某医院颜面部瘢痕整形患者焦虑 抑郁现状及影响因素研究

Status and influencing factors of anxiety and depression in patients receiving facial scar plastic surgery in a hospital

摘要:

目的 探讨颜面部瘢痕整形患者的焦虑抑郁现状及其影响因素。方法 采用单纯随机抽样方法选取中南大学湘雅三医院整形外科的颜面部瘢痕整形患者221例，采用问卷调查法收集患者的一般资料及瘢痕情况，并应用焦虑自评量表、抑郁自评量表和社会支持量表评定患者的焦虑抑郁状况。结果 221例颜面部瘢痕整形患者的焦虑量表评分为（51.17±12.81），抑郁量表评分为（55.49±10.08），均高于国内常模，差异有统计学意义（P <0.01）。焦虑阳性患者为114例（51.6%），抑郁阳性患者为156例（70.6%）。多因素非条件Logistic回归分析结果显示，有配偶（■=2.549，95%CI：1.364~4.762）、重度疼痛（■=1.675，95%CI：1.156~2.427）是焦虑的危险因素；家庭人均月收入高（■=0.605，95%CI：0.466~0.786）、瘢痕有挛缩牵扯（■=0.376，95%CI：0.195~0.727）是焦虑的保护因素。有配偶（■=5.748, 95%CI：2.736~12.075）是抑郁的危险因素；户口在城市（■=0.361，95%CI：0.184~0.707）、家庭人均月收入高（■=0.720，95%CI：0.544~0.953）、客观支持评分高（■=0.826，95%CI：0.732~0.933）是抑郁的保护因素。结论 颜面部瘢痕整形患者焦虑、抑郁患病率均高于一般人群，婚姻状况、疼痛程度、家庭人均月收入、瘢痕是否有挛缩牵扯是患者焦虑的影响因素，婚姻状况、户口所在地、家庭人均月收入、客观支持评分是患者抑郁的影响因素。

Abstract:

【Objectives】 To investigate the status and influencing factors of anxiety and depression in patients receiving facial scar plastic surgery. 【Methods】 By random sampling method, 221 patients receiving facial scar plastic surgery in Department of Plastic Surgery, the Third Xiangya Hospital were selected. General information and scar situation were collected by the use of questionnaires. Self-rating Anxiety Scale, Self-rating Depression Scale and the Social Support Rating Scale were used to assess the patients' anxiety and depression. 【Results】 The anxiety scale score was (51.17 ± 12.81), the depression scale score was (55.49 ± 10.08), both of them were statistically higher than those with the national norm (P < 0.01). Of the 221 patients, 114 cases (51.6%) were anxiety-positive and 156 cases (70.6%) were depression-positive. Multivariate logistic regression analysis showed that having spouse (■ = 2.549, 95%CI: 1.364~4.762) and severe pain (■ = 1.675, 95%CI: 1.156~2.427) were the risk factors of anxiety; high family income (■ = 0.605, 95%CI: 0.466~0.786) and the scar contracture (■ = 0.376, 95%CI: 0.195~0.727) were the protective factors of anxiety. Having spouse (■ = 5.748, 95%CI: 2.736~12.075) was the risk factor in patients with depression; residence in the city (■ = 0.361, 95%CI: 0.184~0.707), high family income ■ = 0.720, 95%CI: 0.544~0.953) and high objective support score (■= 0.826, 95%CI: 0.732~0.933) were the protective factors in patients with depression. 【Conclusions】 Compared with healthy population, the incidences of anxiety and depression in patients receiving facial scar plastic surgery are significantly increased. Marital status, level of pain, family income and whether there is scar contracture pull are the influencing factors of anxiety. Marital status, census register, family income and objective support score are the influencing factors of depression.