社区老年人慢性疼痛现状及心理健康状况分析
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摘要
目的了解某社区老年人慢性疼痛的患病现状及其影响因素和心理健康状况,为医务工作者进行慢性疼痛相关的健康指导提供依据。方法于2017年1—6月随机抽取前来北京市西城区某社区就诊的317例老年人作为调查对象,进行问卷调查和体格检查。根据国际疼痛研究学会(IASP)定义的慢性疼痛诊断标准,将调查对象分为慢性疼痛组和非慢性疼痛组,比较两组间的影响因素差异,并分析慢性疼痛患者的患病现状及心理健康状况。结果老年人慢性疼痛患病率为44.2%,慢性疼痛组和非慢性疼痛组在性别、婚姻状况、居住情况、宗教信仰等方面差异具有统计学意义(P<0.05)。77.1%的慢性疼痛患者有心理障碍,94.3%的患者拒绝心理医生帮助。结论社区老年人慢性疼痛患病率高,疼痛影响因素多,心理健康状况不佳,医务工作者应当定期对老年人进行慢性疼痛相关的健康指导及心理疏导治疗。
Objective To investigate the current situation and its influencing factors,mental health condition of elderly people with chronic pain in community in Beijing and then provide basis for medical practitioners to conduct health guidance of chronic pain.Methods 317 people older than 60 years were investigated randomly by questionnaire and physical examination randomly form January to June,2017.According to diagnostic criteria of chronic pain defined by the international society for the study of pain(IASP),the elderly people were divided into chronic pain groups and non-chronic pain groups.The current situation,mental health conditions and the influencing factors between the groups were analyzed.Results In the community,the prevalence of chronic pain was 44.2%,The diffe-rences between chronic pain groups and non-chronic pain groups in gender,marital status,living condition,religious belief were not statistically significant(P<0.05).77.1% patients with chronic pain had psychological disorder and 94.3% of them refused to see psychiatrists.Conclusion In the community,the prevalence of chronic pain of elderly people is high,which has a lot of influencing factors.Mental health condition of elderly people with chronic pain is poor.Medical practitioners should provide the elderly with health guidance relating to chronic pain and psychological counseling regularly.
Objective To investigate the current situation and its influencing factors,mental health condition of elderly people with chronic pain in community in Beijing and then provide basis for medical practitioners to conduct health guidance of chronic pain.Methods 317 people older than 60 years were investigated randomly by questionnaire and physical examination randomly form January to June,2017.According to diagnostic criteria of chronic pain defined by the international society for the study of pain(IASP),the elderly people were divided into chronic pain groups and non-chronic pain groups.The current situation,mental health conditions and the influencing factors between the groups were analyzed.Results In the community,the prevalence of chronic pain was 44.2%,The diffe-rences between chronic pain groups and non-chronic pain groups in gender,marital status,living condition,religious belief were not statistically significant(P<0.05).77.1% patients with chronic pain had psychological disorder and 94.3% of them refused to see psychiatrists.Conclusion In the community,the prevalence of chronic pain of elderly people is high,which has a lot of influencing factors.Mental health condition of elderly people with chronic pain is poor.Medical practitioners should provide the elderly with health guidance relating to chronic pain and psychological counseling regularly.
引文
[1] 刘凌云,尹心红.老年人慢性疼痛自我管理的研究进展[J].中华现代护理杂志,2011,17(18):2222-2224.
[2] 刘玉红,刘玉春.高龄老年慢性疼痛病人自我管理状况分析[J].护理研究,2014,28(6):688-689.
[3] 董琼芬.老年患者慢性疼痛的观察及护理[J].医学信息(上旬刊),2011,24(1):89-90.
[4] Yi XB,李水清,于普林.老年人慢性疼痛治疗进展[J].中华老年医学杂志,2010,29(2):89-92.
[5] 赵阳,冯晨秋,娄凤兰.社区老年慢性疼痛患者心理健康状况及影响因素[J].中国疼痛医学杂志,2015,21(03):224-227.
[6] 魏爽,韩奇,郑拥军,等.上海市居民慢性疼痛患病现状调查[J].中国疼痛医学杂志,2015,21(6):417-421.
