哈爾濱地區(qū)抑郁癥患者就診行為的社會心理因素分析
發(fā)布時間：2018-09-15 05:52
【摘要】：目的：本文通過對首診于哈爾濱市第一�？漆t(yī)院的抑郁癥患者與首診于哈爾濱醫(yī)科大學附屬第一醫(yī)院、附屬第二醫(yī)院、哈爾濱市第一醫(yī)院、哈爾濱市第二醫(yī)院綜合性醫(yī)院神經(jīng)內(nèi)科的抑郁癥患者自然狀況(如性別、年齡、學歷、性格、收入水平等)、癥狀特點及其家屬對抑郁癥的認識水平等因素的比較,分析導致抑郁癥患者就診行為差異的影響因素,以指導他們正確的就醫(yī)行為。 方法：2009年7月—2010年7月,首診到哈爾濱市第一專科醫(yī)院(以下簡稱�？漆t(yī)院)的抑郁癥患者及其陪同家屬,編為A組；2009年7月—2009年9月首診到哈爾濱醫(yī)科大學第一附屬醫(yī)院、哈爾濱醫(yī)科大學第二附屬醫(yī)院、哈爾濱市第一醫(yī)院、哈爾濱市第二醫(yī)院等綜合性醫(yī)院(以下簡稱綜合性醫(yī)院)神經(jīng)內(nèi)科的抑郁癥患者及其陪同家屬,編為B組。對A、 B兩組抑郁癥患者及其陪同家屬進行一般狀況問卷測查,并對抑郁癥患者進行漢密爾頓抑郁量表(HAMD)、癥狀自評量表(SCL-90)測查,其中A組共收集問卷309份,B組共收集問卷303份 結果：(1)一般狀況問卷調(diào)查：兩組在有無宗教信仰方面有顯著差異(χ2=6.329,p0.05),兩組抑郁癥患者的就診年齡有顯著差異(χ2=11.105,p0.05),具體表現(xiàn)在19歲-30歲、46-55歲年齡段患者與年齡在31歲-45歲、56歲-65歲、66歲及以上者之間的差異.兩組抑郁癥患者在可接受治療費方面差異顯著(χ2=13.705,p0.01),這種差異主要是在可接受的費用在1000以下與1000-2000、1萬以上；1000-2000元與2000-5000元；2000-5000元與1萬以上的家庭間的差異。兩組抑郁癥患者的費用來源有顯著差異(χ2=19.667,p0.01),自費患者與享受醫(yī)療保險(包括城鎮(zhèn)醫(yī)保與居民醫(yī)保)患者間有顯著的差異性。兩組患者家屬對抑郁癥的認識水平有差異有顯著意義(t=2.675,p0.01)使用logistic回歸分析得到三個變量即患者的宗教信仰、可接受的醫(yī)療費用及治療費用來源影響患者的就診行為(2)A、 B兩組患者的客觀抑郁程度無顯著差異(χ2=1.863,p0.05).(3)HAMD因子分：在漢密爾頓抑郁量表中的7個因子中,兩組的白夜變化(t=-2.130,p0.01)、絕望感(t=2.664,p0.01)兩項有顯著差異.(4)SCL-90：兩組SCL-90測出的陽性癥狀均分(t=3.319,p0.01)、強迫癥狀(t=1.916,p0.01)、抑郁(t=0.136,p0.01)、精神病性(t=0.838,p0.01)四項具有顯著差異。使用回歸分析,得到HAMD中三個因子即焦慮軀體化、日夜變化及絕望感對抑郁癥患者的就診行為有影響,而SCL-90中的陽性癥狀均分影響患者的就診行為。 結論： 1.抑郁癥患者的就診年齡、可接受治療費用及治療費用的來源、有無宗教信仰影響其就診行為。19-30歲與46-55歲年齡段傾向綜合醫(yī)院就診,31-45歲,56-66歲及66歲以上者傾向?qū)？漆t(yī)院；有宗教信仰、可接受治療費低及自費的抑郁癥患者易選擇綜合醫(yī)院就診。 2.抑郁癥家屬對抑郁癥的認識水平影響其就診行為。家屬對抑郁癥的認識水平較全面者,易傾向選擇�？漆t(yī)院。 3.抑郁癥患者的主觀癥狀特點影響其就診行為。白夜變化明顯者傾向選擇綜合醫(yī)院就診,而絕望感、強迫癥狀、抑郁、精神病性表現(xiàn)明顯者則傾向?qū)？漆t(yī)院就診。 4.患者的客觀抑郁癥程度對其就診行為無影響。
[Abstract]:OBJECTIVE: To study the natural conditions (such as sex, age, education background, personality, income water) of depressive patients who were first diagnosed in Harbin First Specialized Hospital, the First Affiliated Hospital of Harbin Medical University, the Second Affiliated Hospital, the First Harbin Hospital and the Second Harbin General Hospital. To analyze the influencing factors of the difference in the behavior of patients with depression, and to guide their correct behavior.
