烧伤康复期患者焦虑、抑郁与积极心理品质的关系分析

董利华 韩寅 杨百元

[摘要]目的：探討烧伤康复期患者焦虑、抑郁情绪障碍与积极心理品质的关系。方法：选择笔者医院接诊的40例烧伤康复期患者为研究对象，采用问卷调查的方法，收集患者一般资料及医院焦虑抑郁量表（Hospital Anxiety and Depression Scale，HADS）、心理弹性量表（中文版）（Connor-Davidson Resilience Scale，CD-RISC）、Herth希望量表（Herth hope index，HHI）、感恩量表的评分情况，分析康复期烧伤患者焦虑、抑郁发生率及其与积极心理品质的相关性，并进行单因素、多因素分析。结果：本组40例烧伤患者，焦虑发生率为62.50%，抑郁发生率为60.00%，焦虑患者HADS焦虑评分高于无焦虑患者，抑郁患者HADS抑郁评分高于无抑郁患者，差异有统计学意义（P<0.05）。焦虑、抑郁烧伤康复期患者HHI评分、CD-RISC评分、感恩评分均低于无焦虑或抑郁患者，差异有统计学意义（P<0.05）。Pearson相关性分析显示，烧伤康复期患者HADS焦虑、抑郁评分与HHI评分、CD-RISC评分、感恩评分均呈负相关（P<0.05）。单因素分析结果显示，女性焦虑和（或）抑郁发生率高于男性，Ⅲ度烧伤患者焦虑和（或）抑郁发生率高于Ⅱ度烧伤患者（P<0.05）。多因素logistic回归分析显示，性别、烧伤深度、HHI评分、CD-RISC评分、感恩评分是影响康复期烧伤患者焦虑和（或）抑郁的独立危险因素（P<0.05）。结论：烧伤康复期患者容易出现焦虑抑郁情绪障碍，其与患者希望水平、心理弹性及感恩倾向呈负相关，低水平积极心理品质是康复期烧伤患者发生焦虑抑郁情绪障碍的重要原因之一。

[关键词]烧伤;康复期;焦虑;抑郁;积极心理品质;问卷调查

[中图分类号]R395.1    [文献标志码]B    [文章编号]1008-6455（2019）07-0137-04

Correlation between Emotional Disorders of Anxiety and Depression with Positive Psychological Quality in Patients with Burns during Rehabilitation

DONG Li-hua1，HAN Yin2，YANG Bai-yuan3

（1.Outpatient;2.Department of Burns;3.Department of Neurology，the Seventh People s Hospital of Chengdu，Chengdu 610041，Sichuan，China）

Abstract： Objective  To explore the relationship between emotional disorders of anxiety and depression and positive psychological quality in patients with burns during rehabilitation. Methods  40 patients with burns during rehabilitation admitted to our hospital were selected for the study. The general data， Hospital Anxiety and Depression Scale（HADS）， Connor-Davidson Resilience Scale（CD-RISC）， Herth Hope Index（HHI） and gratitude scale were collected by questionnaire survey. The incidence rates of anxiety and depression in patients with burns during rehabilitation and their correlation with positive psychological quality were analyzed， and the univariate and multivariate analysis were performed on anxiety and/or depression in patients with burns during rehabilitation. Results  The incidence of anxiety and depression was 62.50% and 60.00% in 40 burn patients. The HADS anxiety score of anxiety patients was higher than that of non-anxiety patients， and the HADS depression score of depression patients was higher than that of non-depression patients（P<0.05）. The HHI score， CD-RISC score and gratitude score of burned patients with anxiety and depression in convalescent stage were lower than those of patients without anxiety or depression（P<0.05）. Pearson correlation analysis showed that HADS anxiety and depression scores were negatively correlated with HHI score， CD-RISC score and gratitude score（P<0.05）. Univariate analysis showed that the incidence of anxiety and/or depression in women was higher than that in men， and the incidence of anxiety and/or depression in patients with third degree burns was higher than that in patients with second degree burns（P<0.05）. Multivariate Logistic regression analysis showed that gender， burn depth， HHI score， CD-RISC score and gratitude score were independent risk factors for anxiety and/or depression in burn patients during rehabilitation period（P<0.05）. Conclusion  Patients with burns during rehabilitation are prone to emotional disorders of anxiety and depression， and emotional disorders are negatively correlated with the hope level， psychological resilience and gratitude tendency. Low positive psychological quality is one of the important reasons for anxiety and depression in patients with burns during rehabilitation.

Key words： burns; during rehabilitation; anxiety; depression; positive psychological quality; questionnaire survey

烧伤是一种突发性创伤应激事件，患者从早期就诊转为康复期，身体和心理都发生一定转变，加上遗留的瘢痕，造成患者功能障碍、容貌改变等问题，从而导致患者社会适应能力、人际交往能力显著下降，出现焦虑、抑郁等情绪障碍[1]。康复期患者因长期的康复治疗、经济负担、家庭关系、人际关系等方面的影响，情绪障碍的发病率较高，国内外学者除关注烧伤患者的治愈外，也逐渐对其心理状态变化开展了一系列研究[2]。多项研究表明，烧伤康复期患者常伴有焦虑、抑郁情绪障碍，不仅影响机体免疫功能，还不利于患者的身心康复及回归社会[3]。积极心理品质理论认为，心理健康的目标不应单纯局限于消极心理的预防和矫正，更需重视积极心理品质的发现和培养，积极心理品质可消除消极情绪的负面影响，减少焦虑、抑郁的发生[4]。……