老年慢性心力衰竭患者抑郁症状严重程度与社会支持的相关性及其影响因素

Relationship between the severity of depressive symptoms and social support in elderly patients with chronic heart failure and the influencing factors

目的:研究老年慢性心力衰竭患者抑郁症状严重程度与社会支持的关系,分析其相关的影响因素。方法:选取我院2014年6月-2017年6月240例老年慢性心力衰竭患者为研究对象,采用汉密顿抑郁量表(HAMD)评估患者抑郁症状严重程度,采用社会支持评定量表(SSRS)评估患者获得的社会支持情况;根据HAMD评分将患者分为有抑郁症状组与无抑郁症状组,比较两组临床资料。分析老年慢性心力衰竭患者抑郁症状严重程度与社会支持的关系。结果:经Pearson相关性分析,老年慢性心力衰竭患者HAMD评分与客观支持、主观支持、社会利用度、社会支持总分呈负相关(P<0.05)。240例老年慢性心力衰竭患者中,无抑郁症状患者77例,轻度抑郁症状患者128例,中度抑郁症状患者30例,重度抑郁症状患者5例,抑郁症状发生率为67.9%。有抑郁症状组年龄≥70岁、女性、无配偶、经济收入<3000元/月、无医疗保险、吸烟、病程≥5年、住院次数>3次、NYHA心功能分级Ⅲ级的患者比例显著高于无抑郁组(P<0.05)。经Logistic回归分析显示,年龄、性别、配偶、病程、住院次数、NYHA心功能分级是老年慢性心力衰竭患者抑郁症状严重程度的独立影响因素。结论:社会支持程度差的老年慢性心力衰竭患者更易产生抑郁症状。年龄、性别、配偶、经济收入、医疗保险、吸烟、病程、住院次数、NYHA心功能分级等9个因素对老年慢性心力衰竭抑郁症状严重程度有显著影响。

Objective:To study the relationship between the severity of depressive symptoms and social support inelderly patients with chronic heart failure and the influencing factors.Methods:A total of 240elderly patients withchronic heart failure treated in the hospital from June 2014to June 2017were selected as the subjects,The severityof depressive symptoms and social support obtained by patients were assessed with the Hamilton Depression Scale(HAMD)and the Social Support Rating Scale(SSRS),According to the HAMD score,the patients were divided intodepression group and non-depression group,and the clinical data were compared between the two groups,The relationship between depressive symptoms and social support in elderly patients with chronic heart failure was analyzed.Results:Pearson correlation analysis showed that HAMD scores of elderly patients with chronic heart failure werenegatively correlated with objective support,subjective support,social availability and total score of social support(P<0.05),In the 240elderly patients with chronic heart failure,there were 77patients without depressive symptoms,128patients with mild depressive symptoms,30patients with moderate depressive symptoms and 5patients with severe depressive symptoms,The incidence of depressive symptoms was 67.9%,The proportions of age≥ 70yearsold,female,No spouse,economic income<3000yuan/month,no medical insurance,smoking,course of disease≥5years,times of hospitalization>3times and NYHA grade III cardiac function in the depression group were significantly higher than those in non-depression group(P<0.05),Logistic regression analysis showed that age,gender,spouse,course of disease,times of hospitalization and NYHA grade of cardiac function were independent influencingfactors of depressive symptoms in elderly patients with chronic heart failure.Conclusion:The patients with poor social support are more likely to have depressive symptoms.Age,gender,spouse,economic income,medical insurance,smoking,course of disease,times of hospitalization and NYHA grade of cardiac function have significant effects onthe severity of depressive symptoms in elderly patients with chronic heart failure.