老年冠心病住院患者生活质量及心理状态病例对照研究

论文编号:HL128  论文字数:8543.页数:18

论文题目：老年冠心病住院患者生活质量及心理状态病例对照研究

摘 要

 目 的：冠心病是对人类健康与寿命影响最大的慢性病之一,在传统注重内科疗效的基础上,关注其心理状态及其生活质量问题将具有十分重要的现实意义。我们采用艾森克个性问卷(EPQ)[1]、症状自评量表(SCL-90)[2]及生活质量综合评定问卷(GQOLI)[3]对60例冠心病患者进行了测试,并同健康人加以比较,旨在了解冠心病患者的心理状态及其生活质量,为冠心病综合性治疗和康复提供心理学依据。
 方 法：采用“老年人生活质量调查表”评定生活质量,生活满意度内容共11项:满意为3分,一般为2分,不满意为1分,总评价30~33分为良,22~29分为中等,11~21分为差。采用症状自评量表(SCL-90)[3]评定临床症状,SCL-90包括90个项目(按0、1、2、3、4评分)9个症状因子。将两量表测试结果与全国常模进行对照。所有测试均在经过培训的2名主治医师指导下,由受试者独立完成。全部数据采用t检验及直线相关分析。
 结 果：影响老年冠心病患者生活质量满意度的有身体健康、医疗保健、家庭生活、经济收入、人际关系、子女孝顺等因子，躯体化、人际敏感、抑郁、焦虑、敌对、恐怖等因子与常模比较有极显著性差异(P<0.01)。生活满意度与心理健康的关系极其密切，将患者的生活满意度总分与SCL-90各因子分进行直线相关分析,结果表明二者之间呈高度负相关,即生活满意度得分越低,SCL-90各症状因子得分越高。生活质量与焦虑、抑郁情绪呈显著负相关,生活质量受病人的文化程度、既往住院次数的影响较大,也与经济收入、家庭负担、总病程、性别、行为类型等多方面因素有关。
 结 论：躯体疾病严重影响老年住院患者的生命质量，临床治疗改善患者生理症状的同时,给予心理关怀、社会支持,以提高冠心病患者的生存质量。
 
关键词：冠心病；生活质量；心理状态；病例对照研究
论文类型：研究报告 
Tite: Coronary heart disease in elderly hospitalized patients quality of life and psychological state of case control study

ABSTRACT

 Objective: Explore the quality of life of patients hospitalized with coronary heart disease and psychological state.
 Methods: A "quality of life of older survey" assessment of the quality of life, life satisfaction, a total of 11 content: Satisfaction for the three points, usually 2 minutes, not satisfied to 1, and the total assessment is divided into 30 to 33 good, 22 to 29 are divided into middle, 11 to 21 are divided into poor. Using the symptom checklist (SCL-90) [3] assessed clinical symptoms, SCL-90 includes 90 items(Rated by 0,1,2,3,4) Nine symptom factors. The two scale test results were compared with the national norm. All tests are two physicians trained under the guidance of the subjects independently. All the data using t test and linear correlation analysis.
 Results:Affect the quality of life in patients with coronary heart disease satisfaction with physical health, health care, family life, income, relationships, children, filial piety and other factors, Somatization, interpersonal sensitivity, depression, anxiety, hostility, phobia and other factors compared with the norm there was a significant difference(P<0.01)。Life satisfaction and mental health of the patient's relationship with life satisfaction score of SCL-90 factor scores for linear correlation analysis, The results show that showed a high negative correlation between the two, That is, lower life satisfaction scores, SCL-90 symptom factor scores of the higher. Quality of life and anxiety and depression was significantly negatively related to quality of life of patients affected by educational level, previous hospitalizations of greater impact, But also with income, family responsibilities, the total duration, gender, type of behavior, and many other factors
 Conclusion Somatic diseases seriously affect quality of life of elderly hospitalized patients, clinical improvement in patients with physical symptoms, while giving psychological care, social support, to improve the quality of life in patients with coronary heart disease.
 Key words:Coronary heart disease;Quality of life; Psychological state; Case-control study
Paper type:Research report

目 录

1 绪 论…………………………………………………………………………… 01
 1.1背景及意义 …………………………………………………………………01
 1.2研究目的及目标 ……………………………………………………………01
 1.2.1研究目的……………………………………………………………… 02
 1.2.2研究目标……………………………………………………………… 02
 1.3关键词及定义……………………………………………………………… 02
 1.3.1冠心病………………………………………………………………… 02
 1.3.2生活质量……………………………………………………………… 02
 1.3.3心理状态……………………………………………………………… 03
 1.3.4病例对照研究………………………………………………………… 03
 1.4文献回顾…………………………………………………………………… 03
 1.4.1老年冠心病的临床概况……………………………………………… 03
 1.4.2老年冠心病患者的心理状态………………………………………… 03
 1.4.3老年冠心病患者的生活质量的现况………………………………… 04
 1.4.4老年冠心病患者的生活质量和心理状态的评定…………………… 04
2 研究设计与方法…………………………………………………………………05
 2.1研究设计……………………………………………………………………05
 2.2研究对象……………………………………………………………………05
 2.3研究步骤……………………………………………………………………05
 2.4研究工具及方法……………………………………………………………05
 2.4.1研究工具……………………………………………………………… 05
 2.4.2研究方法……………………………………………………………… 06
 2.5资料分析……………………………………………………………………06
3 结果与分析………………………………………………………………………07
 3.1生活质量满意度与全国常模比较…………………………………………07
 3.2 SCL-90各因子分与国内常模比较……………………………………… 07
 3.3生活满意度与心理健康的关系……………………………………………08
4 讨论 …………………………………………………………………………… 09
 4.1心理和社会因素对冠心病患者的影响…………………………………… 09
 4.2影响生活质量的因素……………………………………………………… 09
5 结论………………………………………………………………………………11
致 谢……………………………………………………………………………… 12
参考文献……………………………………………………………………………13