复发肺结核患者心理健康及社会支持状况调查

目的分析复发肺结核患者心理健康及社会支持状况特点，为进一步改善复发肺结核患者的治疗，针对性地进行心理干预提供依据。方法采用症状自评量表（SCL-90）、社会支持评定量表（SSRS）对98例复治涂阳患者进行问卷调查研究，记录不同性别、年龄、文化程度及婚姻状态患者的SCL-90、SSRS评分情况。并选择同期初治涂阳患者140例和健康志愿者120例作为对照。采用t检验和方差分析对各项指标均数进行统计分析。结果女性复治涂阳肺结核患者SCL-90阳性项目数高于男性患者（P〈0．01）。不同年龄复发涂阳患者．在强迫症状、人际关系、恐怖3个因子上（P〈0．05）以及客观支持上（P〈0．01）存在差异。不同文化程度复发涂阳患者，在强迫症状、人际关系、抑郁、恐怖、偏执5个因子上以及客观支持上（P〈0．05）存在差异。未婚、离异患者社会支持低于已婚患者（P〈0．01）。复治涂阳肺结核患者SCL-90阳性项目数高于健康对照组（P〈0．01），而客观、主观支持及支持总分低于健康对照组（P〈0．01）。结论复治涂阳患者心理健康水平较差，社会支持低。在严格执行全程督导管理过程中，要注重配合心理干预和治疗。

The Study on Psychological Health and Social Support Situation of Patients with Recurrent Smear-Positive Pulmonary Tuberculosis

Objective To investigate the psychological health status and social support situation of the patients with recurrent smear-positive pulmonary tuberculosis and provide scientific basis for psychological intervention. Methods Questionnaires of Symptom Check List 90 （SCL-90） and social support rating scale （SSRS） were used for investigating 98 cases of recurrent smear-positive pulmonary tuberculosis, 140 cases of new smear-positive pulmonary tuberculosis, and 120 cases of healthy volunteer. Results Positive factors （SCL-90） of the female with recurrent smear-positive pulmonary tuberculosis were significantly higher than those of male （P〈0.01）. The SCL-90 results showed that there were differences in the obsessive-compulsive, interpersonal relationship, phobic anxiety among patients of different ages（P〈0.05）. Differences in obsessive-compulsive, interpersonal relationship, depression, phobic anxiety, and paranoid ideation were also observed among patients with different education levels（P〈0.05）. The social support of married patients was higher than those of spinsterhood patients and divorce patients（P〈0.01 ）. Positive factors of the patients with recurrent smear-positive pulmonary tuberculosis group were significantly higher than those of control group （P〈0.01）. And the scores on subjective, objective and total social support of patient with recurrent smear-positive pulmonary tuberculosis were much lower than those of control group （P〈0.01）. Conclusion The above results showed the psychosocial intervention is necessary along with the directly observed treatment short-courses （DOTS）.