【摘要】：目的：調查濟南市3個區(qū)圍絕經(jīng)期女性的心理困擾狀況；研究圍絕經(jīng)期癥狀、心理彈性及社會支持與圍絕經(jīng)期心理困擾的關系；進一步探討圍絕經(jīng)期癥狀與心理彈性、社會支持的交互作用對圍絕經(jīng)期女性心理困擾影響,為提高該群體的心理健康水平提供理論依據(jù)。方法：2014年3月至2015年3月,采用方便抽樣法選取676名圍絕經(jīng)期女性進行問卷調查。采用一般資料問卷、凱勒斯心理困擾量表(10-item Kessler Psychological Distress Scale, K10)、絕經(jīng)期評定量表(Menopause Rating Scale, MRS)、彈性量表簡化版(10-item Connor-Davidson Resilience Scale, CD-RISC10)以及領悟社會支持量表(Perceived Social Support Scale, PSSS)分別測量研究對象的一般人口學信息及月經(jīng)相關情況、心理困擾、圍絕經(jīng)期癥狀、心理彈性及社會支持水平。采用SPSS 17.0統(tǒng)計軟件對數(shù)據(jù)進行錄入和分析,統(tǒng)計分析主要包括：描述性分析、單因素分析、Binary logistic回歸分析、分層回歸分析。結果：1.圍絕經(jīng)期女性心理困擾、圍絕經(jīng)期癥狀、心理彈性與社會支持的得分情況圍絕經(jīng)期女性心理困擾的得分范圍為10-40,平均得分(20.44±5.78)。按照K1022分的劃界標準,其中有41.3%的圍絕經(jīng)期女性報告了中重度的心理困擾；圍絕經(jīng)期癥狀的得分范圍為0-28,平均得分(10.06±5.80),其中各分維度得分由高到低依次為：心理癥狀(4.07±2.66)、軀體癥狀(4.07±2.47)、泌尿生殖道癥狀(1.92±1.93)；心理彈性的得分范圍為1-40,平均得分(25.05±7.32)；社會支持的得分范圍為23～84,平均得分(59.05±12.07)。2.圍絕經(jīng)期女性心理困擾差異的單因素分析將圍絕經(jīng)期女性劃分為無心理困擾組(K1022分)與心理困擾組(K10≥22分)后進行單因素分析。結果顯示,心理困擾組在無日常鍛煉、患有慢性病、初潮年齡(≥16歲)與月經(jīng)量減少上女性所占比例高于無心理困擾組(χ2=25.65,χ2=15.12,,=7.75與χ2=17.06,均P0.05)；兩組在圍絕經(jīng)期癥狀、心理彈性及社會支持得分上存在顯著差異,心理困擾組在圍絕經(jīng)期癥狀得分上高于無心理困擾組(t-15.17,P0.001),而在心理彈性與社會支持得分上低于無心理困擾組(t=8.66與t=8.92,均P0.001)。3.圍絕經(jīng)期女性心理困擾影響因素的Logistic回歸分析以有無心理困擾作為因變量,以單因素分析中所有P0.05的變量為自變量進行Logistic回歸分析。結果顯示,圍絕經(jīng)期癥狀中的軀體癥狀、心理癥狀及泌尿生殖道癥狀與圍絕經(jīng)期心理困擾正相關,是其危險性因素(odds ratio(OR)=1.159,OR=1.425與OR=1.181,均P0.001)；心理彈性、社會支持與其心理困擾負相關,是其保護性因素(OR=0.965與OR=0.924,均P0.05)。4.圍絕經(jīng)期癥狀與心理彈性、社會支持的交互效應分析采用分層回歸分析方法,分別檢驗圍絕經(jīng)期癥狀×心理彈性、圍絕經(jīng)期癥狀×社會支持的交互效應。結果顯示,圍絕經(jīng)期癥狀與心理彈性對圍絕經(jīng)期心理困擾有顯著交互作用(戶-0.071,P0.05),方差凈解釋量達1%,而圍絕經(jīng)期癥狀與社會支持對心理困擾無交互作用(戶-0.025,P0.05)。結論：1.圍絕經(jīng)期女性存在較高的心理困擾水平,其發(fā)生率為41.3%。2.日常運動、慢性病、初潮年齡及月經(jīng)量與圍絕經(jīng)期心理困擾有關。3.圍絕經(jīng)期癥狀是圍絕經(jīng)期女性心理困擾發(fā)生的危險因素,社會支持、心理彈性是其心理困擾發(fā)生的保護因素。心理彈性緩沖了圍絕經(jīng)期癥狀對圍絕經(jīng)期心理困擾的不良影響。
[Abstract]:Objective: To investigate the psychological distress of perimenopausal women in 3 districts of Ji'nan, and to study the relationship between perimenopausal symptoms, mental resilience and social support and perimenopausal psychological distress, and further explore the effects of perimenopausal symptoms, psychological elasticity and social support on the psychological distress of women in the perimenopausal period, in order to improve the group. The psychological health level was provided with theoretical basis. Methods: from March 2014 to March 2015, 676 perimenopausal women were selected by the convenient sampling method. The general data questionnaire (10-item Kessler Psychological Distress Scale, K10), and the menopause Assessment Scale (Menopause Rating Scale, MRS) were used. The 10-item Connor-Davidson Resilience Scale (CD-RISC10) and the perceived social support scale (Perceived Social Support Scale, PSSS) measured the general demographic information and menstrual related information, psychological distress, peri menopause symptoms, psychosoelasticity and social support levels, using SPSS 17. The data were recorded and analyzed by the software. The statistical analysis mainly included descriptive analysis, single factor analysis, Binary logistic regression analysis, and stratified regression analysis. Results: 1. perimenopausal women's psychological distress, perimenopausal symptoms, psychological resilience and social support scores were 10 in perimenopausal women's psychological distress. -40, the average score