耐药肺结核患者领悟社会支持的影响因素研究

doi:10.3969/j.issn.1000-6621.2020.06.012

摘要/Abstract

摘要：

目的探索耐药肺结核患者领悟社会支持的相关影响因素。方法选取2018年1月至2019年8月上海市肺科医院结核科收治的所有耐药肺结核患者160例作为研究对象。采用《领悟社会支持量表》(主要内容包括家庭支持、朋友支持、其他支持)评估患者社会支持程度,根据《领悟社会支持量表》总评分50分为界点将患者分为高分组(68例)和低分组(92例),采用logistic多因素回归分析耐药肺结核患者领悟社会支持的影响因素。结果 logistic多因素回归分析结果显示,年龄>60岁(OR=6.900;95%CI:2.984~15.953;P=0.005)、初中及以下学历(OR=2.870;95%CI:1.236~6.665;P<0.001)、未婚(OR=1.257;95%CI:0.545~2.899;P=0.045)或离异(OR=3.960;95%CI:1.742~9.001;P=0.030)、轻度抑郁(OR=6.325;95%CI:2.910~13.750;P=0.022)或中度及以上抑郁(OR=10.733;95%CI:3.847~29.950;P<0.001)、农村地区(OR=2.294;95%CI:1.209~4.353;P=0.040)、家庭人均月收入<2500元(OR=5.881;95%CI:2.348~14.733;P<0.001)、复治(OR=2.030;95%CI:1.074~3.838;P=0.013)及耐多药(OR=1.860;95%CI:0.854~4.048;P<0.001)或广泛耐药(OR=3.409;95%CI:1.533~7.581;P<0.001)均是耐药肺结核患者领悟社会支持的危险因素。结论年龄>60岁、初中及以下学历、未婚或离异、抑郁、农村地区、家庭人均月收入<2500元、复治及耐多药或广泛耐药等,是耐药肺结核患者领悟社会支持的危险因素。

关键词: 结核, 抗多种药物性, 社会支持, 认知, 问卷调查, 因素分析, 统计学

Abstract:

Objective The aim of the study is to explore the influencing factors of perceived social support in patients with drug-resistant tuberculosis. Methods From January 2018 to August 2019, 160 patients with drug-resistant tuberculosis admitted to the tuberculosis Department of Shanghai Pulmonary Hospital were selected as the study object. The perceived social support scale was used to evaluate the degree of social support of patients, and according to the total score of perceived social support scale (mainly including family support, friend support, and other supports) with the threshold point of 50 scores, patients were divided into high group (68 cases) and low group (92 cases). The influencing factors of perceived social support of patients with drug-resistant tuberculosis were analyzed by logistic multivariate regression analysis. Results Logistic multivariate regression analysis showed that age >60 years (OR=6.900; 95%CI: 2.984-15.953; P=0.005), junior high school and below (OR=2.870;95%CI: 1.236-6.665; P<0.001), unmarried (OR=1.257; 95%CI: 0.545-2.899; P=0.045) or divorced (OR=3.960;95%CI: 1.742-9.001; P=0.030), mild depression (OR=6.325; 95%CI: 2.910-13.750; P=0.022) or moderate or above depression (OR=10.733; 95%CI: 3.847-29.950; P<0.001), rural area (OR=2.294; 95%CI: 1.209-4.353; P=0.040), family monthly income per capita <2500 yuan (OR=5.881; 95%CI: 2.348-14.733; P<0.001), retreatment (OR=2.030; 95%CI: 1.074-3.838; P=0.013), and multi-drug resistance (OR=1.860; 95%CI: 0.854-4.048; P<0.001) or extensive drug resistance (OR=3.409; 95%CI: 1.533-7.581; P<0.001) were risk factors of perceived social support for patients with drug-resistant tuberculosis. Conclusion Age >60 years old, junior high school or below, unmarried or divorced, depression, rural areas, monthly income per family <2500 yuan, retreatment and multi-drug or extensive drug resistance are risk factors of perceived social support for patients with drug-resistant tuberculosis.

