新型冠状病毒肺炎疫情期间对冠心病患者的心理调查及进行针对性干预效果分析  

A analysis of psychological survey and intervention for patients with coronary heart disease during COVID-19

作　　者：张姝 司晓云 候艳平 蒋先文 李伟 李道远 邓有金 ZHANG Shu;SI Xiao-yun;HOU Yan-ping;JIANG Xian-wen;LI Wei;LI Dao-yuan;DENG You-jin(Department of Cardiology,Panzhou People's Hospital Panzhou 561601,China;Department of Cardiology,Affiliated Hospital,Guizhou Medical University,Guiyang 550004,China)

机构地区：[1]盘州市人民医院心血管内科,贵州省盘州市561601 [2]贵州医科大学附属医院心血管内科

出　　处：《中国心血管病研究》2020年第6期517-521,共5页Chinese Journal of Cardiovascular Research

基　　金：国家自然科学基金(81960047);贵州省科技计划(黔科合平台人才(2018)5608、黔科合支撑[2019]2800、黔科合基础[2019]1260);贵州省普通高等学校科技拔尖人才支持计划(黔教合KY字(2016)070);贵阳市科技计划(GY2017-34、[2019]9-1-34);临床医学PBL教学实践改革项目(2017007);心血管病理论与实践教学案例库项目(0711007020256)。

摘　　要：目的探讨新型冠状病毒肺炎(COVID-19)疫情期间冠心病患者的心理影响因素及对其进行针对性干预效果分析.方法选取2020年1月21日至3月16日盘州市人民医院心内科收治的冠心病患者152例作为研究对象,按病种分为是否合并高血压合并组;是否合并糖尿病合并组;ACS组、稳定型心绞痛组.记录研究对象的性别、年龄、吸烟史、合并慢性基础疾病等相关信息.对研究对象进行SCL90问卷调查,所得评分与中国常模组分值进行对比分析,以此因子进行相关因素的回归分析,随后进行针对性的心理性干预治疗,干预治疗后1周再次进问卷评估.结果152例调查对象中收回146份有效问卷.ACS组与稳定型心绞痛组及中国常模组相比,躯体化及焦虑因子差异具有统计学意义[(1.98±0.46)比(1.32±0.40)、(1.98±0.46)比(1.37±0.48)、(2.12±0.57)比(1.50±0.39)、(2.12±0.57)比(1.39±0.43),P均<0.05].合并糖尿病组与非合并糖尿病组及中国常模组相比,抑郁及焦虑因子差异具有统计学意义[(2.12±0.36)比(1.55±0.62)、(2.12±0.36)比(1.50±0.59)、(1.97±0.45)比(1.40±0.36)、(1.97±0.45)比(1.39±0.43),P均<0.05].合并高血压组与非合并高血压组及中国常模组相比,躯体化及强迫因子差异具有统计学意义[(2.13±0.54)比(1.38±0.59)、(2.13±0.54)比(1.37±0.48)、(2.24±0.57)比(1.64±0.54)、(2.24±0.57)比(1.62±0.58),P均<0.05].对ACS患者、合并糖尿病患者及合并高血压患者进行Logistic回归分析发现,相关因素分别为:担心被感染(OR=0.94)、担心病情加重(OR=1.48);担心住院时间延长(OR=1.41)、担心被感染(OR=0.71)、担心病情加重(OR=1.36)、担心增加医疗费用(OR=1.21);担心自己被感染(OR=0.53)、担心应用ACEI制剂(OR=1.48)、担心应用ARB制剂(OR=0.63).经过心理干预及针对性处理后再次进行问卷调查则原异常评分均无差异.结论COVID-19疫情对ACS、高血压、糖尿病患者均造成了不同程度的精神心理�Objective To explore the psychological factors of patients with coronary heart disease and the effectiveness of targeted interventions during COVID-19.Methods A total of 152 patients with coronary heart disease admitted to the Department of Cardiology during the COVID-19 in Panzhou People's Hospital were selected as the research subjects.The patients were divided into combined or non-combined hypertension group;combined or non-combined diabetes group;ACS group and stable angina group.The relevant information such as the sex,age,smoking history and combined chronic underlying diseases of the research subjects were record.The SCL90 score questionnaire survey was conducted on the research subjects and the score was compared with the Chinese norm component value.This factor was used for regression analysis of relevant factors and then targeted psychological intervention treatment was performed.The questionnaire evaluations were repeatal again.Results Among the 152 respondents,146 valid questionnaires were withdrawn.Compared with the stable angina pectoris and the Chinese norm,the ACS group had statistically significant differences in somatization and anxiety factors[(1.98±0.46)vs.(1.32±0.40),(1.98±0.46)vs.(1.37±0.48),(2.12±0.57)vs.(1.50±0.39),(2.12±0.57)vs.(1.39±0.43),all P<0.05].Compared with non-combined diabetes and Chinese norms,the combined diabetes group had statistically significant depression and anxiety factors[(2.12±0.36)vs.(1.55±0.62),(2.12±0.36)vs.(1.50±0.59),(1.97±0.45)vs.(1.40±0.36),(1.97±0.45)vs.(1.39±0.43),all P<0.05].Compared with the non-combined hypertension group and the Chinese regular model,the combined hypertensive group had statistically significant differences in somatization and obsessive factors[(2.13±0.54)vs.(1.38±0.59),(2.13±0.54)vs.(1.37±0.48),(2.24±0.57)vs.(1.64±0.54),(2.24±0.57)vs.(1.62±0.58),all P<0.05].Loogistic regression analysis of ACS patients,patients with diabetes and patients with hypertension showed the related factors as:worrying about infection(OR=0.

关 键 词：新型冠状病毒肺炎 冠状动脉疾病 心理干预 

分 类 号：R563.1[医药卫生—呼吸系统] R541.4[医药卫生—内科学]