2型糖尿病患者心理健康状况与应对方式的调查研究

目的 调查2型糖尿病患者的心理健康状况,总结应对方式类型特点,分析心理健康状况与应对方式的关系.方法 本研究共纳入167例2型糖尿病患者,其中,男性94例,女性73例,年龄22～80岁[（57.93±13.02）岁].使用症状自评量表（SCL90）进行心理健康状况评分.另外,使用应对方式量表（CSQ）评估2型糖尿病患者应对方式.同时收集患者年龄、性别、病程、并发症情况、糖化血红蛋白（HbA1c）以及治疗方式等资料.计算存在心理健康问题患者的阳性率,分析2型糖尿病患者心理健康相关因素,以及心理健康与应对方式之间的关系.结果 有32.3％的2型糖尿病患者存在不同类型的心理健康问题,其中,躯体化障碍、强迫症状和人际关系敏感患病率较高（16.8％,15.6％,15.6％,χ2=38.8,P＜0.01）.相对于无心理健康问题组来说,有心理健康问题组患者在不成熟的应对方式上的得分较高,如自责[（4.50±3.00）vs.（2.48±2.18）,P＜0.01]、退避[（5.63±2.40）vs.（4.88±2.09）,P＜0.01]以及合理化[（5.83±2.40）vs.（4.88±2.09）,P＜0.01].结论 2型糖尿病患者易出现心理健康问题,与此类患者不成熟的应对方式有关,临床工作者应重视2型糖尿病患者心理问题的早期筛查和干预.

Investigation on mental health and coping style in type 2 diabetic patients

Objective To investigate the mental health and coping styles in patients with type 2 diabetes mellitus,and analyze the relationship between mental health and coping skills.Methods A total of 167 type 2 diabetic patients were enrolled in the study [including 94 male and 73 female,aged 22 to 80 years,mean age：（57.93 ± 13.02） years].SCL90 （Symptom Checklist90） and coping style questionnaire （CSQ） were used to evaluate mental health and coping styles,respectively.Information on patient age,gender,disease duration,complications,glycosylated hemoglobin （HbA1c） and treatment were collected.The demographic and glycemic data were also studied.Finally,the risk factors associated with mental health and the relationship between mental health and coping style were statistically analyzed.Results 32.3% （54/167） patients with type 2 diabetes had mental health problems.Somatization disorder,obsessive-compulsive symptom and interpersonal sensitivity were the most common morbidities （16.8%,15.6%,15.6%,χ2=38.8,P 〈0.01）.Compared with patients without mental health problems,patients with immature coping style had higher scores in the questionnaire,including self-accusation [（4.50 ± 3.00）vs.（2.48 ± 2.18）,P 〈0.01],avoidance [（5.63 ± 2.40） vs.（4.88 ± 2.09）,P 〈0.01] and rationalization [（5.83 ± 2.40）vs.（4.88 ± 2.09）,P 〈0.01].Conclusions Type 2 diabetic patient have more mental health problems,and the immature coping style have an opposite influence on mental health.Therefore,physicians should pay more attention to the early assessment and intervention of mental health in type 2 diabetics.