地震后北川羌族地区髋膝骨关节炎患者的心理问卷调查
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摘要
目的了解地震后北川羌族地区髋膝骨关节炎(OA)患者心理健康状况。方法采用焦虑自评量表(SAS)、抑郁自评量表(SDS)及创伤后应激障碍(PTSD)诊断标准对北川羌族地区197例髋膝OA患者及213名无髋膝OA的对照人群进行心理问卷调查;采用健康调查问卷(SF-36)及西安大略和麦克马斯特大学(WOMAC)OA指数对197例髋膝OA患者进行调查。对所有调查结果进行统计学分析。结果 OA组和对照组SDS总标准分比较差异有统计学意义(t=4.214,P=0.044);OA组和对照组SAS总标准分比较差异有统计学意义(t=4.302,P=0.042)。SAS总标准分超过临界分的人数百分比:OA组为30例,占15.2%,对照组为8例,占3.8%,差异有统计学意义(χ2=16.019,P<0.05)。SDS总标准分超过临界分的人数百分比:OA组为85例,占43.2%,对照组为28例,占13.1%,差异有统计学意义(χ2=46.141,P<0.05)。197例OA患者有心理疾病者92例(46.7%),其中焦虑者30例(15.2%),抑郁者85例(43.1%),PTSD患者59例(29.9%);213名对照组有心理疾病48例(22.5%),其中焦虑者8例(3.8%),抑郁者28例(13.1%),PTSD患者33例(15.5%)。OA组有心理疾病者SF-36中躯体疼痛、情感职能及精神健康3个维度的平均得分明显低于无心理疾病者,且差异有统计学意义(P<0.05)。OA组有心理疾病者WOMACOA指数中疼痛及功能活动得分高于无心理疾病者(P<0.05)。结论地震后北川羌族地区髋膝OA患者具有较高的心理问题,较低的生活质量,并且OA患者有心理疾病者关节疼痛更明显。
Objective To investigate psychological health status of osteoarthritis (OA) patients in Beichuan country after earthquake. Methods One hundred and ninty-seven patients with OA and 213 health controls were enrolled and received psychological investigation. Zung′s self-rating anxiety scale(SAS), self-rating depression scale(SDS) and PTSD were recorded to assess the effects on paients with OA and health controls after the earthquake. Patients with OA were evaluated with the WOMAC and the 36-question scale health survey questionnaire. Results SDS and SAS total scores of OA patients were statistically different from that of the controls(t=4.214, 4.302, P=0.044, 0.042). SAS total number of points over critical norm percentage of OA patients was 15.2%, health controls was 3.8%. SDS total number of points over critical norm percentage of OA patients was 43.2%, health controls was 13.1%. There were 92 OA patients with mental diseases, in whom 30 had anxiety, 85 had depression, 59 patients were with PTSD. There were significant difference between OA patients with and without mental diseases in body pain, emotion and mental health. In OA patients, scores of pain and physical function with mental diseases were higher than that of OA patients without mental diseases. Conclusion More OA patients have depression, anxiety and PTSD than health controls in Beichuan Qiang area after the earthquake, and in whom scores of pain intensity are higher.
Objective To investigate psychological health status of osteoarthritis (OA) patients in Beichuan country after earthquake. Methods One hundred and ninty-seven patients with OA and 213 health controls were enrolled and received psychological investigation. Zung′s self-rating anxiety scale(SAS), self-rating depression scale(SDS) and PTSD were recorded to assess the effects on paients with OA and health controls after the earthquake. Patients with OA were evaluated with the WOMAC and the 36-question scale health survey questionnaire. Results SDS and SAS total scores of OA patients were statistically different from that of the controls(t=4.214, 4.302, P=0.044, 0.042). SAS total number of points over critical norm percentage of OA patients was 15.2%, health controls was 3.8%. SDS total number of points over critical norm percentage of OA patients was 43.2%, health controls was 13.1%. There were 92 OA patients with mental diseases, in whom 30 had anxiety, 85 had depression, 59 patients were with PTSD. There were significant difference between OA patients with and without mental diseases in body pain, emotion and mental health. In OA patients, scores of pain and physical function with mental diseases were higher than that of OA patients without mental diseases. Conclusion More OA patients have depression, anxiety and PTSD than health controls in Beichuan Qiang area after the earthquake, and in whom scores of pain intensity are higher.
引文
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[2]Ozcetin A,Ataoglu S,Kocer E,et al.Effects of depression and anxiety on quality of life of patients with rheumatoid arthritis,knee osteoarthritis and fibromyalgia syndrome.West Indian Med J,2007,56(2):122-129.
[3]Altanta RD.Criteria for classification of disease:osteoarthritis.J Rheumatol,1991,27:10.
[4]Bellamy N,Buchanan WW,Goldsmith CH,et al.Validation study of WOMAC:a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug thera-py in patients with osteoarthritis of the hip or the knee.J Rheumatol,1988,15(12):1833-1840.
[5]许军,胡敏燕,杨云滨,等.健康测量量表SF-36.中国行为医学科学,1999,8(2):150-152.
[6]中华医学会精神科分会.中国精神障碍分类与诊断标准(CCMD-3).3版.济南:山东科技出版社,2001:97-98.
[7]Keefe FJ,Somers TJ.Psychological approaches to understanding and treating arthritis pain.Nat Rev Rheumatol,2010,6(4):210-216.
[8]Somers TJ,Keefe FJ,Godiwala N,et al.Psychosocial factors and the pain experience of osteoarthritis patients:new findings and new directions.Curr Opin Rheumatol,2009,21(5):501-506.
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