Key words: Tuberculosis, multidrug-resistant, Social support, Cognition, Questionnaires, Factor analysis, statistical

汤玲玲, 陈丹萍, 方雪娥, 施婷, 蔡丽萍, 李策. 耐药肺结核患者领悟社会支持的影响因素研究[J]. 中国防痨杂志, 2020, 42(6): 604-608. doi: 10.3969/j.issn.1000-6621.2020.06.012

TANG Ling-ling, CHEN Dan-ping, FANG Xue-e, SHI Ting, CAI Li-ping, LI Ce. Study on the influencing factors of perceived social support in patients with drug-resistant tuberculosis[J]. Chinese Journal of Antituberculosis, 2020, 42(6): 604-608. doi: 10.3969/j.issn.1000-6621.2020.06.012

图/表 3

表1

表2

表3

耐药肺结核患者领悟社会支持的二元logistic多因素分析

变量	β值	$s x ˉ$ 值	Wald χ²值	OR值	95%CI值	P值
年龄(>60岁)	1.932	0.738	6.850	6.900	2.984~15.953	0.005
学历(初中及以下)	1.054	0.317	11.062	2.870	1.236~6.665	<0.001
婚姻状况
未婚	0.229	0.116	3.888	1.257	0.545~2.899	0.045
离异	1.376	0.604	5.192	3.960	1.742~9.001	0.030
抑郁状况
轻度抑郁	1.845	0.774	5.679	6.325	2.910~13.750	0.022
中度及以上抑郁	2.373	0.751	10.018	10.733	3.847~29.950	<0.001
居住地为农村	0.830	0.401	4.287	2.294	1.209~4.353	0.040
家庭人均月收入(<2500元)	1.772	0.564	9.868	5.881	2.348~14.733	<0.001
复治	0.708	0.287	6.086	2.030	1.074~3.838	0.013
耐药类型
耐多药	0.621	0.196	10.025	1.860	0.854~4.048	<0.001
广泛耐药	1.226	0.389	9.940	3.409	1.533~7.581	<0.001

表3

参考文献 18

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因素	低分组(92例)	高分组(68例)	χ²值	P值
年龄组(岁)			22.184	<0.001
<40	26(28.3)	20(29.4)
40~	20(21.7)	36(53.0)
>60	46(50.0)	12(17.6)
性别			0.682	0.409
女	32(34.8)	28(41.2)
男	60(65.2)	40(58.8)
学历			11.838	0.003
大专及以上	22(23.9)	34(50.0)
高中	44(47.8)	20(29.4)
初中及以下	26(28.3)	14(20.6)
婚姻状况			11.682	0.003
已婚	40(43.5)	44(64.7)
未婚	16(17.4)	14(20.6)
离异	36(39.1)	10(14.7)
抑郁状况			34.726	<0.001
无抑郁	20(21.7)	46(67.6)
轻度抑郁	44(47.8)	16(23.6)
中度以上抑郁	28(30.5)	6(8.8)
居住地			6.557	0.010
城镇	34(37.0)	39(57.4)
农村	58(63.0)	29(42.6)
有无医保			0.058	0.809
有	80(87.0)	60(88.2)
无	12(13.0)	8(11.8)
家庭人均月收入(元)			15.293	<0.001
<2500	38(41.3)	12(17.6)
2500~	40(43.5)	30(44.2)
>5000	14(15.2)	26(38.2)
患者类型			4.803	0.028
初治	38(41.3)	40(58.8)
复治	54(58.7)	28(41.2)
耐药类型			9.358	0.009
单耐药	22(23.9)	30(44.1)
耐多药	30(32.6)	22(32.4)
广泛耐药	40(43.5)	16(23.5)

变量	赋值
年龄	<40岁=0;40~岁=1;>60岁=2
学历	大专及以上=0;高中=1;初中及以下=2
婚姻状况	已婚=0;未婚=1;离异=2
抑郁状况	无=0;轻度=1;中度以上=2
居住地	城镇=0;农村=1
家庭人均月收入	>5000元=0;2500~元=1;<2500元=2
患者类型	初治=0;复治=1
耐药类型	单耐药=0;耐多药=1;广泛耐药=2