肺结核患者确诊时负性情绪反应及其影响因素研究  

A study on patients' negative emotional reactions and its influencing factors at the diagnosis of pulmonary tuberculosis

作　　者：陈彬[1] 王晓萌[1] 顾华[1] 钟节鸣[1] 陈松华[1] 陆红妹[2] 贾巧娟[3] 

机构地区：[1]浙江省疾病预防控制中心,浙江杭州310051 [2]长兴县疾病预防控制中心 [3]义乌市疾病预防控制中心

出　　处：《浙江预防医学》2014年第3期237-241,共5页Zhejiang Journal of Preventive Medicine

基　　金：浙江省医药卫生科研基金项目(2009A040;2013KYB 060)

摘　　要：目的探索肺结核患者确诊时的负性情绪及影响因素,为针对性干预提供依据。方法选择浙江省2个县的结核病定点门诊,对就诊的440例患者进行问卷调查,并随机抽取20例进行半结构化定性访谈。运用单因素卡方检验分析患者情绪反应及其影响因素。结果回收有效问卷437份,有效定性访谈19例。得知患肺结核时,患者出现担心、震惊、自责、无助和羞愧等负性情绪发生率分别为58.58%、29.75%、20.37%,10.98%和35.70%。负性情绪原因主要是年轻患者不相信自己得病或认为结核病是"不治之症"等。50岁以上人群震惊(40.26%)、担心(58.44%)、自责(38.96%)发生率相对较高(P<0.05);离婚或丧偶人群担心(95.24%)、震惊(61.90%)、自责(61.09%)、无助(42.86%)发生率较高(P<0.05);农民群体震惊(48.89%)、担心(70.37%)、自责(43.70%)发生率相对较高(P<0.05)。定性访谈中,6例患者有怀疑情绪,其中5例<35岁;6例患者有担心情绪;各有2例患者羞愧自责及悲观,均>38岁。结论肺结核患者确诊时容易发生负性情绪,老年患者、离婚、丧偶及农民等人群发生率相对较高。Objective To investigate patients’negative emotional reactions and its influencing factors when pulmonary tuberculosis （PTB ） was diagnosed, and to provide evidence for health education and intervention. Methods A questionnaire survey was conducted among 440 PTB patients who were treated at the designated clinics of two counties in Zhejiang Province.Twenty patients at one clinic were randomly selected for a semi-structured interview.Results A total of 437 qualified questionnaires were collected and 19 patients were successfully interviewed.When they were told the result of diagnosis,58.58% patients felt worried,29.75% were shocked,20.37% tended to blame themselves,10.98% felt helpless and 35.70%had a sense of shame.In the semi-structured interview,the main reasons for negative emotions told by the patients were disbelieving the fact of getting the disease and misunderstanding TB was incurable.Old people felt more shocked （40.26%）,worried （58.44%）and self-blaming （38.96%）about the diagnosis of TB.The divorced and widowed expressed more reactions of worry （95.24%）, shock （6 1.09%）, self -blame （6 1.09%）, helpless （42.86%）.Farmers had higher rate of shock （48.89%）,worry （70.37%）,and self-blame （43.70%）.Conclusion Negative emotions or feelings were popular among TB patients when the disease was diagnosed.The elders,divorced or widowed people and farmers need to be attached more importance during the process of health education or intervention.

关 键 词：肺结核 负性情绪 影响因素 

分 类 号：R521[医药卫生—内科学]