本文選題：HIV陰性檢測 + 健康焦慮�。� 參考：《大連醫(yī)科大學》2013年碩士論文

【摘要】：目的：考察艾滋病自愿檢測（HIV Voluntary Counseling and Testing，VCT）門診中HIV檢測結(jié)果為陰性的人群健康與疾病相關(guān)網(wǎng)絡使用情況、健康焦慮、軀體癥狀以及抑郁水平與社區(qū)人群、門診患者之間的差異，探索互聯(lián)網(wǎng)使用對HIV陰性檢測人群健康焦慮的影響，并對其相關(guān)影響因素的作用方式和途徑進行初步探討。 方法：1、對象：有效被試620人，其中HIV陰性檢測者157人，門診對照組157人，社區(qū)對照組306人，年齡在15~60歲。2、問卷：采用一般情況表、健康相關(guān)網(wǎng)絡搜索行為調(diào)查表、易感性心理因素調(diào)查表、健康焦慮問卷（HAQ）、病人健康問卷軀體癥狀量表（PHQ-15）、病人健康問卷抑郁量表（PHQ-9）、健康相關(guān)網(wǎng)絡使用問卷（HIUQ）分別對社區(qū)組、門診組和HIV陰性檢測組人群進行調(diào)查，各量表的得分分組比較采用F檢驗、兩因素方差分析、采用分層回歸分析和檢驗健康焦慮和抑郁的影響因素；應用路徑分析驗證網(wǎng)絡使用對健康焦慮的中介作用模型。 結(jié)果：1、三組人群健康相關(guān)網(wǎng)絡使用情況不同，社區(qū)組中使用網(wǎng)絡的人數(shù)所占 比例最高84.0%（257人）；門診對照組中在網(wǎng)上搜索健康信息的人數(shù)所占比例最高73.9%（116人）；使用即時通訊工具如論壇、QQ群等交流健康與疾病相關(guān)信者中HIV陰性檢測組的比例最高45.9%（45人）。 2、HIV陰性檢測組與社區(qū)、門診對照組人群在軀體癥狀、健康焦慮、抑郁得分上差異顯著HIV陰性檢測組的軀體癥狀得分顯著高于社區(qū)組(P0.01)，但與門診組差異不顯著（P0.05）；在健康焦慮及抑郁得分上均顯著高于社區(qū)和門診組。 3、網(wǎng)絡使用對健康焦慮的主效應顯著F（2，377）=15.13， p0.01，隨著網(wǎng)絡使用頻率的增多，健康焦慮水平呈上升的趨勢；易感性對健康焦慮的主效應顯著，F(xiàn)（2，377）=8.34，p0.01；易感性與網(wǎng)絡使用的交互作用顯著，說明網(wǎng)絡使用因素對不同易感性人群的影響不同，易感性高的個體頻繁進行健康或疾病相關(guān)的網(wǎng)絡搜索時更容易產(chǎn)生健康焦慮，而網(wǎng)絡作用對低易感性個體的健康焦慮影響不明顯；性別與網(wǎng)絡使用的交互作用顯著。 4、采用Pearson相關(guān)分析，軀體癥狀、健康焦慮抑郁均與網(wǎng)絡使用頻率存在著顯著的正相關(guān)（p0.01）。其中健康焦慮、抑郁、軀體癥狀與網(wǎng)絡使用頻率的相關(guān)系數(shù)分別為0.36、0.25、0.15，健康焦慮與網(wǎng)絡使用的關(guān)系最為密切，此外，健康焦慮與抑郁、軀體癥狀之間也存在著較強的相關(guān)性，相關(guān)系數(shù)分別為0.66、0.54、0.64。 5、對健康焦慮的影響因素進行多元分層回歸分析，結(jié)果顯示基本情況中性別對健康焦慮的預測作用顯著，組別和易感性作為原因變量對預測健康焦慮的作用顯著，做出了新的貢獻，解釋力增加了31%，網(wǎng)絡使用對健康焦慮的預測作用顯著解釋力增加了5.1%。 6、通過路徑分析看出：從易感性出發(fā)指向健康焦慮和網(wǎng)絡使用的路徑系數(shù)分別為0.38和0.28，均達到了顯著性水平，從易感性指向軀體癥狀、抑郁的路徑系數(shù)沒有達到了顯著性水平；從健康焦慮出發(fā)指向軀體癥狀、抑郁的路徑系數(shù)分別為0.48和0.55，達到了顯著性水平。 結(jié)論： 1、 HIV陰性檢測者使用互聯(lián)網(wǎng)交流健康或疾病信息的比例高于對照組。 2、HIV陰性檢測者的軀體癥狀水平與門診組相近；健康焦慮抑郁水平顯著高于門診和社區(qū)對照組。 3、易感性個體隨著健康相關(guān)網(wǎng)絡使用的頻率增加容易產(chǎn)生健康焦慮，，而對于非易感性個體網(wǎng)絡使用對健康焦慮的影響不明顯。 4、易感性心理因素是健康焦慮的主要的預測因素，網(wǎng)絡使用是易感性因素預測健康焦慮的重要中介因素。即網(wǎng)絡使用激發(fā)了個體潛隱的易感性素質(zhì)導致焦慮的發(fā)生。 5、本次“陰性艾滋病”事件的爆發(fā)，可能就是在網(wǎng)絡的影響作用下，高易感性個體間HIV相關(guān)健康焦慮的傳播與強化。
[Abstract]:Objective: To investigate the health and disease related network use, health anxiety, somatomatic symptoms and depression levels between the community population and outpatients in the HIV Voluntary Counseling and Testing (VCT) outpatient clinic, which are negative for HIV detection results, and explore the health of the Internet using HIV negative detection population health. The influence of anxiety and the ways and means of influencing factors are discussed.
Methods: 1 subjects: 620 effective subjects, including 157 HIV negative test, 157 outpatient control group, 306 community control group and 15~60 year old.2, questionnaire: health related network search behavior questionnaire, susceptibility psychological factor questionnaire, health anxiety questionnaire (HAQ), patient health questionnaire somatic symptom scale (PH) Q-15), the patient health questionnaire Depression Scale (PHQ-9), the health related network use questionnaire (HIUQ) was used to investigate the community group, the outpatient group and the HIV negative test group. The scores of each scale were compared with the F test, two factor variance analysis, and the stratified regression analysis and test of the influencing factors of health anxiety and depression; the application path was used. The mediating effect of Internet use on health anxiety was analyzed and verified.
Results: 1, three groups of people had different health related network usage.
The highest percentage was 84% (257); the proportion of people searching for health information on the Internet in the outpatient control group was the highest (116), and the ratio of HIV negative test groups such as instant messaging tools such as forum, QQ group and other communication health and disease related believers was the highest (45).
