老年高血压合并糖尿病患者疾病恐惧感现状及其影响因素  

Current status and influencing factors of fear of disease progression in elderly patients with hypertension and diabetes mellitus

作　　者：李超[1] 孙星 安红雨 叶春花[1] Li Chao;Sun Xing;An Hongyu;Ye Chunhua(Department of General Practice,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100043,China)

机构地区：[1]首都医科大学附属北京朝阳医院全科医学科,北京100043

出　　处：《中华老年多器官疾病杂志》2025年第2期129-134,共6页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：首都卫生发展科研专项基金(2022-2Z-2038)。

摘　　要：目的 探讨老年高血压合并2型糖尿病(T2DM)患者疾病进展恐惧心理与生活质量现状及其影响因素。方法 选择首都医科大学附属北京朝阳医院2020年1月至2023年1月收治的380例老年高血压合并T2DM患者为研究对象。采用中文版恐惧疾病进展简化量表(FOP-Q-SF)与健康调查简表(SF-36)调查患者疾病进展恐惧心理及生活质量情况。采用SPSS 22.0统计软件进行数据分析。根据数据类型,分别采用方差分析、t检验或χ^(2)检验进行组间比较。采用多元线性回归模型分析患者疾病进展恐惧与生活质量的影响因素。采用Pearson相关性分析评估患者疾病进展恐惧与生活质量的相关性。结果 380例患者中有366例完成问卷调查,有效问卷回收率为96.32%。老年高血压合并T2DM患者FOP-Q-SF量表总平均分(32.23±5.74)分。心理功能失衡病例共162例(44.26%),SF-36总平均分(445.12±63.79)分。Pearson相关性分析提示,患者FOP-Q-SF与SF-36量表中躯体功能、躯体疼痛、精力、情绪职能、精神健康及量表总得分之间均呈负相关(r=-0.463,-0.374,-0.465,-0.388,-0.473,-0.523;P<0.05)。多元线性回归分析显示,高血压病程(β=0.136;P=0.029)、糖尿病病程(β=0.094;P=0.008)及冠心病(CHD)(β=0.174;P=0.014)对FOP-Q-SF得分有正向预测作用;家庭月收入(β=-0.184;P=0.012)、血糖达标(β=-0.143;P=0.019)、血压达标(β=-0.155;P=0.011)及服药依从性(β=-0.184;P<0.001)对FOP-Q-SF得分有负向预测作用,其共同解释因变量40.60%的变异度。家庭月收入(β=0.176;P<0.001)、体育锻炼(β=0.135,P=0.007)、血糖达标(β=0.236;P<0.001)、血压达标(β=0.116;P<0.001)及服药依从性(β=0.215;P<0.001)对患者SF-36得分有正向预测作用;CHD(β=-0.165;P<0.001)及脑梗死(β=-0.174;P<0.001)对SF-36得分有负向预测作用,其共同解释因变量47.40%的变异度。结论 老年高血压合并T2DM患者疾病进展恐惧现象普遍,有相当比例的患者存在心理失衡现象,Objective To explore the current status of fear of disease progression and quality of life in elderly patients with hypertension complicated with type 2 diabetes mellitus(T2DM).Methods A total of 380 elderly patients with hypertension and T2DM admitted to our hospital from January 2020 to January 2023 were recruited and served as the study subjects.Chinese version of fear of progression questionnaire-short form(FOP-Q-SF)and 36-item short form health survey(SF-36)were used to investigate their status of fear of disease progression and quality of life.SPSS statistics 22.0 was used for data analysis.ANOVA,Student′s t test or Chi-square test was adopted for intergroup comparison depending on data type.Multivariate linear regression model was applied to analyze the influencing factors for fear of disease progression and quality of life,and Pearson correlation analysis was employed to assess the correlation between fear of disease progression and quality of life.Results Among the 380 patients,366 cases completed our questionnaire survey,with a recovery rate of 96.32%.Their total average score of FOP-Q-SF scale was(32.23±5.74)points.There were 162 cases(44.26%)of psychological function imbalance,and the total average score of SF-36 scale was(445.12±63.79)points.Pearson correlation analysis indicated that FOP-Q-SF score was negatively correlated with physical function,bodily pain,vitality,emotional role,mental health and total score of SF-36 scale(r=-0.463,-0.374,-0.465,-0.388,-0.473,-0.523;P<0.05).Multivariate linear regression analysis found that the duration of hypertension(β=0.136;P=0.029),duration of diabetes mellitus(β=0.094;P=0.008),and coronary heart disease(CHD)(β=0.174;P=0.014)had positive predictive effects on FOP-Q-SF score,while family monthly income(β=-0.184;P=0.012),controlled blood glucose(β=-0.143;P=0.019),controlled blood pressure(β=-0.155;P=0.011)and medication compliance(β=-0.184;P<0.001)had negative predictive effects on FOP-Q-SF score,which jointly explained 40.60%of the variation of the

关 键 词：老年人 高血压 2型糖尿病 疾病进展恐惧 生活质量 

分 类 号：R544.1[医药卫生—心血管疾病] R587.1[医药卫生—内科学]