帕金森病病耻感状况及有关影响因素的多因素分析

Multivariate analysis of Parkinson's disease stigma and related influencing factors

目的调查帕金森病(PD)病耻感状况,分析有关影响因素。方法选取2020年9月至2022年10月南京医科大学附属脑科医院老年医学科196例PD患者,收集患者临床资料,应用慢性病病耻感量表(SSCI)调查患者病耻感状况;采用单因素分析、Pearson相关性分析获得PD患者病耻感可能影响因素;多元线性回归分析进一步确定PD患者病耻感的影响因素。结果本研究共发放问卷196份,回收有效问卷184份,有效回收率为93.88%。患者PD统一评定量表Ⅲ(UPDRS-Ⅲ)评分平均(24.59±8.64)分;PD统一评定量表Ⅱ(UPDRS-Ⅱ)评分平均(9.47±2.06)分;非运动症状量表(NMSS)评分平均(18.25±5.18)分;汉密尔顿焦虑量表(HARS)评分平均(14.80±3.92)分;汉密尔顿抑郁量表-24项(HDRS-24)评分平均(16.94±5.27)分;蒙特利尔认知功能评估量表(MoCA)评分平均(26.82±1.52)分;SSCI评分平均(55.04±10.28)分。单因素分析可知,不同年龄、病程、工作状态、婚姻状态、运动症状亚型、改良Hoehn-Yahr分期(H-Y分期)PD患者SSCI评分比较,差异有统计学意义(P<0.05)。Pearson相关性分析可知,PD患者SSCI评分与UPDRS-Ⅲ、UPDRS-Ⅱ、NMSS、HARS、HDRS-24评分均呈正相关(P<0.05),与MoCA评分呈负相关(P<0.05)。多元线性回归分析显示,年龄(β值=-0.275、t=5.046、P<0.001)、运动症状亚型(β值=0.139、t=2.534、P<0.05)、UPDRS-Ⅱ评分(β值=0.268、t=3.394、P<0.001)、HDRS-24评分(β值=0.319、t=4.113、P<0.001)均为PD患者病耻感的影响因素。结论PD患者病耻感较严重,年龄、运动症状亚型、UPDRS-Ⅱ评分、HDRS-24评分均为有关影响因素,可据此采取针对性干预措施,以期降低患者病耻感。

Objective To investigate the stigma of Parkinson's disease(PD)and analyze the influencing factors.Method A total of 196 PD patients in the hospital from September 2020 to October 2022 were selected.The clinical data of the patients were collected,and the Stigma Scale for Chronic Illness(SSCI)was used to investigate the stigma of the patients.Univariate analysis and Pearson correlation analysis were used to obtain the possible influencing factors of stigma in PD patients.Multiple linear regression analysis further determined the influencing factors of stigma in PD patients.Results A total of 196 questionnaires were distributed in this study,and 184 valid questionnaires were finally recovered,with an effective recovery rate of 93.88%.The average Unified Parkinson's Disease Rating ScaleⅢ(UPDRS-Ⅲ)score of patients was(24.59±8.64);The average Unified Parkinson's Disease Rating ScaleⅡ(UPDRS-Ⅱ)score was(9.47±2.06);The non-motor symptom evaluation scale(NMSS)score was(18.25±5.18);The average score of Hamilton anxiety rating scale(HARS)was(14.80±3.92);The average score of Hamilton depression rating scale-24(HDRS-24)was(16.94±5.27);The average score of Montreal Cognitive Assessment Scale(MoCA)was(26.82±1.52);The average SSCI score was(55.04±10.28).Univariate analysis showed that there were significant differences in SSCI scores among PD patients with different age,course of disease,working status,marital status,motor symptom subtypes and modified Hoehn-Yahr stage(H-Y stage)(P<0.05).Pearson correlation analysis showed that SSCI score of PD patients was positively correlated with UPDRS-Ⅲ,UPDRS-Ⅱ,NMSS,HARS and HDRS-24 scores(P<0.05),and negatively correlated with MoCA score(P<0.05).Multivariate linear regression analysis showed that age(β=-0.275,t=5.046,P<0.001),motor symptom subtype(β=0.139,t=2.534,P<0.05),UPDRS-Ⅱscore(β=0.268,t=3.394,P<0.001),HDRS-24 score(β=0.319,t=4.113,P<0.001)were the influencing factors of stigma in PD patients.Conclusion The stigma of PD patients is serious.Age,motor symptom subtype,UPDRS-Ⅱscore and HDRS-24 score are all related influencing factors.Targeted intervention measures can be taken accordingly to reduce the stigma of patients.