• 廣州中山大學(xué)附屬第一醫(yī)院呼吸內(nèi)科(廣東廣州 510080);

目的 對(duì)支氣管哮喘(簡(jiǎn)稱哮喘)患者按全球哮喘防治創(chuàng)議(GINA)進(jìn)行健康教育指導(dǎo)下的規(guī)范治療,對(duì)治療前后的抑郁情緒發(fā)生情況、哮喘控制測(cè)試(ACT)得分及生存質(zhì)量進(jìn)行調(diào)查分析。方法 對(duì)入選調(diào)查的59例門診哮喘患者要求同時(shí)填寫CES-D量表、ACT量表和生存質(zhì)量量表,在健康教育指導(dǎo)下規(guī)范治療后復(fù)診并再次填寫上述量表,對(duì)前后兩次所得量表的數(shù)據(jù)以CES-D得分按有否抑郁情緒排序進(jìn)行統(tǒng)計(jì)學(xué)處理。結(jié)果 ⑴有抑郁情緒的哮喘患者規(guī)范治療前占40.7%(24/59),經(jīng)規(guī)范治療后降低為13.6%(8/59),配對(duì)χ2檢驗(yàn)顯示差異有統(tǒng)計(jì)學(xué)意義(P=0.00)。⑵有無(wú)抑郁情緒兩組組間比較可見(jiàn),規(guī)范治療前生存質(zhì)量及其5個(gè)構(gòu)成因素中,除活動(dòng)受限和對(duì)自身健康的關(guān)心外的3個(gè)因素差異均有統(tǒng)計(jì)學(xué)意義(P amp;lt;0.05),規(guī)范治療后生存質(zhì)量及其5個(gè)構(gòu)成因素中除活動(dòng)受限和心理因素外的3個(gè)因素差異均有統(tǒng)計(jì)學(xué)意義(P amp;lt;0.05)。ACT得分規(guī)范治療前組間比較未見(jiàn)明顯差異(P gt;0.05),規(guī)范治療后組間比較差異有統(tǒng)計(jì)學(xué)意義(P amp;lt;0.05)。⑶相關(guān)分析顯示,規(guī)范治療前哮喘患者的抑郁情緒與生存質(zhì)量及構(gòu)成生存質(zhì)量5因素中的哮喘癥狀、心理狀況和對(duì)刺激原的反應(yīng)呈明顯的負(fù)相關(guān)(P amp;lt;0.05),與ACT得分及構(gòu)成生存質(zhì)量其他2個(gè)因素則未見(jiàn)明顯相關(guān)(P gt;0.05),規(guī)范治療后生存質(zhì)量及其5個(gè)構(gòu)成因素中除活動(dòng)受限和心理因素外的3個(gè)因素皆呈顯著差異(P amp;lt;0.05),且與ACT也呈明顯的負(fù)相關(guān)(P amp;lt;0.05)。結(jié)論 哮喘癥狀和對(duì)刺激原的反應(yīng)是影響哮喘人群抑郁情緒最具共性的因素,心理因素和對(duì)自身健康的關(guān)心也影響哮喘人群抑郁情緒值得引起重視;健康教育對(duì)哮喘患者配合規(guī)范治療、控制癥狀和減輕抑郁情緒至關(guān)重要。

引用本文: 李志平,鐘韻,郭禹標(biāo),彭麗紅,黃旭斌,黃建強(qiáng),謝燦茂. 支氣管哮喘患者健康教育指導(dǎo)下規(guī)范治療前后抑郁情緒、哮喘控制及生存質(zhì)量的調(diào)查. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2007, 6(2): 101-104. doi: 復(fù)制

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  1. 1. Ettinger A,Reed M,Cramer J.Depression and comorbidity in community-based patients with epilepsy or asthma.Neurology,2004,63:1008-1014.
  2. 2. 張嵐,徐大華.哮喘患者的情緒障礙調(diào)查.中國(guó)臨床心理學(xué)雜志,2001:9:135-136.
  3. 3. National Institutes of Health,National Heart Lung and Blood Institute.Global Strategy for Asthma Management and Prevention.NIH Publication No 02-3659 Issued January,1995 (updated 2004).
  4. 4. Radloff LS.The CES-D scale:A self-report depression scale for research in the general population.Appl Psychol Meas,1977,1:385-401.
  5. 5. Nathan RA,Schatz M,Kosinski M,et al.Performance of the Asthma Control TestTM (ACT) in adolescent patients with asthma.J Allergy Clin Immunol,2005,115:S146.
  6. 6. 李凡,蔡映云,王蓓玲,等.5分制成人哮喘生存質(zhì)量評(píng)分表的檢驗(yàn).現(xiàn)代康復(fù),2001,5:7-9.
  7. 7. 李連弟,蔡映云,王曉燕,等.哮喘患者的焦慮抑郁情緒調(diào)查.中國(guó)行為醫(yī)學(xué)科學(xué),1998,7:205,178.