结核病患者产生病耻感与领悟社会支持的相关性研究

doi:10.3969/j.issn.1000-6621.2020.09.023

摘要/Abstract

摘要：

选取2019年7—12月于成都市公共卫生临床医疗中心结核科就诊结核病患者201例作为研究对象。采用结核病相关病耻感量表、领悟社会支持量表进行调查。201例结核病患者病耻感总得分中位数(四分位数)为10(7,12)分,领悟社会支持总得分中位数(四分位数)为62(54,71)分,病耻感与领悟社会支持呈负相关(r=-0.461, P<0.001)。患者被确诊为结核病后,均不同程度地产生病耻感,职业、患病时间、并发症个数是影响结核病患者病耻感的主要因素,学历是影响结核病患者领悟社会支持的主要因素。

关键词: 结核, 行为和行为机制, 情感症状, 病耻感, 领悟社会支持, 问卷调查, 因素分析, 统计学

Abstract:

Two hundred and one tuberculosis patients visiting Chengdu Public Health Clinical Center from July to December 2019 were enrolled as study objects. Stigma scale and perceived social support scale were used for investigation. The total scores of stigma and social support were 10 (7,12) and 62 (54,71) respectively in 201 tuberculosis patients. There was a negative correlation between stigma and social support (r=-0.461,P<0.001). After the patients were diagnosed with tuberculosis, they all had different degrees of stigma. Occupation, duration of illness and the number of complications were the main factors affecting the stigma of tuberculosis patients, and education level affected the understanding of social support.

Key words: Tuberculosis, Behavior and behavior mechanisms, Affective symptoms, Stigma, Perceived social support, Questionnaires, Factor analysis, statistical

刘晓莉, 雷丽梅, 郭周莉, 黄殷, 徐静, 赵霞, 王燕, 付莉. 结核病患者产生病耻感与领悟社会支持的相关性研究[J]. 中国防痨杂志, 2020, 42(9): 1002-1008. doi: 10.3969/j.issn.1000-6621.2020.09.023

LIU Xiao-li, LEI Li-mei, GUO Zhou-li, HUANG Yin, XU Jing, ZHAO Xia, WANG Yan, FU Li. Study on the relationship of stigma and social support of tuberculosis patients[J]. Chinese Journal of Antituberculosis, 2020, 42(9): 1002-1008. doi: 10.3969/j.issn.1000-6621.2020.09.023

图/表 5

表1

不同因素调查对象的病耻感、领悟社会支持得分情况比较

因素	患者例数	病耻感			领悟社会支持
因素	患者例数	得分[M(Q₁,Q₃)]	统计检验值	P值	得分[M(Q₁,Q₃)]	统计检验值	P值
性别			Z=-0.747	0.455		Z=-1.695	0.090
男	120	10(8,12)			60(53,69)
女	81	9(6,13)			64(54,72)
年龄组(岁)			H=9.231	0.010		H=8.638	0.013
18~	91	9(5,12)			65(56,72)
41~	74	10(9,13)			61(53,60)
≥66~89	36	11(9,15)			58(47,65)
学历			H=12.168	0.007		H=23.525	0.000
小学及以下	63	11(9,14)			59(42,65)
初中	63	9(8,12)			60(54,70)
高中/中专	40	9(4,12)			68(60,72)
大学及以上	35	9(4,12)			67(59,72)
婚姻			H=10.160	0.006		H=18.539	0.000
未婚	53	9(4,11)			67(62,72)
已婚	133	10(9,13)			60(51,69)
离异/丧偶	15	11(7,14)			54(48,63)
职业			H=17.177	0.002		H=23.140	0.000
在校学生	20	5(2,9)			71(63,72)
离退休人员	21	11(9,14)			60(57,67)
事业单位/企业人员	40	9(7,12)			69(59,78)
农民	68	10(8,13)			60(48,69)
其他^a	52	10(7,13)			60(51,65)
家庭人口数			H=3.202	0.202		H=1.788	0.409
1~3	70	11(8,13)			60(50,68)
4~5	102	9(6,13)			63(54,72)
≥6	29	10(8,12)			63(54,73)
个人月收入(元)			H=7.296	0.063		H=18.353	0.000
<1000	93	9(7,11)			63(55,70)
1000~	78	11(7,14)			59(50,68)
4000~	21	10(9,12)			66(60,74)
≥8000	9	9(3,11)			76(69,84)
患病时间(年)			H=4.088	0.129		H=1.710	0.425
<1	143	9(7,12)			63(54,73)
1~	45	9(9,13)			60(54,68)
≥5	13	11(8,17)			69(41,72)
耐药情况			Z=-0.663	0.508		Z=-1.055	0.291
是	36	9(7,12)			61(55,72)
否	165	10(7,13)			62(51,70)
治疗情况			Z=-0.394	0.694		Z=-0.033	0.974
初治	131	10(7,13)			62(52,71)
复治	70	9(7,12)			61(54,72)
并发症个数			H=7.400	0.060		H=1.566	0.667
0	131	10(8,13)			63(54,72)
1	59	9(7,11)			61(52,68)
2	7	11(11,17)			60(50,68)
≥3	4	7(6,7)			61(54,70)

