糖尿病肾病血液透析患者心理状况及社会支持分析

目的：研究糖尿病肾病血液透析患者心理状况及社会支持现状，讨论其对策，为其心理康复提供理论依据。方法：2006年7月～2007年6月选择沈阳军区总医院行血液透析的糖尿病肾病患者为透析组，同期未行血液透析的糖尿病肾病患者为对照组。采用症状自评量表（SCL-90）对心理状况进行调查。该量表共有90个项目并分为躯体化、强迫症状、人际关系、抑郁、焦虑、敌对、恐怖、偏执狂、精神病性等9个症状因子分和总症状指数，采用1-5级评分。评估标准：单项因子分及总症状指数达到3分以上，定为阳性，提示可能存在明显的心理问题。在测试前采用统一的指导语说明测试的目的及意义，让患者对照量表的每一项，根据自己的实际情况做出真实的自我评定，独立完成。心理检测由经培训的专业人员进行。采用社会支持评定量表（SSRS）调查评定两组患者的社会支持情况。结果：所有研究对象均完成测试，全部进入结果分析。糖尿病肾病血液透析组抑郁、恐怖、焦虑、躯体化各因子等各项因子分明显高于对照组(P<0. 01)。糖尿病肾病血液透析组患者社会支持量表总分、主观支持、对社会支持利用度明显低于对照组 (P<0.01)。结论：糖尿病肾病血液透析患者焦虑症状和抑郁等症状的检出率较高。进行血透者,临床医生有必要加强心理社会干预，以改善患者的心理状况。

Analysis on social support and psychologic status in patients with diabetic nephropathy undergoing hemodialysis

Abstract] Objective To investigate and analysis on status of psychological health and social support of hemodialysis patients with diabetes nephropathy, so as to provide psychological evidence for the therapy and prevention .Methods A total of 67 hemodialysis patients with diabetes nephropathy were selected as study group and 67 non- hemodialysis patients with diabetes nephropathy as control group from. Shenyang Military General Hospital between July 2006 and June 2007.Their psychological status were investigated with SCL-90, which consisted of 90 items in 9 factors and total symptom indexes of somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism, and the 1-5-grade scoring system was used. Evaluation standard: The single factor score and total symptom index reached 3 points was taken as positive, indicating that there may be obvious psychological problems. The purpose and significance of the test were illustrated with uniform instruction before the test, and the soldiers were asked to compare each item in SCL-90, and independently make actual self-evaluation according to their own conditions. The psychological test was performed by trained professional personnel, Social Support Rating Scale were used for assessment of social support of hemodialysis patients. Results All the patients finished the test and were involved in the analysis of results. Hemodialysis patients with diabetes nephropathy had significantly higher scores mainly in scale somatization, anxiety, depression, psychotic factors, additional items of SCL-90 than those of the control group. (P<0.01). The subjective support and social support availability of social support evaluation scale among the hemodialysis patients with diabetes nephropathy was lower than the compared group(P<0. 01).Conclusion The morhidity of depression and anxiety in diabetes nephropathy patients after hemodialysis is higher .The physicians should enchance the psychological intervention to improve psychological status of hemodialysis patients with diabetes nephropathy.