275例早中期帕金森病患者社会参与现状及其相关因素分析

汪虹; 许方蕾; 汤爱玲; 张月; 管强; 龚海燕

doi:10.16766/j.cnki.issn.1674-4152.003255

275例早中期帕金森病患者社会参与现状及其相关因素分析

doi: 10.16766/j.cnki.issn.1674-4152.003255

汪虹^{1, 2},
许方蕾³,
汤爱玲³,
张月²,
管强²,
龚海燕^2, ,

1.
同济大学医学院，上海 200092
2.
同济大学附属同济医院神经内科，上海 200065
3.
同济大学附属同济医院护理部

基金项目:

国家重点研发计划课题 2018YFC1314704

上海市同济医院国自然培育项目 GJPY2148

详细信息

通讯作者:
龚海燕，E-mail: hai_yan_gong@126.com

中图分类号: R742.5
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- 文章访问数: 180
- HTML全文浏览量: 96
- PDF下载量: 10
- 被引次数: 0
出版历程
- 收稿日期: 2022-10-09
- 网络出版日期: 2024-01-13

Social participation status and its related factors in patients with mild to moderate Parkinson's disease: a 275-case study

1.
School of Medicine, Tongji University, Shanghai 200092, China

摘要

摘要: 目的了解早中期帕金森病患者社会参与的现状, 并对其相关因素进行分析, 为患者制定个性化、针对性强的干预方案提供可参考的依据。方法采用便利抽样的方法选取2021年1-12月至上海市同济医院神经内科门诊就诊的275例早中期帕金森病患者, 进行一般资料、自主参与问卷(IPA)、自我护理能力量表(ESCA)、统一帕金森病评定量表第Ⅲ部分(UPDRS-Ⅲ)和领悟社会支持量表(PSSS)的问卷调查, 采用多元线性回归分析探讨其影响因素。结果早中期帕金森病患者平均IPA总分为(65.25±28.78)分, 属于中度参与水平; 多元线性回归显示, 文化程度(t=10.562, P < 0.001)、疾病分期(t=10.601, P < 0.001)、自我护理能力(t=3.212, P=0.001)、运动功能障碍程度(t=2.121, P=0.034)和领悟社会支持(t=3.562, P < 0.001)是影响早中期帕金森病患者社会参与的主要因素。结论影响早中期帕金森病患者社会参与水平的因素是多方面的, 医务人员应根据主要影响因素制定针对性的干预措施, 扩大社会对该类患者的关注度, 以促进患者参与社会, 提高其生活质量。
- 帕金森病 /
- 社会参与 /
- 影响因素
Abstract: Objective To investigate the social participation status of people with mild to moderate Parkinson's disease (PD), and to analyze the factors associated with it, in order to provide a reference for intervention. Methods A total of 275 patients with mild to moderate PD who visited the clinic of the Department of Neurology in Shanghai Tongji Hospital from January to December 2021 were selected using convenience sampling.The patients were assessed using a general information questionnaire, the impact on participation and autonomy questionnaire (IPA), the exercise of self-care agency scale (ESCA), the unified Parkinson's disease rating scale part Ⅲ(UPDRS-Ⅲ), and the perceived social support scale (PSSS). Results The mean total score of social participation in mild to moderate PD patients was (65.25±28.78) points.Multivariate regression analysis showed that education level (t=10.562, P < 0.001), disease stage (t=10.601, P < 0.001), self-care ability (t=3.212, P < 0.01), motor dysfunction (t=2.121, P < 0.05) and perceived social support (t=3.562, P < 0.001) were the factors most associated with social participation in mild to moderate PD patients. Conclusion The level of social participation in mild to moderate PD patients was related to many factors.More social attention should be paid to these patients and interventions should be provided based on the factors involved to improve their ability to participate in society and their quality of life.
- Parkinson's disease /
- Social participation /
- Related factors

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表 1 275例早中期PD患者IPA具体得分情况(x±s，分)

Table 1. IPA scores of 275 patients with mild to moderate PD (x±s, points)

