肺结核病患者心理社会因素研究

目的　研究肺结核患者心理因素及社会支持情况。方法　采用统一的指导语 ,运用症状自评量表 (SCL 90 )及社会支持评定量表 (SSRS)对 13 2例肺结核患者 (研究组 )和 71名健康志愿者(健康对照组 )进行调查 ,采用t检验及方差分析对各项指标均数进行统计分析。结果　肺结核患者躯体化、强迫症状、焦虑、恐怖、偏执、精神病性因子分及SCL 90阳性项数的均数分别为 1 77± 0 51、1 63± 0 50、1 53± 0 51、1 3 3± 0 41、1 40± 0 45、1 41± 0 40和 3 6 0 7± 2 0 84,明显高于健康对照组的1 3 0± 0 49、1 43± 0 49、1 3 8± 0 65、1 2 4± 0 48、1 49± 0 69、1 3 0± 0 44和 2 4 92± 18 2 2 ,差异有非常显著性 (P <0 0 1)。SCL 90症状自评结果在文化程度上显示出一定差异。SSRS评定结核患者的客观、主观支持及支持总分分别为 6 90± 2 81、19 2 5± 5 62和 3 2 96± 7 86,均显著低于健康对照组的7 92± 2 57、2 1 54± 5 82和 3 6 51± 9 0 1,差异有非常显著性 (P <0 0 1) ;痰涂片阳性患者的主观支持总分为 18 15± 5 72 ,较阴性患者的 2 0 75± 5 78低 ,差异有显著性 (P <0 0 5) ;未婚患者的主观、客观支持及支持总分分别为 17 19± 4 2 0、6 17± 2 18及 3 0 3 5± 5 96,均低于

A study of the psychological and social factors in patients with pulmonary tuberCulosis

OBJECTIVE: To investigate the mental health and social support in patients with tuberculosis. METHODS: Questionnaires were performed in 132 patients with tuberculosis and 71 healthy volunteers using Symptom Checklist 90 (SCL-90) and Social Support Rating Scale (SSRS). Statistical analyses were processed using Student's t test and ANOVA test. RESULTS: Somatization, obsessive-compulsiveness, anxiety, phobic anxiety and paranoid ideation, psychotism and the mean of positive factors of SCL-90 of the tuberculosis group (1.77 +/- 0.51, 1.63 +/- 0.50, 1.53 +/- 0.51, 1.33 +/- 0.41, 1.40 +/- 0.45, 1.41 +/- 0.40 and 36.07 +/- 20.84, respectively) were significantly higher than those of the control group (1.30 +/- 0.49, 1.43 +/- 0.49, 1.38 +/- 0.65, 1.24 +/- 0.48, 1.49 +/- 0.69, 1.30 +/- 0.44 and 24.92 +/- 18.22, respectively) (all P < 0.01). The result of symptom self-check differed among patients with different educational levels. The SSRS results of subjective and objective supports and total score of social supports of the tuberculosis group were 6.90 +/- 2.81, 19.25 +/- 5.62 and 32.96 +/- 7.86, respectively, much lower than those of the control group (7.92 +/- 2.57, 21.54 +/- 5.82 and 36.51 +/- 9.01, respectively) (all P < 0.01). Subjective support of patients with smear positive tuberculosis was much lower than that of patients with smear negative disease (18.15 +/- 5.72 vs. 20.75 +/- 5.78, P < 0.05); Subjective support, objective support and total score of social support of the unmarried patients (17.19 +/- 4.20, 6.17 +/- 2.18, 30.35 +/- 5.96, respectively) were lower than those of the married (20.72 +/- 5.96, 7.66 +/- 3.03, 35.19 +/- 8.74, respectively) (all P < 0.01). The results of SCL-90 and SSRS had no statistical relationship. CONCLUSION: Our results suggest that the disordered mental conditions and lower social support in patients with tuberculosis need psychosocial interventions in addition to medical care.