Methods: From July 2009 to July 2010, the patients with depression and their accompanying family members who were first diagnosed in Harbin First Specialist Hospital (hereinafter referred to as the Specialist Hospital) were divided into group A; from July 2009 to September 2009, they were first diagnosed in the First Affiliated Hospital of Harbin Medical University, the Second Affiliated Hospital of Harbin Medical University, the First Hospital of Harbin, and Harbin Medical University. Depressive patients and their accompanying family members in the Department of Neurology of General Hospital (hereinafter referred to as General Hospital) were divided into group B. The general status of depressive patients and their accompanying family members in groups A and B were investigated by questionnaire, and the depressive patients were tested by Hamilton Depression Scale (HAMD) and Symptom Checklist 90 (SCL-90). A total of 309 questionnaires were collected and 303 questionnaires were collected in group B.
Results: (1) General Status Questionnaire: There were significant differences in religious beliefs between the two groups (2 = 6.329, p0.05). There were significant differences in the age of patients with depression between the two groups (2 = 11.105, p0.05). The differences between the patients aged 19-30, 46-55 and those aged 31-45, 56-65, 66 and over. There was a significant difference in the acceptable treatment fee between the two groups (_2 = 13.705, p0.01). The difference was mainly between the acceptable treatment fee below 1000 and over 1000-2000, between 1000-2000 and 2000-5000 yuan, and between 2000-5000 and over 10000 families. There was a significant difference between self-financed patients and those who enjoyed medical insurance (including urban medical insurance and residents'medical insurance). There was a significant difference between the two groups of patients' family members'understanding of depression (t = 2.675, p0.01). Three variables were obtained by logistic regression analysis, namely, patients' religious beliefs, acceptable medical expenses and treatment costs. There was no significant difference in the degree of objective depression between the two groups (_2 = 1.863, p0.05). (3) HAMD factor score: In the seven factors of Hamilton Depression Scale, the day-night changes (t = - 2.130, p0.01) and the sense of despair (t = 2.664, p0.01) were significantly different between the two groups. Average score (t = 3.319, p0.01), obsessive-compulsive symptoms (t = 1.916, p0.01), depression (t = 0.136, p0.01), psychoticism (t = 0.838, p0.01) were significantly different. Regression analysis showed that the three factors in HAMD, namely anxiety somatization, day-night changes and despair, had an impact on the behavior of depressive patients, while the positive symptoms in SCL-90 affected patients. Visiting behavior.
Conclusion:
1. The age of patients with depression, the source of acceptable treatment costs and treatment costs, whether religious beliefs affect their treatment behavior. People aged 19-30 and 46-55 tend to visit general hospitals, those aged 31-45, 56-66 and over tend to specialist hospitals; those with religious beliefs, low and self-supporting treatment fees are easy to choose. Choose a general hospital.
