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目的探讨尘肺病患者抑郁状态自评及其影响因素,为制定该人群心理干预方案提供参考。方法采用SPS抽样方法选取2011-2014年确诊的63名尘肺病患者者设为尘肺病组,选取65例接触粉尘工龄>5年,无职业性尘肺病的接尘者为对照组。两组对象统一发放调查表,调查了解并比较两组对象的人口学特征、职业史、个人生活方式及尘肺病诊断期别、呼吸系统症状、抑郁评分,分析该类人群抑郁状态及影响因素。两组间比较计量资料采用t检验,计数资料采用χ2检验,并采取协方差分析消除混杂因素影响,组内比较采用方差分析,两两比较采用q检验,尘肺病抑郁影响因素在单因素分析的基础上再用非条件logistic回归作多因素分析,P<0.05为差异有统计学意义。结果两组吸烟指数、工龄、呼吸系统症状、诊断期别、抑郁评分比较差异有统计学意义(t=3.254,t=1.363,χ2=0.291,0.214,χ2=1.343,1.237,1.351,t=3.212,P<0.05);尘肺组组内抑郁评分比较,壹期、贰期、叁期患者抑郁评分随着诊断期别的增高而增高,3组比较差异有统计学意义(F=3.170,P<0.05);叁期患者的评分与壹期患者比较(q=4.163,P<0.05),叁期患者的评分与贰期患者比较差异有统计学意义(q=4.182,P<0.05),壹期、贰期患者比较差异有统计学意义(q=4.632,P<0.05);3种及3种以上呼吸系统症状者评分与3种以内呼吸系统症状者比较差异有统计学意义(F=1.313,P<0.05)。非条件logistic多因素回归分析显示,尘肺诊断期别、呼吸系统症状是影响尘肺病患者抑郁自评的因素(OR=2.549,95%CI=1.415~4.519;OR=1.037,95%CI=1.010~1.012)。结论尘肺诊断期别、呼吸系统症状是影响尘肺病患者抑郁自评的因素,因此,在心理干预中应结合患者期别和症状进行个体化干预和心理疏导。
Objective To explore the self-assessment of depression status and its influential factors in patients with pneumoconiosis, and to provide reference for the development of psychological intervention programs for this population. Methods Sixty-three patients with pneumoconiosis who were diagnosed in 2011-2014 were selected as the pneumoconiosis patients by SPS sampling method. Sixty-five patients with exposure to dust aged> 5 years were selected as the control group. Two groups of subjects issued a questionnaire to investigate and understand the demographic characteristics, occupational history, personal lifestyle and the diagnosis of pneumoconiosis, respiratory symptoms and depression scores of the two groups. The depression status and influencing factors were analyzed. Two sets of comparative measurement data using t test, count data using χ2 test, and analysis of covariance to eliminate the influence of confounding factors, the group was compared using analysis of variance, two pairs of comparisons using q test, pneumoconiosis factors affecting depression in univariate analysis Based on the non-conditional logistic regression multivariate analysis, P <0.05 for the difference was statistically significant. Results There were significant differences in smoking index, length of service, respiratory symptoms, diagnosis period and depression score between the two groups (t = 3.254, t = 1.363, χ2 = 0.291,0.214, χ2 = 1.343,1.237,1.351, t = 3.212 , P <0.05). Compared with the depression score in the pneumoconiosis group, the depression scores of patients in the first, second and third phases increased with the increase of the diagnosis time, the difference was statistically significant in the three groups (F = 3.170, P < (Q = 4.183, P <0.05). The score of three-term patients was significantly higher than that of patients of the first phase (q = 4.163, P <0.05) (Q = 4.632, P <0.05). There were significant differences in scores of three or more respiratory symptoms and those of three respiratory symptoms (F = 1.313, P <0.05). Non-conditional logistic multivariate regression analysis showed that pneumoconiosis diagnosis and respiratory symptoms were the factors influencing depression self-assessment in patients with pneumoconiosis (OR = 2.549, 95% CI = 1.415-4.519; OR = 1.037, 95% CI = 1.010 ~ 1.012). Conclusions In the diagnosis of pneumoconiosis, the respiratory symptoms are the factors that affect the self-assessment of depression in patients with pneumoconiosis. Therefore, individual interventions and psychological counseling should be carried out in combination with the patient’s stage and symptoms in psychological intervention.