维持性血透患者的心理状态研究

研究我国血透患者的心理状况并进行针对性的心理治疗。方法 采用症状自评量表(SCL90-R)、多维度健康状况心理控制源量表(MHLC)、艾森克个性问卷(EPQ)及终末期肾脏病(ESRD)患者专用的生活质量表对北京六个医院透析中心的92名维持性血透患者进行了心理状态的研究,并与美国及加拿大相同的研究进行了比较分析。结果 本组的血透存在着抑郁、焦虑、恐怖等心理障碍,出现心理障碍的比例显著高于美国同类患者(P<0.01),且焦虑的发生率高于美国同类患者(P<0.01)。这些障碍与MHLC中机遇项分(CED)显著相关(P<0.01)。EPQ中神经质项分高者倾向于发生抑郁、焦虑等心理障碍。本组的血透患者客观生活质量较加拿大同类患者低(P<0.01),但在总的生活满意度上没有显著性差异。生活质量与心理及躯体因素均呈显著相关,心理障碍与躯体症状也显著相关(P<0.01)。结论 本组的血透患者心理状态与美国加拿大同类患者相比既有相同之处,又有特殊之处。我们应该兼顾病人的躯体和精神两方面的健康,努力提高他们的生活质量。

Psychological status in maintenance hemodialysis patients.

To study psychological status of maintenance hemodialysis (MHD) patients and carry out psychotherapy in China. Methods 92 MHD patients from six dialysis units in Beijing were investigated by means of three psychological re ting scales; symptom check list 90 (SCL-90), multidimentional health locus of control (MHLC), Eysenck personality questionaire (EPQ) and one questionair of quality of life specific for end-stage renal disease (ESRD) patients. The result of this study was compared with the data from HD centers in USA and Canada. Results A higher proportion of psychological disturbance especially in anxiety was found in our MHD patients than those in USA ( P <0.01). The psychological disturbance was significantly correlated with chance externality dimention of MHLC( P <0.01). Patients with high scores for neuroticism of EPQ trended towards appearance of depression and anxiety. A lower objective quality of life was showed in our MHD patients compared with those in Canada. But there was not a significant difference in overall life satisfaction between both groups. The objective quality of life in our MHD patients was significantly correlated with both psychological and somatic status ( P < 0.01) and psychological disturbance was associated with somatic symptoms ( P < 0.01). Conclusion Our MHD patients shared some common psychological features with those in USA and Canada, and they had some special psychological characteristics. We should take care of both somatic and psychological health of MHD patients to improve their quality of life.