癫痫患者病耻感与心理弹性、社会支持状况的关系  

Relationship between stigma and psychological resilience,social support in patients with epilepsy

作　　者：张钦 付晓燕[1] 袁莹娜 朱欣欣 孙林洁 ZHANG Qin;FU Xiaoyan;YUAN Yingna;ZHU Xinxin;SUN Linjie(Fifth Ward,Department of Neurology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院神经内科五病区,450000

出　　处：《中国健康心理学杂志》2024年第9期1309-1314,共6页China Journal of Health Psychology

基　　金：河南省科技攻关计划项目(编号:182102310081)。

摘　　要：目的:分析癫痫患者病耻感与心理弹性、社会支持状况的关系。方法:选取2021年4月—2023年4月,某院癫痫患者118例,分别采用癫痫患者病耻感评分量表(KSSE)、社会支持评定量表(SSRS)及心理弹性量表(CD-RISC),对其进行调查。采用Logistic分析病耻感影响因素。采用Spearman相关分析癫痫患者病耻感与心理弹性、社会支持的相关性。结果:118例癫痫患者中有病耻感88例(74.58%),无病耻感30例(25.42%)。居住地、文化程度、月收入及及焦虑、抑郁程度比较上差异有统计学意义;有病耻感组CD-RISC、SSRS均低于无病耻感组;经logistic回归分析显示,居住农村(OR=1.966,95%CI=1.036~3.732)、文化程度低(OR=1.972,95%CI=1.003~3.878)、月收入不足3000元(OR=1.049,95%CI=1.049~3.961)、焦虑(OR=2.197,95%CI=1.033~4.672)、抑郁(OR=2.151,95%CI=1.040~4.451)、低CD-RISC(OR=3.714,95%CI=1.061~12.993)水平及低SSRS水平(OR=3.367,95%CI=1.115~10.17)是影响癫痫患者病耻感的影响因素,其中低CD-RISC水平影响最为显著,可能作为独立危险因素;癫痫患者病耻感与社会支持、心理弹性呈负相关(r=-0.878,-0.770;P<0.001)。结论:癫痫患者社会支持和心理弹性可降低患者病耻感,可通过提高患者心理弹性水平和社会支持间接作用改善患者病耻感。临床护理工作者应对乡村患者、受教育程度较低且低收入癫痫患者给予更多的心理干预、健康宣教等照护。Objective:To analyze the relationship between stigma and psychological resilience,social support in patients with epilepsy.Methods:A total of 118 patients with epilepsy in the hospital were enrolled between April 2021 and April 2023,and they were investigated by the Kilifistigma scale for epilepsy(KSSE),social support rating scale(SSRS)and Connor-Davidson resilience scale(CD-RISC),respectively.The influencing factors of stigma were analyzed by Logistic analysis.The correlation between stigma and psychological resilience,social support was analyzed by Spearman correlation analysis.Results:Among the 118 patients with epilepsy,there were 88 cases(74.58%)with stigma and 30 cases(25.42%)without.The differences in place of residence,education level,monthly income,anxiety and depression between stigma group and non-stigma group were statistically significant(P<0.05).The scores of CD-RISC and SSRS in stigma group were lower than those in non-stigma group(P<0.05).Logistic regression analysis showed that living in rural areas(OR=1.966,95%CI=1.036~3.732),low education level(OR=1.972,95%CI=1.003-3.878),monthly income<3000 yuan(OR=1.049,95%CI=1.049~3.961),anxiety(OR=2.197,95%CI=1.033~4.672),depression(OR=2.151,95%CI=1.040~4.451),low CD-RISC score(OR=3.714,95%CI=1.061~12.993)and low SSRS score(OR=3.367,95%CI=1.115~10.17)were influencing factors of stigma in epilepsy patients.Low CD-RISC score was of the most significant effects on stigma,which might be an independent risk factor(P<0.05).Stigma was negatively correlated with social support and psychological resilience in epilepsy patients(r=-0.878,P<0.001;r=-0.770,P<0.001).Conclusion:High levels of social support and psychological resilience can reduce stigma in epilepsy patients.Increasing psychological resilience and social support can indirectly improve stigma.Clinical nursing workers should give more psychological intervention,health education and other care to rural patients and those with low education level and income.

关 键 词：癫痫 病耻感 心理弹性 社会支持 

分 类 号：R395.3[哲学宗教—心理学] R749.1[医药卫生—医学心理学]