尘肺患者心理健康状况及其影响因素分析

Analysis on mental health status and influencing factors of pneumoconiosis patients

目的了解不同期别职业性尘肺病患者的心理健康状况及其影响因素。方法回顾性分析2022年1-12月在山东省职业卫生与职业病防治研究院职业性肺病科住院治疗的57例尘肺病患者(尘肺组)、724例健康成年男性(常模组)的相关资料,应用症状自评量表、应对方式问卷、呼吸困难(modified British medical research council,mMRC)评分和一般情况调查表对尘肺患者的心理健康状况及影响因素进行调查。结果尘肺组患者的总分及各因子得分均高于常模组,SCL-90总分为(174.61±64.77)vs(129.96±38.76)分,其中躯体化因子为(2.45±0.86)vs(1.38±0.49)分、强迫症状因子为(2.09±0.85)vs(1.66±0.61)分、抑郁因子为(1.98±0.82)vs(1.51±0.60)分、焦虑因子为(1.97±0.84)vs(1.41±0.44)分、敌对因子为(1.82±0.78)vs(1.48±0.56)分、恐怖因子为(1.63±0.75)vs(1.23±0.37)分、精神病性因子为(1.72±0.67)vs(1.32±0.44)分,差异均有统计学意义(均P<0.05)。尘肺患者SCL-90总分及各因子得分与mMRC呼吸困难评分无相关性(P>0.05)。年龄(OR=1.090,95%CI:1.004~1.184,P<0.05)及消极应对方式(OR=8007.941,95%CI:60.453~1060780.289,P<0.01)均为心理异常的危险因素。结论尘肺病患者心理健康水平和应对方式值得关注,采用消极应对方式的尘肺病患者心理健康水平较差。

Objective To investigate the mental health status and influencing factors of patients with occupational pneumoconiosis in different stages.Methods A retrospective analysis was performed for the relevant data of 57 patients with pneumoconiosis(pneumoconiosis group)and 724 healthy adult males(normal group)hospitalized in the Department of Occupational Pulmonology of Shandong Academy of Occupational Health and Occupational Medicine from January to December 2022,and the mental health status and influencing factors of pneumoconiosis patients were investigated by Symptom Checklist-90,coping style questionnaire,modified British medical research council(mMRC)score and general condition questionnaire.Results The total score and the scores of the following factors in the pneumoconiosis group were higher than those in the normal group.The differences of total score of SCL-90[(174.61±64.77)vs(129.96±38.76)points],the scores of somatization factor[(2.45±0.86)vs(1.38±0.49)points],obsessive-compulsive factor[(2.09±0.85)vs(1.66±0.61)points],depression factor[(1.98±0.82)vs(1.51±0.6)points],anxiety factor[(1.97±0.84)vs(1.41±0.44)points],hostility factor[(1.82±0.78)vs(1.48±0.56)points],terror factor[(1.63±0.75)vs(1.23±0.37)points]and psychoticism factor[(1.72+0.67)vs(1.32+0.44)points]were statistically significant(all P<0.05).The total score of SCL-90 and the scores of various factors in patients with pneumoconiosis were not correlated with the score of mMRC score(P>0.05).Age(0R=1.090,95%Cl:1.004-1.184,P<0.05)and negative coping style(OR=8007.941,95%CI:60.453-1060780.289,P<0.01)were risk factors for psychological abnormalities.Conclusion The mental health level and coping methods of patients with pneumoconiosis are worthy of attention,while the mental health level of patients with pneumoconiosis who adopt passive coping methods is poor.