2. Depression family members'understanding of depression affects their hospitalization behavior.
3. Subjective symptoms of depressive patients affect their treatment behavior. Those with obvious changes in daytime and night tend to choose general hospitals, while those with despair, obsessive-compulsive symptoms, depression and psychotic manifestations tend to go to specialized hospitals.
4. the degree of objective depression has no effect on the patient's behavior.
【學位授予單位】：黑龍江中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R749.4
本文編號：2243968
[Abstract]:OBJECTIVE: To study the natural conditions (such as sex, age, education background, personality, income water) of depressive patients who were first diagnosed in Harbin First Specialized Hospital, the First Affiliated Hospital of Harbin Medical University, the Second Affiliated Hospital, the First Harbin Hospital and the Second Harbin General Hospital. To analyze the influencing factors of the difference in the behavior of patients with depression, and to guide their correct behavior.
Methods: From July 2009 to July 2010, the patients with depression and their accompanying family members who were first diagnosed in Harbin First Specialist Hospital (hereinafter referred to as the Specialist Hospital) were divided into group A; from July 2009 to September 2009, they were first diagnosed in the First Affiliated Hospital of Harbin Medical University, the Second Affiliated Hospital of Harbin Medical University, the First Hospital of Harbin, and Harbin Medical University. Depressive patients and their accompanying family members in the Department of Neurology of General Hospital (hereinafter referred to as General Hospital) were divided into group B. The general status of depressive patients and their accompanying family members in groups A and B were investigated by questionnaire, and the depressive patients were tested by Hamilton Depression Scale (HAMD) and Symptom Checklist 90 (SCL-90). A total of 309 questionnaires were collected and 303 questionnaires were collected in group B.
Results: (1) General Status Questionnaire: There were significant differences in religious beliefs between the two groups (2 = 6.329, p0.05). There were significant differences in the age of patients with depression between the two groups (2 = 11.105, p0.05). The differences between the patients aged 19-30, 46-55 and those aged 31-45, 56-65, 66 and over. There was a significant difference in the acceptable treatment fee between the two groups (_2 = 13.705, p0.01). The difference was mainly between the acceptable treatment fee below 1000 and over 1000-2000, between 1000-2000 and 2000-5000 yuan, and between 2000-5000 and over 10000 families. There was a significant difference between self-financed patients and those who enjoyed medical insurance (including urban medical insurance and residents'medical insurance). There was a significant difference between the two groups of patients' family members'understanding of depression (t = 2.675, p0.01). Three variables were obtained by logistic regression analysis, namely, patients' religious beliefs, acceptable medical expenses and treatment costs. There was no significant difference in the degree of objective depression between the two groups (_2 = 1.863, p0.05). (3) HAMD factor score: In the seven factors of Hamilton Depression Scale, the day-night changes (t = - 2.130, p0.01) and the sense of despair (t = 2.664, p0.01) were significantly different between the two groups. Average score (t = 3.319, p0.01), obsessive-compulsive symptoms (t = 1.916, p0.01), depression (t = 0.136, p0.01), psychoticism (t = 0.838, p0.01) were significantly different. Regression analysis showed that the three factors in HAMD, namely anxiety somatization, day-night changes and despair, had an impact on the behavior of depressive patients, while the positive symptoms in SCL-90 affected patients. Visiting behavior.
Conclusion:
1. The age of patients with depression, the source of acceptable treatment costs and treatment costs, whether religious beliefs affect their treatment behavior. People aged 19-30 and 46-55 tend to visit general hospitals, those aged 31-45, 56-66 and over tend to specialist hospitals; those with religious beliefs, low and self-supporting treatment fees are easy to choose. Choose a general hospital.
2. Depression family members'understanding of depression affects their hospitalization behavior.
3. Subjective symptoms of depressive patients affect their treatment behavior. Those with obvious changes in daytime and night tend to choose general hospitals, while those with despair, obsessive-compulsive symptoms, depression and psychotic manifestations tend to go to specialized hospitals.
4. the degree of objective depression has no effect on the patient's behavior.
【學位授予單位】：黑龍江中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R749.4
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