肺结核患者病耻感与抑郁的相关性
| 作者: |
1陈锦苏,
1张兰
1 解放军福州总医院第二住院部结核科，福州 350025 |
| 通讯: |
陈锦苏
Email: 3352584393@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2018.04.021 |
| 基金: | 南京军区医药卫生科研项目(10MA113)。 |
摘要
目的：探讨肺结核患者病耻感状况及其影响因素，以及其与抑郁的相关性。方法：对2017年1至9月解放军福州总医院106例肺结核患者分别采用自行编制的一般资料问卷、结核病患者病耻感量表(tuberculosis-related stigma scale，TSS)、Beck抑郁问卷(Beck depression inventory，BDI)进行人口学和疾病特征、病耻感及抑郁状况调查，分析病耻感的影响因素及其与抑郁相关性。结果：本组肺结核患者中男61例，女45例，年龄20~68(41.08±10.72)岁。TSS量表中他人贬低维度评分27.85±8.41，自我负面感受维度评分25.25±7.77。BDI问卷评分11.59±7.84，其中无抑郁者占66.98%(71/106)、轻度抑郁占15.09%(16/106)、中度抑郁占13.21%(14/106)、重度抑郁占4.72%(5/106)。与向亲友坦白病情者相比，隐瞒病情者TSS量表中他人贬低维度(29.41±7.41 vs 25.07±9.06，t=2.425，P=0.017)和自我负面感受维度(27.26±6.92 vs 21.53±8.34，t=3.444，P<0.001)评分均显著升高(P<0.05)。在不同人口学特征(性别、年龄、婚姻状况、文化程度、居住地、经济收入、医保类型)和疾病特征(病程、是否初诊)方面，患者之间的TSS量表评分差异无统计学意义(P>0.05)。肺结核患者TSS量表中他人贬低维度(r=0.623，P<0.001)和自我负面感受维度(r=0.419，P<0.001)评分均与BDI评分呈显著正相关。结论：肺结核患者存在病耻感的程度较高，向亲友隐瞒病情的患者往往存在更强烈的病耻感，其病耻感与抑郁的发生或加重相关，临床上应加强对肺结核患者病耻感的干预。
关键词：
肺结核；病耻感；抑郁
Correlation of stigma and depression in patients with pulmonary tuberculosis
CorrespondingAuthor: CHEN Jinsu Email: 3352584393@qq.com
DOI: 10.3978/j.issn.2095-6959.2018.04.021
Foundation: This work was supported by the Medical and Health Scientific Research Project Foundation form Nanjing Military Region, China (10MA113).
Abstract
Objective: To investigate the stigma in patients with pulmonary tuberculosis, the influencing factors of stigma, and its correlation with depression. Methods: The demographic and disease characteristics, stigma and depression status of 106 cases of pulmonary tuberculosis in our hospital during the period from January 2017 to September were investigated using self-made general information questionnaire, tuberculosis-related stigma scale (TSS), and Beck depression inventory (BDI). The factors affecting the stigma of patients with lung tuberculosis and its correlation with depression were analyzed. Results: There were 61 males and 45 females, with an age of 20–68 (41.08±10.72) years old. In the TSS scale, the score of community perspectives towards TB stigma was 27.85±8.41, and the score of patient perspectives towards TB stigma was 25.25±7.77. The BDI questionnaire score was 11.59±7.84, with no depression in 66.98% (71/106), mild depression in 15.09% (16/106), moderate depression in 13.21% (14/106), and severe depression in 4.72% (5/106). Compared with those who disclosed their illness to others, the score of community (29.41±7.41 vs 25.07±9.06, t=2.425, P=0.017) and patient (27.26±6.92 vs 21.53±8.34, t=3.444, P<0.001) perspectives towards TB stigma in those who did not disclose their illness to others were significantly increased (P<0.05 or P<0.01). The TSS scores between patients with different demographic characteristics (gender, age, marital status, educational level, residence, income, health insurance type) and different disease characteristics (duration, whether newly diagnosed) showed no significant difference (P>0.05). The score of community (r=0.623, P<0.001) and patient (r=0.419, P<0.001) perspectives towards TB stigma were positively correlated with BDI scores in patients with pulmonary tuberculosis. Conclusion: Patients with pulmonary tuberculosis have serious disease-related stigma. Those who did not disclose their illness to others were more likely to have more serious stigma. The stigma of patients with pulmonary tuberculosis associated with the occurrence or progress of depression. We should strengthen the intervention on pulmonary tuberculosis-related stigma.
Keywords：
pulmonary tuberculosis; stigma; depression