表1

表2

表3

201例结核病患者病耻感的多因素分析

自变量	β值	s $x ˉ$ 值	标准化β值	t值	P值
常量	8.516	3.097	-	2.750	0.007
性别	-0.553	0.632	-0.061	-0.875	0.383
年龄	0.036	0.025	0.154	1.451	0.149
学历	-0.290	0.398	-0.071	-0.729	0.467
婚姻
未婚	-	-	-	-	-
已婚	-0.723	0.852	-0.077	-0.848	0.398
离异/丧偶	-1.408	1.654	-0.062	-0.852	0.396
职业
在校学生	-	-	-	-	-
离退休	4.068	1.818	0.282	2.238	0.026
事业单位/企业	3.362	1.467	0.304	2.291	0.023
农民	3.993	1.430	0.428	2.792	0.006
其他^a	3.888	1.302	0.385	2.986	0.003
家庭人口数	-0.733	0.464	-0.111	-1.581	0.116
个人月收入	-0.102	0.478	-0.019	-0.214	0.831
患病时间	1.473	0.621	0.199	2.373	0.019
治疗情况	-0.973	0.804	-0.105	-1.210	0.228
耐药情况	-0.324	0.862	-0.028	-0.376	0.707
并发症个数	-1.068	0.499	-0.159	-2.142	0.033

表3

表4

201例结核病患者领悟社会支持的多因素分析

自变量	β值	s $x ˉ$ 值	标准化β值	t值	P值
常量	61.680	9.044	-	6.820	0.000
性别	1.398	1.845	0.053	0.758	0.450
年龄	-0.099	0.073	-0.144	-1.364	0.174
学历	2.352	1.163	0.195	2.022	0.045
婚姻
未婚	-	-	-	-	-
已婚	0.854	2.489	0.031	0.343	0.732
离异/丧偶	-4.756	4.829	-0.072	-0.985	0.326
职业
在校学生	-	-	-	-	-
离退休	-1.436	5.307	-0.034	-0.271	0.787
事业单位/企业	-0.959	4.285	-0.030	-0.224	0.823
农民	-4.365	4.176	-0.159	-1.045	0.297
其他^a	-6.482	3.801	-0.219	-1.705	0.090
家庭人口数	2.370	1.354	0.123	1.750	0.082
个人月收入	1.462	1.396	0.093	1.047	0.297
患病时间	-0.314	1.813	-0.014	-0.173	0.863
耐药情况	-2.362	2.518	-0.070	-0.938	0.349
治疗情况	-1.831	2.348	-0.067	-0.780	0.437
并发症个数	0.453	1.457	0.023	0.311	0.756

表4

表5

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项目	负面经历		情感反应		应对方式		病耻感总分
项目	r值	P值	r值	P值	r值	P值	r值	P值
家庭支持	-0.047	0.508	-0.043	0.192	-0.063	0.373	-0.054	0.198
朋友支持	-0.402	0.000	-0.436	0.000	-0.447	0.000	-0.473	0.000
其他支持	-0.382	0.000	-0.389	0.000	-0.417	0.000	-0.436	0.000
领悟社会支持总分	-0.394	0.000	-0.416	0.000	-0.445	0.000	-0.461	0.000