發(fā)布時間：2018-03-22 00:22

  本文選題：艾滋病　切入點：VCT　出處：《中國疾病預(yù)防控制中心》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：研究背景 心理問題與HIV/AIDS存在相互關(guān)系,前者可導(dǎo)致高危行為,病毒和機會性感染會損害中樞神經(jīng)系統(tǒng),感染本身、抗病毒治療負(fù)作用、社會歧視和侮辱又可引起心理問題。因此,為易感者和HIV感染者/患者(People Living with HIV/AIDS,PLWHA)提供心理干預(yù)是預(yù)防高危行為,防止HIV傳播的重要措施之一。艾滋病自愿咨詢檢測(Voluntary Counselling and Testing, VCT)門診是發(fā)現(xiàn)易感人群和PLWHA的有效途徑,也是求診者得到心理干預(yù)的重要場所,只有充分了解VCT門診求診者心理狀況,才能制定相應(yīng)政策和提供有針對性的心理干預(yù)服務(wù)。 研究目的 了解北京市某疾控中心VCT門診求診者心理狀況,探討求診者心理健康的影響因素,為提高求診者心理健康水平,降低感染傳播HIV的風(fēng)險提供科學(xué)依據(jù)。 研究方法 本研究為橫斷面調(diào)查,研究對象為2012年9月2013年6月前來北京市某疾控中心VCT門診進行咨詢檢測的所有求診者。采用癥狀自評量表SCL-90、艾森克人格問卷(EPQ)和社會支持評定量表對所有求診者進行測評,測評采用匿名的方式,調(diào)查數(shù)據(jù)采用SPSS19.0和Excel軟件計算合并均數(shù)、標(biāo)準(zhǔn)差,進行方差分析、t檢驗、Dunnett-t檢驗、相關(guān)分析及多元Logistic回歸等統(tǒng)計學(xué)分析。 研究結(jié)果 2012年9月——2013年6月共調(diào)查VCT門診求診者173人,收到有效問卷161份。161名求診者中心理癥狀檢出率為45.34%,排在前三位的心理癥狀依次為強迫、焦慮、抑郁。心理癥狀陽性者近期心理癥狀較PLWHA、感染HIV高危人群、軀體疾病、神經(jīng)癥患者嚴(yán)重。本研究以SCL-90總分、各因子分作為衡量心理健康的指標(biāo),以SCL-90總分篩選陽性和各因子分篩查陽性為因變量探討影響心理健康的影響因素。心理癥狀主要的影響因素有神經(jīng)質(zhì)和客觀支持,以SCL-90總分篩選陽性作多元Logistic回歸分析顯示,影響求診者心理健康的因素是神經(jīng)質(zhì)(N)(OR=1.10,95%CI:1.06-1.13)和客觀支持(OR=0.86,95%CI:0.76-0.98),回歸方程的預(yù)測準(zhǔn)確率達72.7%,未發(fā)現(xiàn)艾滋病相關(guān)因素對求診者心理健康的影響。以SCL-90各因子篩查陽性為因變量作多元Logistic回歸分析發(fā)現(xiàn)神經(jīng)質(zhì)(N)進入了除敵對因子以外所有心理因子,其他影響因素還有精神質(zhì)(P)、內(nèi)外向(E)、客觀支持。各因子回歸方程的預(yù)測準(zhǔn)確率在70.2%-93.8%之間。 研究結(jié)論 VCT門診求診者心理健康水平低于全國常模,存在不同程度的心理問題,強迫、焦慮、抑郁癥狀出現(xiàn)較多。尤其是心理癥狀篩選陽性的求診者存在明顯的不良情緒,其近期心理癥狀較PLWHA、HIV高危人群、神經(jīng)癥和其他軀體疾病嚴(yán)重。面臨有可能感染HIV時,具有神經(jīng)質(zhì)傾向的求診者容易出現(xiàn)心理問題,而社會支持有助于減少心理癥狀。急需提高VCT門診工作人員對求診者心理癥狀的認(rèn)識和心理干預(yù)能力,開展良好的轉(zhuǎn)介服務(wù),使心理癥狀嚴(yán)重者能得到專業(yè)的咨詢和治療。
[Abstract]:Research background. Psychological problems are related to HIV/AIDS, the former can lead to high-risk behavior, viral and opportunistic infections can damage the central nervous system, infection itself, antiviral treatment negative effects, social discrimination and stigma can cause psychological problems. Providing psychological intervention for people Living with HIV / AIDS / HIV / AIDS PLWHA is one of the important measures to prevent high risk behaviors and prevent the spread of HIV. Voluntary Counselling and testing (VCT) clinic is an effective way to find the susceptible population and PLWHA. It is also an important place for patients to get psychological intervention. Only by fully understanding the psychological condition of VCT outpatients can we formulate corresponding policies and provide targeted psychological intervention services. Research purpose. To understand the psychological status of the patients in VCT outpatient clinic of a disease control center in Beijing, and to explore the influencing factors of their mental health, to provide scientific basis for improving the mental health level of the patients and reducing the risk of infection and transmission of HIV. Research method. This study is a cross-sectional survey. The subjects of the study were all the patients who came to the VCT clinic of a Beijing CDC for counseling and testing before September 2012. SCL-90, Eysenck Personality questionnaire (Eysenck Personality questionnaire) and Social support rating scale were used to evaluate all the patients. SPSS19.0 and Excel software were used to calculate the combined mean and standard deviation, and the analysis of variance (ANOVA) was performed by Dunnett-t test, correlation analysis and multivariate Logistic regression. Research results. From September 2012 to June 2013, a total of 173 VCT outpatients were investigated, and the positive rate of psychological symptoms was 45.34. The first three psychological symptoms were obsessive-compulsion and anxiety. Depression. Patients with positive psychological symptoms have more recent psychological symptoms than PLWHA. patients with high risk of HIV infection, somatic disease and neurosis are more serious. In this study, the total score of SCL-90 and the scores of each factor were taken as indicators of mental health. The influencing factors of mental health were investigated by using SCL-90 total score screening positive and factor score screening positive as dependent variables. The main influencing factors of psychological symptoms were neuroticism and objective support. Multiple Logistic regression analysis showed that SCL-90 total score screening positive was used as multivariate Logistic regression analysis. The factors affecting the mental health of the patients were neurotic 1.1095 CI: 1.06-1.13) and objective support: 0.866% CI: 0.76-0.98. The predictive accuracy of regression equation was 72.7. No influence of AIDS-related factors on the mental health of the patients was found. The positive screening of SCL-90 factors was taken as a dependent variable. Multiple Logistic regression analysis showed that neurotic N) entered all psychological factors except hostile factors. Other influencing factors were psychoticism, introversion and extroversion, objective support. The prediction accuracy of regression equation was 70.2% -93.8%. Research conclusion. The mental health level of VCT outpatients was lower than the national norm, and there were many psychological problems, compulsion, anxiety and depression. Its recent psychological symptoms are more serious than those of PLWHA high risk group, neurosis and other somatic diseases. When it is possible to be infected with HIV, patients with neuroticism tend to have psychological problems. The social support is helpful to reduce psychological symptoms. It is urgent to improve the cognition and psychological intervention ability of VCT outpatient staff to develop good referral service so that the patients with severe psychological symptoms can get professional counseling and treatment.
【學(xué)位授予單位】：中國疾病預(yù)防控制中心
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R512.91

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