全科病房慢性阻塞性肺疾病患者焦虑抑郁状况调查及影响因素分析

周晓苹; 方荣华

doi:10.16766/j.cnki.issn.1674-4152.002510

全科病房慢性阻塞性肺疾病患者焦虑抑郁状况调查及影响因素分析

doi: 10.16766/j.cnki.issn.1674-4152.002510

周晓苹,
方荣华^,

四川大学华西医院特需医疗中心/四川大学华西护理学院，四川成都 610041

基金项目:

四川省科学技术厅重点研发项目 2020YFS0151

详细信息

通讯作者:
方荣华, E-mail: fangronghua@126.com

中图分类号: R563 R395.1
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- 被引次数: 0
出版历程
- 收稿日期: 2021-05-29
- 网络出版日期: 2022-09-21

Investigation and analysis of factors affecting anxiety and depression in patients with chronic obstructive pulmonary disease in general wards

ZHOU Xiao-ping,
FANG Rong-hua^,

Department of International Medical Center, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, China

摘要

摘要: 目的调查全科病房慢性阻塞性肺疾病患者焦虑抑郁现状及影响因素, 为对患者实施针对性的护理干预措施提供科学依据。方法选用四川大学华西医院心理卫生中心编制的"华西心晴指数"量表(HEI)及研究组自行设计的一般情况调查表, 对2017年10月-2020年10月期间收入四川大学华西医院全科病房的慢性阻塞性肺疾病患者178例进行焦虑抑郁现状调查。以HEI>8分为存在焦虑抑郁情绪, 对调查对象人口学特征与HEI得分进行分析, 并采用多因素logistic回归分析住院慢性阻塞性肺疾病患者焦虑抑郁的影响因素。结果 178例慢性阻塞性肺疾病患者中, 80例(44.94%)患者存在焦虑抑郁情绪。年龄、疾病分期、并发症、体重指数、营养风险得分、自理能力得分、文化程度及婚姻状况与其焦虑抑郁相关(均P < 0.05), 而性别、费用与其焦虑抑郁无明显相关性(均P>0.05)。多因素logistic回归分析提示, 患者自理能力得分低、营养风险得分高是慢性阻塞性肺疾病患者焦虑抑郁的主要危险因素(均P < 0.05)。结论全科病房住院的慢性阻塞性肺疾病患者普遍存在焦虑抑郁情绪, 自理能力低及营养风险高的慢性阻塞性肺疾病患者更易发生焦虑抑郁, 建议临床医务人员应多关注这部分人群, 早期识别并筛查其影响因素, 从而采取针对性的干预措施, 改善患者疾病预后, 提高其生活质量。
- 全科病房 /
- 慢性阻塞性肺疾病 /
- 住院患者 /
- 焦虑 /
- 抑郁 /
- 影响因素
Abstract: Objective To investigate the current situation and factors of anxiety and depression in patients with chronic obstructive pulmonary disease in general wards and to provide scientific basis for targeted nursing interventions. Methods Participants were 178 chronic obstructive pulmonary disease patients who were included from the general ward of West China Hospital of Sichuan University during October 2017 to October 2020.The"Huaxi Emotional-distress Index"(HEI) scale developed by the Mental Health Center in West China Hospital of Sichuan University and the general situation questionnaire designed by the research team were used to screen the prevalence of anxiety and depression.HEI>8 points was determined as anxiety and depression.Demographic characteristics and HEI scores of the respondents were analysed, and multivariate logistic regression was adopted to analyse the influencing factors of anxiety and depression. Results Amongst 178 patients with chronic obstructive pulmonary disease, 80 cases (44.94%) had anxiety and depression.Age, disease stage, complications, body mass index, nutritional risk score, activity of daily living (ADL) score, education level and marital status were related to anxiety and depression (all P < 0.05), whereas gender and cost were not significantly correlated with anxiety and depression (all P>0.05).Multivariate logistic regression analysis suggested that ADL score and nutritional risk score were the main risk factors for anxiety and depression in these patients (all P < 0.05). Conclusion Anxiety and depression are common in patients with chronic obstructive pulmonary disease in the general ward.Low ADL and high nutritional risk are associated with higher risk of developing anxiety and depression.We suggest that clinical medical staff should pay more attention to these patients and identify and screen their influence factors early, so that targeted interventions can be taken to improve their prognosis and quality of life.
- General wards /
- Chronic obstructive pulmonary disease /
- Inpatient /
- Anxiety /
- Depression /
- Influencing factors