[7] 陈春明,孔灵芝.中国成人超重和肥胖症预防控制指南[M].北京:人民卫生出版社,2006.
[8] 陈国良.慢性疼痛患者情绪、生活质量及其干预效果研究[D].北京:中国人民解放军医学院,2013:89.
[9] 方芳.慢性疼痛的评价和护理现状[J].现代护理,2006,12(9):807-809.
[10] 于布为.2010中华医学会全国麻醉学术年会欢迎辞[A].2010中华医学会全国麻醉学术年会论文汇编[C].北京:中华医学会,2010:3.
[11] 杨敏.慢性疼痛患者疼痛特征及其与抑郁、焦虑情绪的关系[D].长沙:中南大学,2010.
[12] 周江华,邹川,董碧蓉.老年慢性持续性疼痛的管理[J].现代临床医学,2015(5):390-392,396.
[13] 黄娟,孙婷,黄子萍,等.桂西边远少数民族地区老年人慢性疼痛状况及自我管理分析[J].右江民族医学院学报,2016,38(2):214-215,219.
[14] 赵巍峰.慢性低背痛患者的生活质量、执行功能及其影响因素的研究[D].长沙:中南大学,2009.
[15] Gureje O,Von Korff M,Simon GE,et al.Persistent pain and well-being:a World Health Organization Study in Primary Care[J].JAMA,1998,280(2):147-151.
[16] 冯晨秋,王贞慧,高晖,等.老年人慢性疼痛现状及其影响因素的调查[J].解放军护理杂志,2012,29(12):9-11,35.
[17] 施华,马世龙,潘兰霞.慢性疼痛对老年人日常生活影响及应对方式调查[J].中医临床研究,2016,8(32):114-116.
[18] 郑天源,侯进才,卢锦玲,等.北京市朝阳区慢性疼痛疾病流行病学调查报告[J].中国疼痛医学杂志,2010,16(6):339-341.
[19] Coyle DE,Sehlhorst CS,Behbehani MM.Intact female rats are more susceptible to the development of tactile allodynia than ovariectomized female rats following partial sciatic nerve ligation(PSNL)[J].Neur Lett,1996,203(1):37-40.
[20] 税敏,彭丽桦,闵苏.871例门诊患者疼痛现状及其相关分析[J].重庆医学,2015,44(20):2812-2814.
[21] Dunnk KS,Horgas AL.Religious and nonreligious coping in older adults experiencing chronic pain.[J].Pain Manag Nur,2004,5(1):19-28.
[22] Ng KF,Tsui SL,Chan WS.Prevalence of common chronic pain in Hong Kong adults[J].Clin J Pain,2002,18(5):275-81.
[23] Wilson S,Chaloner N,Osborn M,et al.Ormed physiotherapy for chronic pain:patient experiences of treatment and therapeutic process[J].Physiotherapy,2017,103(1):98-105
[24] Aigner M,Bach M.Clinical utility of DSM-IV pain disorder[J].Compr Psychiatry,1999,40(5):353-357.
[25] 吴爱勤.导言:慢性疼痛与心身障碍的探讨[J].医学与哲学(B),2014(12):8.
[26] Jensen MP,Ehde DM,Hoffman AJ,et al.Cognitions,coping and social environment predict adjustment to phantom limb pain[J].Pain,2002,95(1-2):133-142.
[27] 梁颖.慢性疼痛患者自我管理的应用概况[J].中外医疗,2015(9):20-22.
[28] 祁俊菊,王仙园,杜秋华,等.对慢性腰背痛患者实施心理干预的效果研究[J].中国康复医学杂志,2013,28(9):855-858. (收稿日期 2018-03-12)(本文编辑熊月琳)
[2] 刘玉红,刘玉春.高龄老年慢性疼痛病人自我管理状况分析[J].护理研究,2014,28(6):688-689.
[3] 董琼芬.老年患者慢性疼痛的观察及护理[J].医学信息(上旬刊),2011,24(1):89-90.
[4] Yi XB,李水清,于普林.老年人慢性疼痛治疗进展[J].中华老年医学杂志,2010,29(2):89-92.