was (20.44 + 5.78). According to the demarcation standard of the K1022 score, 41.3% of the perimenopausal women reported the moderate and severe psychological distress; the range of perimenopausal symptoms was 0-28 and the average score was (10.06 + 5.80), of which the scores from high to low were: psychological symptoms (4.07 + 2.66), physical symptoms (4.07 + 2.47), and secreting. The symptoms of urinary tract were (1.92 + 1.93), the score of mental resilience was 1-40, the average score was (25.05 + 7.32), the score of the social support was 23~84, the average score (59.05 + 12.07).2. in the peri menopausal women was divided into no psychological distress group (K1022) and psychological distress group (K10 The results showed that the psychological distress group had no daily exercise, with chronic disease, the age of the menarche (16 years old) and the decrease of menstrual volume were higher than that without psychological distress group (x 2=25.65, X 2=15.12, =7.75 and 2=17.06, P0.05); the two groups were in the scores of perimenopausal symptoms, psychosoelasticity and social support. There were significant differences. The scores of peri menopausal symptoms were higher than those without psychological distress (t-15.17, P0.001), while the scores of mental resilience and social support were lower than those without psychological distress (t=8.66 and t=8.92, P0.001) in.3. perimenopausal women's psychological distress. The regression analysis of the factors of psychological distress in the perimenopausal women had no psychological distress as a cause of change. Logistic regression analysis was performed on all P0.05 variables in single factor analysis. The results showed that the physical symptoms, psychological symptoms, and genitourinary symptoms in the perimenopausal symptoms were positively related to perimenopausal psychological distress, and were the risk factors (odds ratio (OR) =1.159, OR=1.425 and OR=1.181, all P0.001); psychosoelasticity, society. It will support the negative correlation with their psychological distress. It is a protective factor (OR=0.965 and OR=0.924, P0.05).4. perimenopausal symptoms and psychosoelasticity, and the interaction effect of social support is analyzed by stratified regression analysis. The interaction effects of perimenopausal symptoms, psychosoelasticity, menstrual symptoms and social support are examined respectively. Menopause symptoms and mental resilience have a significant interaction effect on perimenopausal psychological distress (-0.071, P0.05), the net explanation of variance is 1%, while perimenopausal symptoms and social support have no interaction with psychological distress (-0.025, P0.05). Conclusion: 1. perimenopausal women have a higher level of psychological distress, the incidence of which is 41.3%.2. daily transport. Dynamic, chronic disease, age of menarche, menarche and perimenopausal psychological distress related to the perimenopausal symptoms of.3. perimenopausal symptoms are the risk factors for perimenopausal women's psychological distress, social support and psychological elasticity are the protective factors for their psychological distress. The psychological resilience buffers the adverse effects of perimenopausal symptoms on perimenopausal psychological distress.
【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R473.71

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