性应激反应问卷(SASRQ)评分及社会支持水平的影响因素,并分析两者相关性,以制定针对性干预策略。方法:回顾性分析2020年8月—2021年4月于南充市中心医院及川北医学院附属医院进行甲状腺手术治疗的160例患者的临床资料,所有患者术后均在调查人员的指导下填写SASRQ及社会支持评定量表。对患者的临床基线资料进行单因素分析,并对其有统计学意义的因素进行多因素logistic回归分析,并筛选出影响甲状腺手术患者术后SASRQ评分及社会支持水平的独立危险因素,并以Pearson相关系数分析SASRQ评分与社会支持水平的相关性。结果:单因素结果显示,已婚、外向患者的SASRQ评分得分低于未婚(含丧偶及离婚)、内向患者,差异有统计学意义(P<0.05);年龄>50岁、已婚、居住地城镇、外向患者的社会支持评分得分高于年龄≤50岁、未婚(含丧偶及离婚)、居住地农村、内向患者,差异有统计学意义(P<0.05);多因素logistic回归分析结果显示,未婚(含丧偶及离婚)、内向均为影响行甲状腺手术患者术后SASRQ评分的危险因素(OR=2.277、2.171,P=0.038、0.038);年龄≤50岁、未婚(含丧偶及离婚)、居住地农村、内向均为影响行甲状腺手术患者术后社会支持水平的危险因素(OR=2.234、2.195、2.145、2.171,P=0.037、0.036、0.038、0.031);经Pearson相关系数分析,SASRQ评分与社会支持水平呈负相关(r=-0.485,P<0.05)。结论:未婚(含丧偶及离婚)、内向均为影响行甲状腺手术患者术后SASRQ评分的危险因素;年龄≤50岁、未婚(含丧偶及离婚)、居住地农村、内向均为影响行甲状腺手术患者术后社会支持水平的危险因素。而SASRQ评分与社会支持水平呈负相关,即社会支持水平越低,则患者SASRQ评分越高,应激反应越强,临床上可通过心理疏导、护理质量的改进及完善社会支持等措施改善患者应激状态。

Objective:To explore the influencing factors of Stanford acute stress response questionnaire(SASRQ)score and social support level in patients after thyroid surgery,and analyze the correlation to develop targeted intervention strategies.Method:A retrospective analysis was conducted on the clinical data of 160 patients who underwent thyroid surgery in the Nanchong Central Hospital and the Affiliated Hospital of North Sichuan Medical College from August 2020 to April 2021.All patients completed the SASRQ and social support rating scale under the guidance of investigators after surgery.Single factor analysis was conducted on the clinical baseline data of patients,and multivariate logistic regression analysis was performed on statistically significant factors.Independent risk factors affecting postoperative SASRQ score and social support level of thyroid surgery patients were screened,and the Pearson correlation coefficient was used to analyze the correlation between SASRQ score and social support level.Result:The univariate results showed that the SASRQ scores of married and extroverted patients were lower than those of unmarried(including widowed and divorced)and introverted patients,the differences were statistically significant(P<0.05).The social support scores of patients aged>50 years old,married,residing in urban areas,and extroverted individuals were higher than those of patients aged≤50 years old,unmarried(including widows and divorces),residing in rural areas,and introverted individuals,the differences were statistically significant(P<0.05).The results of multivariate logistic regression analysis showed that unmarried(including widowed and divorced)and introverted individuals were both risk factors for postoperative SASRQ scores in patients undergoing thyroid surgery(OR=2.277,2.171,P=0.038,0.038);age≤50 years old,unmarried(including widows and divorces),rural areas of residence,and introversion were all risk factors that affect the postoperative social support level of patients undergoing thyroid surgery(OR=2.234,2.195,2.145,2.171,P=0.037,0.036,0.038,0.031).According to Pearson correlation coefficient analysis,there is a negative correlation between SASRQ score and social support level(r=-0.485,P<0.05).Conclusion:Unmarried(including widowhood and divorce)and introversion are both risk factors that affect postoperative SASRQ scores in patients undergoing thyroid surgery.Age≤50 years old,unmarried(including widows and divorces),rural areas of residence,and introverted individuals are all risk factors that affect the postoperative social support level of patients undergoing thyroid surgery.The SASRQ score is negatively correlated with the level of social support,which means that the lower the level of social support,the higher the SASRQ score of the patient,and the stronger the stress response.In clinical practice,measures such as psychological counseling,improvement of nursing quality,and improvement of social support can be taken to improve the patients'stress state.