[5] 赵阳,冯晨秋,娄凤兰.社区老年慢性疼痛患者心理健康状况及影响因素[J].中国疼痛医学杂志,2015,21(03):224-227.
[6] 魏爽,韩奇,郑拥军,等.上海市居民慢性疼痛患病现状调查[J].中国疼痛医学杂志,2015,21(6):417-421.
[7] 陈春明,孔灵芝.中国成人超重和肥胖症预防控制指南[M].北京:人民卫生出版社,2006.
[8] 陈国良.慢性疼痛患者情绪、生活质量及其干预效果研究[D].北京:中国人民解放军医学院,2013:89.
[9] 方芳.慢性疼痛的评价和护理现状[J].现代护理,2006,12(9):807-809.
[10] 于布为.2010中华医学会全国麻醉学术年会欢迎辞[A].2010中华医学会全国麻醉学术年会论文汇编[C].北京:中华医学会,2010:3.
[11] 杨敏.慢性疼痛患者疼痛特征及其与抑郁、焦虑情绪的关系[D].长沙:中南大学,2010.
[12] 周江华,邹川,董碧蓉.老年慢性持续性疼痛的管理[J].现代临床医学,2015(5):390-392,396.
[13] 黄娟,孙婷,黄子萍,等.桂西边远少数民族地区老年人慢性疼痛状况及自我管理分析[J].右江民族医学院学报,2016,38(2):214-215,219.
[14] 赵巍峰.慢性低背痛患者的生活质量、执行功能及其影响因素的研究[D].长沙:中南大学,2009.
[15] Gureje O,Von Korff M,Simon GE,et al.Persistent pain and well-being:a World Health Organization Study in Primary Care[J].JAMA,1998,280(2):147-151.
[16] 冯晨秋,王贞慧,高晖,等.老年人慢性疼痛现状及其影响因素的调查[J].解放军护理杂志,2012,29(12):9-11,35.
[17] 施华,马世龙,潘兰霞.慢性疼痛对老年人日常生活影响及应对方式调查[J].中医临床研究,2016,8(32):114-116.
[18] 郑天源,侯进才,卢锦玲,等.北京市朝阳区慢性疼痛疾病流行病学调查报告[J].中国疼痛医学杂志,2010,16(6):339-341.
[19] Coyle DE,Sehlhorst CS,Behbehani MM.Intact female rats are more susceptible to the development of tactile allodynia than ovariectomized female rats following partial sciatic nerve ligation(PSNL)[J].Neur Lett,1996,203(1):37-40.
[20] 税敏,彭丽桦,闵苏.871例门诊患者疼痛现状及其相关分析[J].重庆医学,2015,44(20):2812-2814.
[21] Dunnk KS,Horgas AL.Religious and nonreligious coping in older adults experiencing chronic pain.[J].Pain Manag Nur,2004,5(1):19-28.
[22] Ng KF,Tsui SL,Chan WS.Prevalence of common chronic pain in Hong Kong adults[J].Clin J Pain,2002,18(5):275-81.
[23] Wilson S,Chaloner N,Osborn M,et al.Ormed physiotherapy for chronic pain:patient experiences of treatment and therapeutic process[J].Physiotherapy,2017,103(1):98-105
[24] Aigner M,Bach M.Clinical utility of DSM-IV pain disorder[J].Compr Psychiatry,1999,40(5):353-357.
[25] 吴爱勤.导言:慢性疼痛与心身障碍的探讨[J].医学与哲学(B),2014(12):8.
[26] Jensen MP,Ehde DM,Hoffman AJ,et al.Cognitions,coping and social environment predict adjustment to phantom limb pain[J].Pain,2002,95(1-2):133-142.
[27] 梁颖.慢性疼痛患者自我管理的应用概况[J].中外医疗,2015(9):20-22.
[28] 祁俊菊,王仙园,杜秋华,等.对慢性腰背痛患者实施心理干预的效果研究[J].中国康复医学杂志,2013,28(9):855-858. (收稿日期 2018-03-12)(本文编辑熊月琳)
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