肥胖患者代谢术前抑郁、焦虑状况及其对生命质量的影响  

Depression,anxiety and their effects on quality of life begore metabolic surgery in obese patients

作　　者：张天资[1] 许勤[1] 杨宁琍[2] 汤娟[2] 梁辉[2] 

机构地区：[1]南京医科大学护理学院,211166 [2]南京医科大学第一附属医院普外科

出　　处：《中国实用护理杂志》2018年第4期241-246,共6页Chinese Journal of Practical Nursing

基　　金：江苏省重点学科建设项目（苏教研[2012]2号）;江苏省高校品牌专业建设工程项目（苏教高[2015]11号）

摘　　要：目的调查肥胖患者代谢手术前抑郁、焦虑现况，并分析其对生命质量的影响。方法采用方便抽样，选取2017年3—7月在南京医科大学第一附属医院减重代谢外科行代谢手术患者117例为研究对象，采用9项患者健康问卷（PHQ一9）、广泛性焦虑问卷（GAD．7）、中文版健康调查12条简表（SF．12）收集资料，并采集患者的一般社会人口学资料和临床资料。结果患者PHQ-9得分的中位数为6分，四分位间距为7分，25．6％（30／117）患者有中度、中重度或重度抑郁症状；GAD．7得分的中位数为3分，四分位间距为6分，16．2％（19／117）患者有中度或重度焦虑症状；多元线性回归分析显示，合并症、体质量指数、抑郁症状是肥胖患者术前躯体生命质量的影响因素，可解释总变异的20．0％；抑郁症状得分、焦虑症状得分是其心理生命质量的影响因素，可解释总变异的49．6％。结论对于寻求代谢手术进行治疗的肥胖患者，其抑郁、焦虑发生率高，损害了患者的生命质量。在代谢手术前，应针对抑郁、焦虑等心理问题，常规进行筛查、诊断、干预，以使患者术后最大程度获益于代谢手术。Objective To investigate the status of depression/anxiety in obese patients seeking metabolic surgery and analyze the effects of depression/anxiety on different aspects of quality of life. Methods Convenient sampling was used and 117 metabolic surgery were recruited from the Department of Bariatric and Metabolic Surgery in the First Affiliated Hospital of Nanjing Medical University from March to July,2017. Patient Health Questionnaire（PHQ-9）,Generalized Anxiety Disorder 7-item scale （GAD-7）, 12 item Short-Form Health Survey （SF- 12） and the general information and disease characteristics questionnaire were used to collect data. Results Nearly 25.6%（30/117） of the patients suffered from moderate, moderately severe and severe depression symptoms and the median and interquartile range of PHQ-9 was 6 and 7 points. 16.2% （19/117） of the patients had moderate and severe anxiety symptoms and the median and interquartile range of GAD-7 was 3 and 6 points. Multiple linear regression analysis showed that scores in the physical component of the SF-12 were associated with the body mass index, the presence of comorbidities and depression,which could explain 20.0% of the total variance; the symptoms of depression and anxiety were negatively related to the mental component summary of SF-12, which could explain 49.6% of the total variance. Conclusions The present findings suggests that there is a high occurrence of depression and anxiety in metabolic surgery patients, which severely impair the patients＇ quality of life. As for the obese patients seeking metabolic surgery for treatment, routine screening of depression and anxiety incorporating tile diagnosis of the problems are wan＇anted. Then intervention based on the assessment can be exerted to maximize the benefit of patients undergoing the surgery in the long term.

关 键 词：焦虑 抑郁 生活质量 代谢手术 

分 类 号：R473.6[医药卫生—护理学]