病毒性肝炎患者肝活体组织检查后心理危机状况及相关因素  

Psychological crisis state and related factors in patients with viral hepatitis after liver biopsy

作　　者：方芳 李爽 刁玲玲 孔婉如 王洁 FANG Fang;LI Shuang;DIAO Lingling;KONG Wanru;WANG Jie(Department of Infection,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province,Nanjing 210000,China)

机构地区：[1]南京医科大学第一附属医院感染科,江苏南京210000

出　　处：《中国医药导报》2022年第29期81-84,共4页China Medical Herald

摘　　要：目的观察病毒性肝炎患者肝活体标本检查(以下简称“肝活检”)后心理危机状况,并分析与其相关的危险因素。方法选择2018年10月至2021年10月南京医科大学第一附属医院接受肝活检的107例病毒性肝炎患者,全部患者均于穿刺后3周接受心理危机脆弱性量表(PCVS)调查。对患者基线资料进行调查,比较不同基线特征患者PCVS评分的差异,并评估患者的医学应对方式问卷(MCMQ)、心理弹性量表(CD-RISC)、领悟社会支持量表(PSSS)评分,并进一步分析肝活检患者心理危机状况的影响因素。结果本研究共发放问卷107份,回收107份,回收率为100%。107例肝活检患者PCVS评分为(74.24±12.81)分,发生穿刺并发症患者PCVS评分高于未发生患者(P<0.05)。PCVS评分与患者屈服、回避呈正相关(r>0,P<0.05),与面对、心理弹性、社会支持呈负相关(r<0,P<0.05)。多元线性回归分析结果显示,穿刺并发症(X_(1))、回避(X_(3))、面对(X_(4))、心理弹性(X_(5))、社会支持水平(X_(6))是肝活检患者心理危机的影响因素,得到方程:Y=130.664+10.572X_(1)+0.815X_(3)-1.475X_(4)-0.531X_(5)-0.185X_(6)(F=147.812,R2=0.899,调整后R2=0.893,P<0.05)。结论肝活检患者心理危机可能受穿刺并发症、患者应对方式、心理弹性及社会支持水平的影响。Objective To observe the psychological crisis state of patients with viral hepatitis after liver biopsy and to analyze its related risk factors.Methods A total of 107 patients with viral hepatitis who received liver biopsy in the First Affiliated Hospital of Nanjing Medical University from October 2018 to October 2021 were selected.All patients received investigation of psychological crisis vulnerability scale(PCVS)at three weeks after puncture.The patients’baseline data were investigated,and the differences in PCVS scores of patients with different baseline characteristics were compared,and the scores of medical coping style questionnaire(MCMQ),psychological resilience scale(CD-RISC),and perceived social support scale(PSSS)were evaluated,and the influencing factors of psychological crisis state in patients with liver biopsy were further analyzed.Results A total of 107 questionnaires were distributed and 107 were recovered with a recovery rate of 100%.The PCVS score of 107 patients with liver biopsy was(74.24±12.81)points,and the PCVS score of patients with puncture complications was higher than that of patients without puncture complications(P<0.05).PCVS score was positively correlated with patient surrender and avoidance(r>0,P<0.05),and negatively correlated with face,psychological resilience,and social support(r<0,P<0.05).The results of multiple linear regression analysis showed that puncture complications(X_(1)),avoidance(X_(3)),face(X_(4)),resilience(X_(5)),and social support level(X_(6))were the influencing factors of psychological crisis in patients with liver puncture biopsy,and the equation was as follows:Y=130.664+10.572X_(1)+0.815X_(3)-1.475X_(4)-0.531X_(5)-0.185X_(6)(F=147.812,R2=0.899,adjusted R2=0.893,P<0.05).Conclusion The psychological crisis of patients with liver biopsy may be affected by puncture complications,coping modes,psychological resilience and social support.

关 键 词：肝活体标本检查 心理危机 应对方式 心理弹性 社会支持 

分 类 号：R446.8[医药卫生—诊断学]