【摘要】：背景相對于其他患者來說,心力衰竭患者更容易患抑郁。但是由于抑郁和心力衰竭這兩種疾病有些癥狀相似,診斷心力衰竭患者是否患抑郁比較困難。本研究旨在調查作為心力衰竭患者的首診醫(yī)生,全科醫(yī)生對心力衰竭患者抑郁狀況認知情況及其影響因素。方法此項橫斷面觀察性研究的研究對象為3 224例社區(qū)心力衰竭患者。使用醫(yī)院焦慮抑郁量表、PHQ-9抑郁癥篩查量表及PROMIS焦慮抑郁量表中的部分條目調查心力衰竭患者的抑郁狀況并對結果進行評估計算。對為這些患者接診的272例全科醫(yī)生就患者的軀體和心理共病情況進行了電話采訪。使用描述性統(tǒng)計方法分析全科醫(yī)生對患者的抑郁狀況認知情況。使用Logistic回歸分析影響全科醫(yī)生對患者抑郁狀況認知情況的因素。結果全科醫(yī)生僅能診斷出35%的患者患有抑郁。影響其對心力衰竭患者抑郁狀況認知情況的因素有:患者文化水平較高,全科醫(yī)生了解到患者曾患有抑郁,調查前6個月內患者因為情感壓力就診,調查前6個月內患者多次聯(lián)系全科醫(yī)生,經(jīng)紐約心臟病協(xié)會(NYHA)分級標準評估的重度心力衰竭,以及較為嚴重的抑郁癥狀。全科醫(yī)生是否學過心理學或精神病學與其對心力衰竭患者抑郁狀況的認知情況無關。結論研究表明,全科醫(yī)生對心力衰竭患者的抑郁狀況的認知水平較低。其受到多種因素的影響,包括對認知的定義以及社區(qū)臨床實踐情況。鼓勵患者談其情感壓力,花足夠的時間去診療患者,包括了解其抑郁病史,以及特別用心診療文化水平低的患者均可以提升全科醫(yī)生對心力衰竭患者抑郁狀況的認知水平。然而,相對于精神病學診斷標準,全科醫(yī)生診斷出心力衰竭患者患有抑郁對患者預后及其生活質量的影響有待于進一步調查。
[Abstract]:Background patients with heart failure are more likely to suffer from depression than other patients. However, because depression and heart failure have similar symptoms, it is difficult to diagnose depression in patients with heart failure. The purpose of this study was to investigate the cognition and influencing factors of depression in patients with heart failure. Methods A total of 3 224 patients with community heart failure were enrolled in this cross-section observational study. The depression status of patients with heart failure was investigated by using some items of hospital anxiety and depression scale, PHQ-9 depression screening scale and PROMIS anxiety and depression scale, and the results were evaluated and calculated. 272 general practitioners receiving these patients were interviewed by telephone about the physical and psychological co-illness of the patients. Descriptive statistical methods were used to analyze the cognition of general practitioners on depression. Logistic regression analysis was used to analyze the factors influencing the cognition of general practitioners on depression. Results only 35% of the patients were diagnosed as depression by general practitioners. The factors affecting their cognition of depression in patients with heart failure were as follows: the patients had a high level of education, the general practitioner learned that the patients had suffered from depression, and the patients were treated due to emotional stress within six months of the survey. During the first six months of the survey, the patients contacted the general practitioner several times and were assessed by the New York Heart Association (NYHA) rating criteria for severe heart failure, as well as more severe depressive symptoms. Whether a general practitioner has studied psychology or psychiatry has nothing to do with his cognition of depression in patients with heart failure. Conclusion General practitioners' cognition of depression in patients with heart failure is low. It is affected by many factors, including the definition of cognition and community clinical practice. Encouraging patients to talk about their emotional stress and spending enough time to treat and treat patients, including understanding their history of depression, as well as paying special attention to the diagnosis and treatment of patients with low educational level, can improve the general practitioners' awareness of depression in patients with heart failure. However, compared with the diagnostic criteria of psychiatry, the effect of depression on the prognosis and quality of life of patients with heart failure diagnosed by general practitioners needs to be further investigated.
【分類號】：R541.6
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本文編號：2496816