量表维度	维度均分	条目均分
室内自主参与	14.75±5.77	2.11±0.82
室外自主参与	16.57±7.01	3.04±0.72
社会生活自我参与	18.24±4.34	3.14±0.65
家庭角色自我参与	15.69±3.24	2.37±1.00

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表 2 不同特征早中期PD患者IPA得分比较[M(P₂₅, P₇₅)，分]

Table 2. Comparison of IPA scores in mild to moderate PD patients with different characteristics [M(P₂₅, P₇₅), points]

项目	例数	IPA得分	统计量	P值
性别			-2.352^a	0.019
男性	146	69.00(62.00，80.75)
女性	129	64.00(38.50，79.00)
文化程度			6.594^b	0.037
初中及以下	43	64.00(35.00，72.00)
高中或中专	125	66.00(58.00，79.00)
专科及以上	107	67.00(62.00，84.00)
婚姻状况			-1.701^a	0.089
未婚/离异/丧偶	35	68.00(64.00，88.00)
已婚	240	66.00(54.25，77.75)
居住状态			-0.258^a	0.796
独居	33	65.00(53.50，81.50)
非独居	242	66.00(57.50，80.00)
家庭人均月收入			6.444^b	0.092
1 000~3 000元	9	69.50(53.25，88.00)
3 001~5 000元	94	70.50(52.75，80.00)
>5 000元	172	64.50(58.00，82.00)
医疗保险类型			2.778^b	0.249
城镇职工基本医疗保险	16	64.50(35.50，73.50)
城镇居民基本医疗保险	172	65.00(58.00，79.00)
新型农村合作医疗	87	68.00(62.00，84.00)
疾病分期			12.197^b	＜0.001
1期	90	42.00(35.00，63.00)
2期	86	66.00(64.00，72.00)
3期	99	83.00(71.50，87.00)
是否合并其他慢性病			-0.971^a	0.332
是	268	66.00(58.00，80.00)
否	7	46.00(38.00，70.00)
注：^a为Z值，^b为H值。

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表 3 早中期PD患者ESCA、PSSS、UPDRS-Ⅲ与IPA得分的相关性分析(r值)

Table 3. Correlation analysis between the scores of ESCA, PSSS, UPDRS-Ⅲ and IPA in mild to moderate PD patients (r value)

项目	IPA总分	室内自主参与	家庭角色自我参与	室外自主参与	社会生活自主参与
ESCA总分	-0.537	-0.622	-0.478	-0.385	-0.439
自我概念	-0.521	-0.607	-0.448	-0.370	-0.448
自我护理责任感	-0.462	-0.561	-0.426	-0.285	-0.352
自我护理技能	-0.550	-0.628	-0.498	-0.406	-0.440
健康知识	-0.531	-0.611	-0.470	-0.389	-0.438
PSSS总分	-0.537	-0.628	-0.482	-0.369	-0.432
家庭支持	-0.518	-0.615	-0.456	-0.351	-0.425
朋友支持	-0.540	-0.620	-0.497	-0.375	-0.429
其他支持	-0.514	-0.607	-0.459	-0.354	-0.412
UPDRS-Ⅲ总分	0.602	0.658	0.545	0.460	0.505
注：表中数值为Pearson相关系数，均P＜0.05。

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表 4 自变量赋值情况

Table 4. Independent variables and assignment

自变量	赋值方法
性别	男性=1，女性=2
文化程度	初中及以下=1，高中或中专=2，专科及以上=3
疾病分期	1期=1, 2期=2, 3期=3
自我护理能力总分	以实际值赋值
领悟社会支持总分	以实际值赋值
UPDRSⅢ总分	以实际值赋值

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表 5 早中期PD患者社会参与影响因素的多元线性回归分析

Table 5. Multiple logistic regression analysis of social participation in mild to moderate PD patients

变量	B	SE	β	t值	P值
文化程度	7.378	0.699	0.267	10.562	< 0.001
疾病分期	22.824	2.153	0.422	10.601	< 0.001
ESCA总分	0.357	0.111	0.258	3.212	0.001
PSSS总分	0.168	0.047	0.090	3.562	< 0.001
UPDRS-Ⅲ总分	0.435	0.205	0.232	2.121	0.034
注：整体模型R²=0.436，调整后R²=0.434。

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