The research on psychological status of pulmonary tuberculosis patients and influencing factors in Baoshan District, Shanghai

doi:10.3969/j.issn.1000-6621.2021.04.014

Abstract

Abstract:

Objective To analyze the main factors of depression and anxiety among pulmonary tuberculosis (PTB) patients in Baoshan District of Shanghai, so as to provide evidence for targeted interventions. Methods Four hundred and eighty-seven patients with PTB registered in Baoshan District of Shanghai from January 1 to December 31, 2018, those who refused or unable to complete the investigate were excluded, a total of 356 patients with PTB were selected. We used Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7), Social Support Rate Score (SSRS) for investigation. A total of 356 questionnaires were distributed, all the questionnaires were collected and valid, with an effective rate of 100.0%. Results The detection rate of depression and anxiety among PTB patients were 14.6% (52/356) and 6.2% (22/356) respectively. Univariate analysis showed that 48.1% (25/52) of middle social supporters had depression, which was significantly higher than the high social supporters (9.6%, 5/52; χ²=14.405, P=0.001). The detection rates of anxiety within junior high school education, income under 2000 yuan and low/middle social supporters were 36.4% (8/22), 59.1% (13/22) and 50.0% (11/22) respectively, which were significantly higher than those with senior high school education (13.6%, 3/22), income above 5000 yuan (9.1%, 2/22) and high social supporters (0.0%, 0/22), the difference was statistically significant (χ²=10.010, 21.884, 12.327, P=0.018, <0.001, 0.002). Multivariate logistic regression analysis showed that medium social support (high social support as reference, OR=3.782, 95%CI: 1.332-10.738) was the risk factor for depression, income <2000 yuan (income >5000 as reference, OR=8.415, 95%CI: 1.800-39.334) were the risk factors for anxiety. Conclusion The abnormal rate of anxiety and depression of PTB patients in Baoshan District of Shanghai is relatively high. The improvement of social support is helpful to alleviate the depression of patients and the income incense could attribute to relieve the anxiety of patients.

Key words: Tuberculosis, pulmonary, Depression, Anxiety, Factor analysis, statistical

MA Zhi-tao, WANG Na, LYU Yang, HU Wei-hong, CHEN Chang, HE Fan, SHEN Xin, LIU Xiao-feng. The research on psychological status of pulmonary tuberculosis patients and influencing factors in Baoshan District, Shanghai[J]. Chinese Journal of Antituberculosis, 2021, 43(4): 378-384. doi: 10.3969/j.issn.1000-6621.2021.04.014

Figures/Tables 4

特征	抑郁心理状态(52例)				焦虑心理状态(22例)
特征	例数	构成比(%)	χ²值	P值	例数	构成比(%)	χ²值	P值
年龄组(岁)			4.103	0.392			3.095	0.542
17~29	9	17.3			2	9.1
30~39	11	21.2			5	22.7
40~49	3	5.8			2	9.1
50~59	10	19.2			4	18.2
60~90	19	36.5			9	40.9
性别			0.155	0.694			2.370	0.124
男	36	69.2			18	81.8
女	16	30.8			4	18.2
婚姻			0.041	0.839			0.008	0.930
已婚	38	73.1			16	72.7
未婚	14	26.9			6	27.3
教育水平			5.498	0.139			10.010	0.018
小学	9	17.3			7	31.8
初中	20	38.5			8	36.4
高中	11	21.1			3	13.6
大专及大学	12	23.1			4	18.2
收入水平(元)			3.770	0.438			21.884	<0.001
<2000	14	26.9			13	59.1
2000~2999	7	13.5			2	9.1
3000~3999	13	25.0			2	9.1
4000~4999	8	15.4			3	13.6
≥5000	10	19.2			2	9.1
户籍			0.121	0.728			0.332	0.564
本地	36	69.2			16	72.7
外地	16	30.8			6	27.3
社会支持			14.405	0.001			12.327	0.002
低等	22	42.3			11	50.0
中等	25	48.1			11	50.0
高等	5	9.6			0	0.0
特征	抑郁心理状态(52例)				焦虑心理状态(22例)
特征	例数	构成比(%)	χ²值	P值	例数	构成比(%)	χ²值	P值
就诊延迟			1.190	0.275			0.554	0.457
有	24	46.2			7	31.8
无	28	53.8			15	68.2
痰涂片结果			2.197	0.138			2.757	0.097
阳性	20	38.5			10	45.5
阴性	32	61.5			12	54.5
痰培养结果			3.315	0.069			0.099	0.753
阳性	8	15.4			5	22.7
阴性	44	84.6			17	77.3
肺结核空洞			1.357	0.244			0.332	0.564
有	10	19.2			4	18.2
无	42	80.8			18	81.8
治疗方案^a			0.568	0.451			0.924	0.336
2H-R-Z-E/4H-R	48	92.3			21	95.5
2H-R-Z-E-S/6H-E-R	4	7.7			1	4.5
治疗情况			1.089	0.297			1.176	0.278
初治	0	0.0			0	0.0
复治	52	100.0			22	100.0
耐药情况			0.776	0.378			0.889	0.346
耐药	51	98.1			22	100.0
非耐药	1	1.9			0	0.0

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序号	变量定义	赋值方法
X₁	性别	男=1;女=0
X₂	年龄	17~29岁=1;30~39岁=2;40~49岁=3;50~59岁=4;60~90岁=5
X₃	教育水平	小学=1;初中=2;高中=3;大专及大学=4
X₄	收入水平	<2000元=1;2000~2999元=2;3000~3999元=3;4000~4999元=4;≥5000元=5
X₅	社会支持	低等=1;中等=2,高等=3
Y₁	抑郁	有=1,无=0
Y₂	焦虑	有=1,无=0

因素	β值	值	Wald χ²值	P值	OR(95%CI)值
抑郁
社会支持
高等					1.00
中等	1.330	0.532	6.245	0.012	3.782(1.332~10.738)
低等	0.213	0.515	0.171	0.679	1.237(0.451~3.397)
焦虑
收入(元)
≥5000					1.00
4000~4999	1.375	0.942	2.132	0.144	3.954(0.625~25.026)
3000~3999	0.163	1.015	0.026	0.872	1.177(0.161~8.602)
2000~2999	0.704	1.022	0.474	0.491	2.022(0.273~14.990)
<2000	2.130	0.787	7.329	0.007	8.415(1.800~39.334)