耳鸣患者心理社会适应水平现况、影响因素及对策

Psychosocial adjustment level and its influencing factors and countermeasure in patients with tinnitus:a cross-sectional study

目的探讨耳鸣患者心理社会适应水平现况及其影响因素,为耳鸣患者采取针对性策略提供参考依据。方法应用横断面研究,通过便利抽样法选取2021年11月至2022年6月在黑龙江省某三级甲等综合医院符合纳排标准的278例耳鸣患者为研究对象,采用一般资料调查表、疾病心理社会适应水平量表(self-report psycho-social adjustment to illness scale,PAIS-SR)、正念注意觉知量表(mindful attention awareness scale,MAAS)、疾病获益感量表(benefit finding scale,BFS)进行调查分析。采用单因素分析、相关分析方法筛选出具有统计学意义的变量后进行多重线性逐步回归分析,筛选出耳鸣患者心理社会适应的影响因素。结果266例患者完成调查。耳鸣患者PAIS-SR得分为(47.01±1.11)分。单因素分析结果显示,不同年龄、婚姻状况、居住状态、家庭人均月收入、耳鸣严重程度,其心理社会适应水平得分比较,差异具有统计学意义(均P<0.05);Pearson相关分析结果显示,正念注意觉知、疾病获益感与PAIS-SR得分呈负相关(均P<0.01);多重线性回归结果显示,独居、中度及以上耳鸣是患者心理社会适应的风险因素,正念和疾病获益感是耳鸣患者心理社会适应的保护因素(均P<0.01)。结论耳鸣患者心理社会适应水平处于中等水平,尚待改善;医护人员应重点关注独居、耳鸣严重程度高的患者,提高患者的正念水平及疾病获益感,以促进耳鸣患者心理社会适应水平的提升。

Objective To investigate current situations of psychosocial adjustment level and its influencing factors in patients with tinnitus so as to provide a reference of targeted strategies for patients with tinnitus.Methods A cross-sectional study was conducted among 278 patients with tinnitus who were treated in a tertiary hospital in Heilongjiang Province from November 2021 to June 2022.General data questionnaire,self-report psycho-social adjustment to illness scale(PAIS-SR),mindful attention awareness scale(MAAS)and benefit finding scale(BFS)were used in the survey.Single factor analysis and correlation analysis were carried out to find out the statistically significant variables,and then multiple linear stepwise regression analysis was performed to identify the influencing factors of psychosocial adjustment in patients with tinnitus.Results A total of 266 patients completed the survey.Total score of PAIS-SR was(47.01±1.11).By single factor analysis,it was found that there were significant differences in the scores of psychosocial adaptation level among different age,marital status,living status,average monthly income of family and severity of tinnitus(all P<0.05).Pearson correlation analysis identified that mindfulness and benefit finding were negatively correlated with PAIS-SR(all P<0.01).By multiple linear stepwise regression analysis,it was identified that living alone,moderate and above tinnitus were the risk factors for psychosocial adjustment.However,mindfulness and benefit finding were the protective factors for psychosocial adjustment(all P<0.01).Conclusions The psychosocial adjustment level of patients with tinnitus is at a medium level,and an improvement is required.Medical staff should attach more importance to patients who live alone and have a severe tinnitus,to improve the level of mindfulness and the sense of disease benefit,so as to improve the psychosocial adaptation level.