普通患者疾病感知现状及影响因素研究

背景　国内外研究均表明，患者的疾病感知极大影响着其治疗及预后效果。因此，探讨我国普通患者的疾病感知现状及影响因素十分重要，可以为改善我国患者负性疾病感知和提升患者健康提供依据。目的　探讨普通患者疾病感知现状及影响因素。方法　于2018年1-3月，通过方便取样的方式抽取广东省8家医院的500例患者进行现场调查，调查工具选用疾病感知问卷简化版（BIPQ）、维克森林医师信任量表（WFPTS）、中国版10项目大五人格量表（TIPI-C）、病人健康问卷2条目（PHQ-2），最终获得有效数据384例（76.8%）。结果　普通患者的BIPQ总得分为（38.6±9.1）分，认知表征、情绪表征、疾病理解能力维度得分分别为（22.1±7.0）、（13.3±4.0）、（3.2±2.2）分。不同职业、医疗费用对家庭经济影响程度患者的BIPQ总得分存在统计学差异（P<0.05）。Pearson相关分析结果显示：患者BIPQ总得分与WFPTS总得分及仁爱、技术能力维度得分，以及TIPI-C宜人性、情绪稳定性维度得分呈线性负相关（r值为-0.39~-0.14，P<0.05）；患者BIPQ总得分与PHQ-2得分呈线性正相关（r=0.41，P<0.05）。多元线性逐步回归分析结果显示，WFPTS仁爱维度得分、TIPI-C情绪稳定性维度得分、PHQ-2得分是患者BIPQ总得分的影响因素（b值分别为-0.337、-0.781、2.308，P<0.05）。结论　我国普通患者对自身所患疾病认识不足，表现出较多消极情绪，对治疗缺乏信心；患者的抑郁情绪和医疗费用造成的经济压力是疾病感知的危险因素，情绪稳定性和医生的人文关怀是疾病感知的保护因素。

Current Status of Illness Perception among Ordinary Patients and Its Influencing Factors

Background　Numerous studies at home and abroad have shown that illness perception greatly affects the treatment effect and prognosis. Therefore，it is essential to explore the current status of illness perception among ordinary patients and its possible influencing factors in China，which may provide the basis for improving negative illness perception of patients and their health conditions. Objective　To investigate the current status of illness perception among ordinary patients and its influencing factors. Methods　From January to March of 2018，500 patients from eight general hospitals in Guangdong Province were selected for an on-site investigation by convenience sampling method，and 384 cases（76.8%） of valid data were obtained. The Brief Illness Perception Questionnaire（BIPQ），the Wake Forest Physician Trust Scale（WFPTS），Ten-item Personality Inventory in China（TIPI-C），and Patient Health Questionnaire 2-item（PHQ-2） were used for investigation. Results　The score of BIPQ was（38.6±9.1），and scores of the dimension of cognition，emotion，and understanding were（22.1±7.0），（13.3±4.0），and（3.2±2.2）. The scores of BIPQ were significantly different among patients with different occupations and the impact of medical expenses on family economy（P<0.05）. Pearson correlation analysis showed that the scores of BIPQ had a linear negative correlation with the scores of WFPTS and its scores of the dimension of benevolence and technical competence，as well as scores of the dimension of pleasantness and emotional stability in the TIPI-C（r values were -0.39 to -0.14，P<0.05），and the scores of BIPQ were significantly correlated with the scores of PHQ-2 positively（r=0.41，P<0.05）. Multivariate linear stepwise regression analysis showed that influencing factors of the scores of BIPQ were the score of PHQ-2（b=2.308），the score of the dimension of emotional stability in TIPI-C（b=-0.781），and the score of the dimension of benevolence in WFPTS（b=-0.337）（P<0.05）. Conclusion　Patients in China have insufficient understanding of their own illness，and they are lack of confidence in treatment with more negative emotions. Depression and economic stress caused by medical expenses are risk factors for illness perception，while the emotional stability and benevolence of physicians are the protective factors.