老年慢性病患者心理健康状况及应对方式分析

目的 在描述老年慢性病患者心理健康状况的基础上，分析影响心理健康状况的因素，研究应对方式与心理健康状况的关系，提出改善老年慢性病患者心理健康状况的建议。方法 使用自行设计的老年人基本情况问卷、症状自评量表（self-reporting inventory, SCL-90）和应对方式问卷（simplified coping style questionnaire, SCSQ）对老年慢性病患者进行调查。结果 1 264例老年慢性病患者中筛选出心理问题阳性者513例（40.6%），除人际关系敏感外，其他各因子得分均高于中国正常人常模。除婚姻状况和城乡外，其他人口学特征、躯体健康指标及经济均会影响他们的SCL-90得分。积极应对与SCL-90得分的相关系数为-0.120（P<0.001），消极应对与SCL-90得分的相关系数为0.131（P<0.001）。结论 老年慢性病患者心理问题突出，影响因素复杂，应对方式倾向于消极。相关部门应对其进行合理的引导，以改善心理健康状况。

Analysis of the mental status and coping modes among elderly patients with chronic diseases

Objective To describe the mental health status of elderly patients with chronic diseases and identify associated influencing factors, also to evaluate the association between mental health status and coping modes and propose some suggestions to improve their mental health. Methods Self-designed questionnaire, self-reporting inventory (SCL-90) and simplified coping style questionnaire (SCSQ) were used to investigate the elderly patients with chronic diseases. Results 513 cases (40.6%) were screened as positive. Except interpersonal relationship sensitiveness, the scores of other factors were higher than the average score of normal Chinese people. Apart from marital status and residence areas, the other demographic characteristics, physical health indicators and economic variables were all influencing factors for SCL-90 scores. The correlation coefficient between positive coping mode and SCL-90 score was -0.120 (P<0.001), the correlation coefficient between negative coping mode and SCL-90 score was 0.131 (P<0.001). Conclusions The elderly patients with chronic diseases have serious psychological problems, its influencing factors are complex and their coping modes tend to be negative. Reasonable guidance is also needed to improve their mental health status.