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表 1 慢阻肺患者人口统计学特征及其HEI总分

Table 1. Demographic characteristics of COPD patients and their total HEI scores

项目	类别	例(%)	HEI总分(x±s，分)	统计量	P值
性别	男性	110(61.8)	8.37±3.91	-1.385^a	0.168
	女性	68(38.2)	9.21±3.89
年龄(岁)	≤60	11(6.2)	3.82±1.94	12.772^b	＜0.001
	61~75	52(29.2)	8.08±3.54
	≥76	115(64.6)	9.43±3.84
体重指数	＜18.5	49(27.5)	11.27±3.38	11.538^b	＜0.001
	18.5~23.9	96(53.9)	7.69±3.69
	24.0~28.0	27(15.2)	7.74±3.45
	＞28.0	6(3.4)	8.00±4.47
疾病分期	AECOPD	155(87.1)	8.94±3.98	2.821^a	0.008
	COPD	23(12.9)	7.00±2.92
文化程度	本科及以上	36(20.2)	7.50±3.75	4.018^b	0.009
	大专	22(12.4)	9.91±5.17
	中专/高中	33(18.5)	7.42±2.83
	初中及以下	87(48.9)	9.36±3.76
费用	自费	120(67.4)	8.56±3.93	-0.650^a	0.516
	医保	58(32.6)	8.97±3.89
营养风险	有	100(56.2)	10.57±3.62	8.916^a	＜0.001
	无	78(43.8)	3.65±3.80
并发症	有	154(86.5)	9.03±3.98	4.219^a	＜0.001
	无	24(13.5)	6.50±2.49
自理能力	中重度依赖	91(51.1)	11.29±3.25	85.518^b	＜0.001
	轻度依赖	54(30.3)	6.74±2.38
	无依赖	33(18.5)	4.73±1.91
婚姻状况	已婚	150(84.3)	8.23±3.86	6.964^b	＜0.001
	未婚	2(1.1)	9.00±2.83
	离异	2(1.1)	5.50±0.71
	丧偶	24(13.5)	11.83±2.81
居住地	城镇	159(89.3)	8.77±3.96	0.752^a	0.453
	农村	19(10.7)	8.05±3.44
注：^a为t值，^b为F值。

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表 2 自变量赋值方法

Table 2. Argument assignment method

自变量	赋值方法
年龄	≤60岁=2, 61~75岁=1，≥76岁=0
体重指数	＜18.5=3, 18.5~23.9=2, 24.0~28.0=1，＞28.0=0
疾病分期	AECOPD=1，COPD=0
文化程度	本科及以上=3，大专=2，中专/高中=1，初中及以下=0
并发症	有=1，无=0
营养风险	有=1，无=0
自理能力	中重度依赖=2，轻度依赖=1，无须依赖=0
婚姻状况	丧偶=(0, 0)，已婚=(1, 0)，未婚和离异=(0, 1)

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表 3 慢阻肺患者焦虑抑郁的多因素logistic回归分析结果

Table 3. Results of multifactorial logistic regression analysis of anxiety and depression in patients with COPD

项目	B	SE	Wald χ²	P值	OR(95% CI)
年龄	0.008	0.036	0.056	0.712	0.906(0.845-1.023)
体重指数	0.460	0.456	1.018	0.313	1.584(0.648~3.875)
疾病分期	-1.769	1.116	2.514	0.113	0.170(0.019~1.519)
文化程度	0.210	0.259	0.658	0.417	1.234(0.743~2.049)
并发症	0.004	0.939	＜0.001	0.997	1.004(0.159~6.319)
营养风险	1.341	0.344	15.235	＜0.001	3.824(1.950~7.500)
自理能力	-2.826	0.604	21.917	＜0.001	0.059(0.018~0.193)
婚姻状况	0.493	0.317	2.428	0.119	1.638(0.881~3.046)

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