慢性阻塞性肺疾病患者抑郁、焦虑情绪的影响及心理护理  

Analysis of depression and anxiety in patients with chronic obstructive pulmonary disease and mental nursing

作　　者：卿春华[1] 吴尚洁[1] 唐丽[1] 陈燕[1] 陈平[1] 朱熊兆[1] 

机构地区：[1]中南大学湘雅二医院呼吸内科,湖南长沙410011

出　　处：《中国现代医学杂志》2010年第8期1197-1199,共3页China Journal of Modern Medicine

摘　　要：目的调查我院慢性阻塞性肺疾病(COPD)住院病人发生抑郁、焦虑情绪的患病率,分析其相关的影响因素,探讨心理护理的意义。方法对79例COPD患者进行肺功能测试、一般情况登记及医院焦虑抑郁量表(HAD)问卷调查。对有焦虑、抑郁的COPD患者进行心理护理。结果 79例COPD患者中Ⅰ、Ⅱ、Ⅲ及Ⅳ级分别为11例、17例、22例和29例。79例患者中有抑郁情绪的54人(68.4%)。有焦虑情绪的56人(70.9%)。29例Ⅳ级COPD患者中达到抑郁、焦虑症状肯定存在标准的均有26人,高达89.7%。Logistic多因素回归分析,男性比女性病人更易出现焦虑和抑郁症状(OR值分别为1.07,95%CI 1.01～2.04;1.15,95%CI 1.02～2.25),肺功能差的患者更易出现焦虑和抑郁症状(OR值分别为2.36,95%CI 1.99～3.33;2.77,95%CI 2.21～4.04);对病情越了解的病人更易出现焦虑和抑郁症状(OR值分别为1.26,95%CI 0.99～1.62;1.27,95%CI 1.01～2.32)。结论 COPD患者中存在较高的抑郁及焦虑情绪障碍,肺功能受损程度是其主要影响因素。因此,对COPD患者的焦虑、抑郁状态早期识别并加以心理护理具有重要意义。【Objective】To estimate the prevalence of depression and anxiety in patients with Chronic Obstructive Pulmonary Disease（COPD） and to analyze the possible impact factors and the significance of mental nursing.【Methods】79 patients with COPD were measured with Hospital Anxiety and Depression Scale（HADS）.【Results】54（67.7%） patients had depressive symptoms,and 56 cases（69.3%） had anxiety symptoms.There were 26 patients who had significant depression and anxiety symptoms from 29 patients with level-Ⅳ-COPD.From logistic-regression analysis model,we found that males had more risk of depression/anxiety symptoms than females（1.07,95%CI 1.01～ 2.04,1.15,95%CI 1.02～2.25,respectively） and the risk of depression/anxiety symptoms was 2.36/2.77 times greater for patients with severe COPD than those for mild（OR 2.36,95%CI 1.99～3.33,2.77,95%CI 2.21～4.04,respective-ly）.Meanwhile,the patients who knew more about their disease had more risk of epression/anxiety symptom than those who knew less（OR1.26,95%CI 0.99～1.62,1.27,95%CI 1.01～2.32,respectively）.【Conclusion】There is a high prevalence rate of depression/anxiety symptom in patients with COPD and the degree of lung function impairment is the major impact factor.Thus,mental nursing is quite important for those detected COPD patients.

关 键 词：慢性阻塞性肺疾病 抑郁 焦虑 医院焦虑抑郁量表(HAD) 心理护理 

分 类 号：R563[医药卫生—呼吸系统]