心脏手术患者术前焦虑与抑郁的影响因素

目的 探讨人口学变量和手术不确定感等因素对择期心脏手术患者术前焦虑、抑郁状况的影响.方法 采用医院焦虑抑郁量表(HAD)和心脏手术术前焦虑、抑郁自编问卷对已住院择期心脏手术97例患者进行调查,分析相关因素对焦虑、抑郁的影响.结果 焦虑阳性检出率为27%,抑郁阳性检出率为20%,焦虑和抑郁同时存在的阳性检出率为14%.性别在焦虑和抑郁得分上的差异均具有统计学意义T(101)=3.51,P<0.01;T(101)=2.78,P<0.01];文化程度对焦虑得分的影响不显著F(3,98)=1.06,P=0.37];文化程度对抑郁得分的影响差异具有统计学意义F(3,98)=4.10,P<0.01].与手术不确定感有关的3个项目"心里想的都是有关手术的事"、"担心手术失败"、"担心手术后恢复得不好"对焦虑、抑郁得分的影响均具有非常明显的统计学意义(P<0.01).结论 心脏患者的术前焦虑和抑郁状况受到多种因素不同程度的影响,临床上应综合考查多种测量指标,而手术不确定感对焦虑和抑郁的程度有预测作用.

Preoperative anxiety and depression in patients undergoing cardiac surgery and related influencing factors

Objective To study the effects of demographic variables, surgery-related uncertaintyand other related variables on preoperative anxiety and depression in patients undergoing selective cardiacsurgery. Methods 103 patients who were scheduled for cardiac surgery were investigated by using HospitalAnxiety and Depression Scale (HADS) and a self-made questionnaire, and the related influencing factorswere analyzed. Results The positive rates of anxiety, depression, and both anxiety and depression were27%, 20%, and 14% respectively. The anxiety score of the female patients was (7.3±3.8), significantlyhigher than that of the male patients (4.3±3.2), T(97) =3.41 ,P <0.01 ]. The depression score of thefemale patients was (6.4±3.4), significantly higher than that of the male patients (4.3±3.2) ,T(97) =2.98 ,P <0.01 ]. The education background had no significant influence on anxiety score F(3,98) = 1.06,P = 0.37 ]while had significant difference on depression score F ( 3, 98 ) = 4. 10, P < 0.01 ]. The threefactors reflecting the recognition of surgery-related uncertainty, "what I thought is all about the surgery","I'm worrying about the possible failure of surgery" and "I'm worrying about the possible unsatisfiedconvalescence", showed very significant effects on the anxiety and depression scores (all P<0.01).Conclusion The state of preoperative anxiety and depression of the cardiac surgical patients are influencedby multiple factors, which should be considered in clinical practice. Recognition of surgery-relateduncertainty is one of the most important influencing factors that can predict the state of preoperative anxietyand depression.