2, there were significant differences in somatic symptoms, health anxiety and depression scores between the HIV negative test group and the community and the outpatient control group. The scores of somatic symptoms in the HIV negative test group were significantly higher than those in the community group (P0.01), but there was no significant difference between the out-patient group and the out-patient group (P0.05), and the scores in the health anxiety and depression were significantly higher than those in the community and the out-patient groups.
3, the main effect of network use on health anxiety is significant F (2377) =15.13, P0.01, with the increase of network use frequency, the level of health anxiety is rising, the main effect of susceptibility to health anxiety is significant, F (2377) =8.34, P0.01, and the interaction between susceptibility and network use is significant, indicating the factors of network use to different susceptibility people. The influence of the group is different. The individuals with high susceptibility to frequent health or disease related network search are more likely to produce health anxiety, and the effect of the network on the health anxiety of the low susceptibility individuals is not obvious, and the interaction between sex and network use is significant.
4, Pearson correlation analysis, somatic symptoms, health anxiety and depression have significant positive correlation with network use frequency (P0.01). The correlation coefficient of health anxiety, depression, somatic symptoms and network use frequency is 0.36,0.25,0.15, and the relationship between health anxiety and network use is most closely, in addition, health anxiety and depression, body There was also a strong correlation between body symptoms, and the correlation coefficients were 0.66,0.54,0.64.
5, multiple stratified regression analysis on the influencing factors of health anxiety was carried out. The results showed that gender was significant in predicting health anxiety in the basic situation. Group and susceptibility as the cause variable had significant effect on predicting health anxiety, made new contributions, the explanatory power increased by 31%, and the predictive effect of network use on health anxiety was significant. The explanatory power is increased by 5.1%.
6, through the path analysis, we can see that the path coefficients from the susceptibility to the health anxiety and the network use are 0.38 and 0.28 respectively, and all reach the significant level. From the susceptibility to somatic symptoms, the path coefficient of depression has not reached a significant level; from the health anxiety to the somatic symptoms, the path coefficient of depression is respectively 0.48 and 0.55, reaching a significant level.
Conclusion:
1, the proportion of HIV negative test users using Internet to communicate health or disease information is higher than that of the control group.
2, the level of somatic symptoms of HIV negative test group was similar to that of outpatient group, and the level of health anxiety and depression was significantly higher than that of outpatient and community control group.
3, susceptible individuals tend to generate health anxiety with increasing frequency of health related networks, while the use of non susceptible individuals is not significantly affected by health anxiety.
4, the psychological factors of susceptibility are the main predictors of health anxiety. Network use is an important intermediary factor for predicting health anxiety by susceptibility factors. That is, network use stimulates the individual latent susceptibility to anxiety.
5, the outbreak of the "negative AIDS" incident may be the transmission and enhancement of HIV related health anxiety among highly susceptible individuals under the influence of the Internet.

【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R512.91

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