住院乙型肝炎肝硬化患者发生抑郁的危险因素及心理护理干预的效果研究

目的 分析住院乙型肝炎肝硬化患者发生抑郁的危险因素,并探讨心理护理干预对患者抑郁的效果。 方法 回顾性分析郑州市第六人民医院2014年1月-2015年12月间收治的200例住院病毒性肝炎肝硬化患者病例,以抑郁自评量表(SDS)评估患者抑郁情况,采用单因素分析法对患者发生抑郁的危险因素进行分析。采用随机数字法将伴抑郁患者分为2组。对照组给予常规护理,观察组在常规护理基础上给予心理护理干预。并采用心身症状自评量表(SCL-90)、SDS评估患者心理状态变化,对心理护理干预的效果进行评估。 结果 住院乙型肝炎肝硬化患者抑郁的发生率为47.0%,以轻度和中度抑郁为主。年龄小、学历低、家庭收入低、肝硬化严重、乙型肝炎感染>5年是患者出现抑郁的危险因素。心理护理干预后,观察组SCL-90各指标(躯体化、强迫、人际关系、抑郁、焦虑、敌对、恐怖、精神症状)和SDS得分均较干预前显著降低(P<0.05),且明显低于对照组各指标评分(P<0.05)。 结论 住院乙型肝炎肝硬化患者易发生抑郁,年龄小、学历低、家庭收入低、肝硬化严重、乙型肝炎感染>5年是患者发生抑郁的危险因素,优质心理护理干预可有效改善患者抑郁情绪,因此临床上不仅要重视患者发生抑郁的危险因素,还要针对性地采用心理护理来改善患者心理状态。 

Risk factors of depression in patients with hospitalized viral hepatitis cirrhosis and the effect of psychological nursing intervention

Objective To analyze the risk factors of depression in patients with hospitalized viral hepatitis cirrhosis,and investigate the effects of psychological nursing intervention. Methods Two hundred cases of hospitalized viral hepatitis cirrhosis patients in our hospital from January,2014 to December,2015 were retrospectively analyzed.The depression status of patients was detected by self-rating depression scale (SDS),and the risk factors were analyzed by univariate analysis.And the depression patients were randomly divided into two groups.Observation group was given psychological nursing intervention,and control group was given routine nursing.The depression changes of patients were detected by psychosomatic symptoms self-rating scale (SCL-90) and SDS to evaluate the effect of psychological nursing. Results The depression incidence of hospitali zed viral hepatitis cirrhosis patients was 47.0%,mainly including mild and moderate depression.Younger age,lower degree,smaller family income,severe liver cirrhosis,time of Hepatitis B infection>5 year were the risk factors of depression in patients.After psychological nursing intervention,the each index in SCL-90(somatization,coercion,interpersonal relationship,depression,anxiety,hostility,horror,mental symptoms) and SDS scores of observation group were significantly reduced compared to that before psychological nursing (P<0.05),and significantly lower than those of control group (P<0.05). Conclusion Hospitalized viral hepatitis cirrhosis patients easily occurred depression,and younger age,lower degree,smaller family income,severe liver cirrhosis,time of Hepatitis B infection>5 year were its risk factors.Psychological nursing intervention could effectively improve their depression.Therefore,risk factors of depression in Hepatitis B cirrhosis patients should be draw attention,and psychological nursing should be carried out to improve the patient's psychological state.