【摘要】：目的:利用癥狀自評(píng)量表(Symptom checklist-90,SCL-90)對(duì)類(lèi)風(fēng)濕關(guān)節(jié)炎(Rheumatoid Arthritis,RA)患者的心理健康水平進(jìn)行測(cè)評(píng),并將其與全國(guó)常模進(jìn)行比較,再通過(guò)收集患者個(gè)人基本信息及健康狀況的相關(guān)資料,借以了解影響RA患者心理健康狀況的因素,以便有針對(duì)性地實(shí)施有效的心理干預(yù),提高臨床治療效果及患者生存質(zhì)量,減少致殘、致畸的發(fā)生,減輕家庭及社會(huì)負(fù)擔(dān)。方法:隨機(jī)選擇2015年6月1日~2016年10月31日期間新疆醫(yī)科大學(xué)第一附屬醫(yī)院風(fēng)濕免疫科住院及門(mén)診就診的類(lèi)風(fēng)濕關(guān)節(jié)炎(RA)患者為研究對(duì)象,嚴(yán)格按照事先規(guī)定的納入與排除標(biāo)準(zhǔn),最終將符合條件的100例RA患者納入研究,再采用癥狀自評(píng)量表(SCL-90)對(duì)RA患者的心理健康狀況進(jìn)行調(diào)查評(píng)定,并與全國(guó)常模比較。此外,收集RA患者個(gè)人基本情況資料及健康狀況的相關(guān)資料對(duì)可能影響心理健康狀態(tài)的因素展開(kāi)分析。結(jié)果:(1)RA患者心理健康狀態(tài)調(diào)查結(jié)果顯示,其SCL-90評(píng)分與常模比較,在軀體化、強(qiáng)迫癥狀、人際關(guān)系敏感因子、抑郁、焦慮、恐怖、總分上差異均有統(tǒng)計(jì)學(xué)意義(P0.05),且其SCL-90評(píng)分均高于常模;其次RA患者敵對(duì)、偏執(zhí)和精神病性上SCL-90評(píng)分與常模比較差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);(2)RA患者心理健康狀態(tài)影響因素分析結(jié)果顯示,在性別、年齡、居住地、文化程度、婚姻狀況、職業(yè)類(lèi)別、經(jīng)濟(jì)狀況、支付方式、社會(huì)支持度、病程、治療效果、疾病活動(dòng)度、關(guān)節(jié)功能狀態(tài)等這些方面,不同特征RA患者間SCL-90總分差異皆有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:(1)較之于正常人,RA患者心理健康水平普遍偏低。(2)性別、年齡、居住地、文化程度、婚姻狀況、職業(yè)類(lèi)別、經(jīng)濟(jì)狀況、支付方式、病程、治療效果、疾病活動(dòng)度、關(guān)節(jié)功能狀態(tài)均為影響RA患者心理健康水平的因素,具體而言,女性、農(nóng)村居民、已婚、病程較長(zhǎng)、經(jīng)濟(jì)狀況不理想、治療效果較差、關(guān)節(jié)功能狀態(tài)差、社會(huì)支持度偏低、農(nóng)民、支付方式為自費(fèi)的RA患者心理健康水平相對(duì)更低,此外,隨著患者年齡的增長(zhǎng)、關(guān)節(jié)疼痛加重、關(guān)節(jié)功能障礙的進(jìn)一步進(jìn)展以及長(zhǎng)期慢性病的折磨使RA患者心理健康水平下降。
[Abstract]:Objective: to evaluate the mental health of patients with rheumatoid arthritis (Rheumatoid Arthritis,RA) by symptom Checklist (Symptom checklist-90,SCL-90) and compare it with the national norm. In order to understand the factors influencing the mental health status of patients with RA, effective psychological intervention can be carried out in order to improve the effect of clinical treatment and the quality of life of patients with RA by collecting the basic information of patients and relevant information of their health status, so as to understand the factors that affect the mental health status of patients with RA. Reduce the incidence of disability, teratogenicity, and reduce the burden on families and society. Methods: patients with rheumatoid arthritis (RA) from June 1, 2015 to October 31, 2016 were randomly selected from the Department of Rheumatology and Immunology, the first affiliated Hospital of Xinjiang Medical University. According to the criteria of inclusion and exclusion, 100 patients with RA were included in the study. The mental health status of RA patients was investigated and evaluated by using symptom Checklist (SCL-90), and compared with the national norm. In addition, the factors that may affect mental health status were analyzed by collecting personal basic information and health status data of RA patients. Results: (1) the investigation of mental health status of RA patients showed that the SCL-90 scores were compared with the norm in somatization, obsessive compulsion, interpersonal sensitivity, depression, anxiety, phobia, depression, anxiety, anxiety, There were significant differences in total scores (P0.05), and their SCL-90 scores were higher than the norm. Secondly, there was no significant difference in SCL-90 score between RA patients and norm in hostility, paranoid ideation and psychosis (P0.05). (2) the factors influencing mental health status of RA patients were analyzed. The results showed that: sex, age, place of residence, education, marital status, occupation category, economic status, payment method, social support degree, course of disease, therapeutic effect; Disease activity, joint function and other aspects, different characteristics of RA patients with SCL-90 total score differences were statistically significant (P0.05). Conclusion: (1) the mental health level of RA patients is generally lower than that of normal persons. (2) gender, age, residence, education, marital status, occupation category, financial status, payment method, course of disease, therapeutic effect, and so on. Disease activity and joint function were the factors influencing the mental health of RA patients. In particular, female, rural residents, married, long course of disease, poor economic status, poor therapeutic effect, poor joint function, and so on. Social support is low, farmers, self-paid RA patients with a relatively low level of mental health, in addition, as patients age, joint pain aggravated, Further advances in joint dysfunction and chronic disease have reduced mental health in patients with RA.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R593.22

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