心脏移植受者术后社会支持与焦虑抑郁状况、躯体功能相关性分析

目的：探讨心脏移植受者术后社会支持与焦虑抑郁状况、躯体功能相关性。方法：选取2014年12月-2015年12月于我院心脏移植外科接受同种心脏移植且手术顺利出院的受者192例作为研究对象。采用自制《心脏移植受者居家康复状况问卷》收集受者的一般资料,采用《心脏移植受者躯体功能评估表》评估其躯体功能,采用《焦虑抑郁量表（HAD）》评估其心理功能;采用《社会支持评定量表（SSRS）》评估社会支持能力,然后采用单因素和多因素Logistic回归分析心脏移植受者康复影响因素;采用Spearman分析社会支持和焦虑抑郁状况、躯体功能相关性。结果：心脏移植受者躯体功能评分为（15.30±4.31）分,各项得分来看,躯体功能有好到差分别为：自我照顾、活动功能、心肺功能、睡眠以及疲劳状况;焦虑得分为（6.24±2.16）分,其中120例（62.50%）无症状,8例（4.17%）症状可疑,64例（33.33%）存在症状;抑郁得分为（6.39±1.72）分,其中112例（58.33%）无症状,48例（25.00%）症状可疑,32例（16.67%）存在症状;社会支持总分、客观支持、主观支持以及社会支持利用度得分分别为（33.01±5.89）分、（8.62±2.79）分、（17.59±3.91）分和（6.79±1.71）分。单因素结果显示影响心脏移植受者躯体功能的危险因素有文化程度、月药费支出以及是否重返工作;影响心脏移植受者心理功能的危险因素有文化程度、职业、月药费支出、医疗支付方式;影响社会支持的危险因素为是否重返工作。Logistic回归分析结果显示影响躯体功能的因素是文化程度和是否重返工作岗位,影响心理功能的因素是职业和文化程度,影响社会支持的因素是是否重返工作岗位。Spearman相关性分析结果显示,社会支持总分与躯体功能评分呈明显的正相关关系,而与焦虑和抑郁评分呈明显的负相关关系（P＜0.05）。结论：给予心脏移植受者足够的社会支持有利于心脏移植受者躯体和心理功能恢复,且应鼓励其重返工作岗位,提高社会适应能力。

Postoperative cardiac transplant recipients of social support and anxiety depression status and physical function correlation analysis

Objective: to investigate the postoperative cardiac transplant recipients of social support and anxiety depression status and physical function correlation. Methods: In December 2014- December 2015, 192 cases heart transplant surgery same and heart transplant surgery smoothly discharged in our hospital were selected as the research objects. The self-made "heart transplant recipients home rehabilitation status questionnaire" recipients of general information collection, using the physical function evaluation table of heart transplant recipients to assess their physical function, using the anxiety depression scale (HAD) to assess their mental functions; Adopt "social support rating scale (SSRS) to assess social support ability, and then factors influencing rehabilitation heart transplant recipients were analyzed by the single factor and multiple factors Logistic regression. The correlation of social support and anxiety depression status and physical function was analyzed by Spearman. Results: cardiac transplant recipients body function score was (15.30±4.31) points. Body function was good to the bad respectively: self-care, activity function, cardiopulmonary function, sleep and fatigue condition; Anxiety score was (6.24±2.16) points, of which 120 cases (62.50%) of asymptomatic, 8 cases (4.17%) symptoms suspected, 64 cases (33.33%) symptoms; Depression score (6.39±1.72) points, of which 112 cases (58.33%) of asymptomatic, 48 cases (25.00%) symptoms, suspicious symptoms of 32 cases (16.67%); Social support, objective support, subjective support and social support utilization degree scores were (33.01±5.89), (8.62±2.79), (17.59±3.91) and (6.79±1.71), respectively. Single factor according to the results affect the physical function of risk factors were heart transplant recipients with cultural degree, on drug expenditure and whether to return to work. Affect the psychological features of risk factors were heart transplant recipients have cultural degree, occupation, monthly expenses for medicine expenditure, medical payment. Risk factors of affect the social support were whether to return to work. Logistic regression analysis results showed that the factors affecting physical function were a cultural degree and whether to return to work, the influencing factors of psychological function were professional and cultural level, the influencing factors of social support were whether to return to work. Spearman correlation analysis results showed that social support score and physical function score was significantly positive correlation, and score was significantly negative correlation between anxiety and depression (P<0.05). Conclusion: heart transplant recipients enough social support was good for heart transplant recipients body and psychological functional recovery, and should be encouraged to return to work, improve the social adaptation ability.