造血干细胞移植患者的心理情绪及躯体症状分析  

Analysis of psychological emotion and phyiscal symptoms in patients undergoing hematopoietic stem cell transplantation

作　　者：郭彩玲[1] 张川莉[1] 陈凤姣[1] 王凌云[1] 陈莉[1] Guo Cailing;Zhang Chuanli;Chen Fengjiao;Wang Lingyun;Chen Li(West China School of Nursing,Department of Hematology,West China Hospital of Sichuan University,Chengdu 610041,Sichuan Province,China)

机构地区：[1]四川大学华西医院血液内科·华西护理学院,成都610041

出　　处：《国际输血及血液学杂志》2020年第2期134-141,共8页International Journal of Blood Transfusion and Hematology

基　　金：CMB护理青年教师科研基金(13-168-201507)。

摘　　要：目的探讨接受造血干细胞移植(HSCT)的血液系统疾病患者的心理情绪及躯体症状,分析二者之间的关系及其影响因素,为护理干预提供参考依据。方法选择2018年3月至2019年5月,四川大学华西医院血液科收治的拟接受HSCT的70例血液系统疾病患者为研究对象。收集患者的一般临床资料。采用华西心晴指数问卷(HEI)及患者健康问卷(PHQ-15),在移植前(T1)、预处理期(T2)、骨髓抑制期(T3)、血常规检查指标恢复后(T4),分别对患者进行心理情绪及躯体症状评估。对上述不同时间点,HEI、PHQ-15得分比较,采用重复测量资料方差分析。患者性别、文化程度、婚姻状况、职业、疾病类型、造血干细胞来源、HSCT类型构成比,患者躯体症状、不良心理情绪发生率的比较采用χ^2检验。本研究遵循的程序符合四川大学华西医院生物医学伦理分委会制定的伦理学标准,得到该分委会批准[批准文号:2016年审(73)号]。全部患者均在入组时签署临床研究知情同意书。结果①本研究中共64例(91.4%)患者4次问卷调查均合格。其中,男性患者为38例(59.4%),女性为26例(40.6%);年龄为18~61岁,平均为39.1岁。64例患者均为第1次接受HSCT。②T1~T4时间点,患者PHQ-15得分依次为(3.6±2.6)、(13.8±5.5)、(12.3±5.8)及(8.6±5.2)分;HEI得分依次为(4.1±4.1)、(10.0±5.7)、(8.5±5.2)及(6.3±4.7)分。上述不同时间点,患者HEI得分与PHQ-15得分分别比较,差异均有统计学意义(F=173.716,P=0.000;F=175.060,P=0.000)。③T1时间点,接受不同HSCT类型患者的躯体症状发生率比较,差异有统计学意义(χ^2=6.688,P=0.035);不同婚姻状况、文化程度、疾病类型患者的不良心理情绪发生率分别比较,差异均有统计学意义(χ^2=5.486,P=0.033;χ^2=10.127,P=0.038;χ^2=6.574,P=0.037)。T2时间点,不同文化程度与HSCT类型的患者不良心理情绪发生率分别比较,差异均有统计学意义(χ^2=18.018,P=0.001;χ^2=6.11Objectives To investigate the psychological emotion and physical symptoms of patients with hematologic disease undergoing hematopoietic stem cell transplantation(HSCT),to analyze the relationship between the two and their influencing factors,and to provide reference for nursing intervention.Methods From March 2018 to May 2019,70 cases of patients with hematologic disease undergoing HSCT who were admitted to the Department of Hematology,West China Hospital of Sichuan University were collected as study subjects.Collect general clinical data of patients.The Huaxi Emotional-Distress Index(HEI)and Patient Health Questionnaire(PHQ)-15 were used before the transplantation(T1),during pretreatment period(T2),myelosuppression period(T3),and after the recovery of blood routine examination indicators(T4),to evaluate psychological emotion and physical symptoms of patients.The HEI and PHQ-15 scores at different time points were compared using analysis of variance for repeated measurement.Comparison of gender,education,marital status,occupation,type of disease,source of hematopoietic stem cells,type of HSCT,ratio of somatic symptoms,and proportion of patients with adverse psychological and emotional conditions were performed using chi-square test.This study was reviewed by Biomedical Ethics Sub-committee of West China Hospital of Sichuan University(approval number:2016 no.73).All patients signed the informed consent for clinical research at the time of enrollment.Results①All 4 questionaires of 64 patients(91.4%)were qualified in this study.Among them,there were 38 male patients(59.4%)and 26 female patients(40.6%).The age ranged from 18 to 61 years,with an average of 39.1 years.All 64 patients received HSCT for the first time.②From T1 to T4,PHQ-15 scores of all 64 patients received HSCT were(3.6±2.6),(13.8±5.5),(12.3±5.8),and(8.6±5.2)points;HEI scores were(4.1±4.1),(10.0±5.7),(8.5±5.2)and(6.3±4.7)points.Differences between the HEI scores(F=173.716,P=0.000),PHQ-15 scores(F=175.060,P=0.000)at different time points were

关 键 词：造血干细胞移植 体征和症状 精神卫生 情感症状 护理 

分 类 号：R473[医药卫生—护理学]