切换至 "中华医学电子期刊资源库"

第五届中国出版政府奖音像电子网络出版物奖提名奖

中国科技核心期刊

中国科学引文数据库(CSCD)来源期刊

中华重症医学电子杂志 ›› 2023, Vol. 09 ›› Issue (02) : 198 -204. doi: 10.3877/cma.j.issn.2096-1537.2023.02.011

重症护理

危重症孕产妇的心理状况及其影响因素的调查
吴玥琳, 欧泳琳, 肖海燕, 段业英, 陆翠薇, 李德阳, 王懿春, 唐灏珂()   
  1. 510180 广州,广州医科大学精神卫生学院
    510180 广州,广州医科大学公共卫生学院
    510150 广州,广州医科大学附属第三医院重症医学科
    510180 广州,广州医科大学卫生管理学院
    510150 广州,广州医科大学附属第三医院护理部
  • 收稿日期:2022-05-17 出版日期:2023-05-28
  • 通信作者: 唐灏珂
  • 基金资助:
    国家级大学生创新创业训练计划项目(202110570039); 广东省科技创新战略专项资金(大学生科技创新培育)项目(pdjh2021b0414); 广州医科大学学生课外学术科技立项项目(2020A100)

Study on anxiety and depression status and the influential factors in maternal women

Yuelin Wu, Yonglin Ou, Haiyan Xiao, Yeying Duan, Cuiwei Lu, Deyang Li, Yichun Wang, Haoke Tang()   

  1. College of Mental Health, Guangzhou Medical University, Guangzhou 510180, China
    College of Public Health, Guangzhou Medical University, Guangzhou 510180, China
    Department of Critical Care Medicine, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
    College of Health Management, Guangzhou Medical University, Guangzhou 510180, China
    Department of Nursing, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
  • Received:2022-05-17 Published:2023-05-28
  • Corresponding author: Haoke Tang
引用本文:

吴玥琳, 欧泳琳, 肖海燕, 段业英, 陆翠薇, 李德阳, 王懿春, 唐灏珂. 危重症孕产妇的心理状况及其影响因素的调查[J/OL]. 中华重症医学电子杂志, 2023, 09(02): 198-204.

Yuelin Wu, Yonglin Ou, Haiyan Xiao, Yeying Duan, Cuiwei Lu, Deyang Li, Yichun Wang, Haoke Tang. Study on anxiety and depression status and the influential factors in maternal women[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2023, 09(02): 198-204.

目的

探讨危重症孕产妇的心理状况及其影响因素。

方法

选择入住ICU的101例危重症孕产妇作为研究对象,应用医院焦虑抑郁量表对患者的焦虑/抑郁情况进行测定评分,筛选焦虑/抑郁患者,并对这些患者的焦虑/抑郁发生的相关因素进行分析。

结果

危重症孕产妇的焦虑症状检出率为50.5%(51/101),抑郁症状检出率为49.5%(50/101)。单因素分析显示,患者焦虑/抑郁水平与受教育程度(焦虑χ2=8.755,P<0.05;抑郁χ2=12.695,P<0.01)、妊娠结局(抑郁χ2=6.179,P<0.05)、疼痛程度评分(焦虑Z=2.091,P<0.05)和APACHE Ⅱ评分(焦虑Z=2.663,P<0.01)有关;与年龄、婚姻、医保付费情况、产次、流产经历、有创机械通气情况和镇痛镇静药物的使用情况无关(P>0.05)。多因素Logistic回归分析显示,较高疼痛程度(OR=1.185,P<0.05)、较高APACHE Ⅱ评分(OR=1.095,P<0.05)和不良妊娠结局(OR=4.067,P<0.01)为焦虑/抑郁发生的危险因素,较高受教育程度为焦虑/抑郁发生的保护因素(焦虑:大专及以上OR=0.253,P<0.01;抑郁:中专及高中OR=0.183,P<0.01,大专及以上OR=0.148,P<0.001)。

结论

入住ICU的孕产妇焦虑/抑郁发生率较高,患者的妊娠结局、疾病严重程度、疼痛严重程度和受教育程度是其重要影响因素。

Objective

To investigate the psychological status and its related factors of maternal women in the intensive care unit (ICU).

Methods

A total of 101 maternal women in the ICU were included in the study. The Hospital Anxiety and Depression Scale was used to screen the anxiety and/or depression of include patients. The factors that associated with anxiety and depression were analyzed.

Results

The anxiety rate was 50.5% (51/101) and depressive rate was 49.5% (50/101) in these patients. Univariate analysis showed that education (χ2=8.755, P<0.05; χ2=12.695, P<0.01), pregnancy outcome (χ2=6.179, P<0.05), VAS score (Z=2.091, P<0.05) and APACHE Ⅱ score (Z=2.663, P<0.01) other than age, marriage, health insurance payment status, number of deliveries, the experience of miscarriage, receive mechanical ventilation and sedative drug (P>0.05) were associated with anxiety and depression. Multivariable logistic regression analysis showed that high VAS score (OR=1.185, P<0.05), high APACHE Ⅱ score (OR=1.095, P<0.05) and adverse pregnancy outcome (OR=4.067, P<0.01) were risk factors of the development of anxiety and depression, while high education was a protective factor for the development of anxiety and depression (OR=0.253, P<0.01; OR=0.183, P<0.01; OR=0.148, P<0.001).

Conclusion

There is a high incidence of maternal anxiety and depression in the ICU in maternal patients. The pregnancy outcome, severity of illness, pain severity and education level are associated with anxiety and depression.

表1 入住ICU的101例危重症孕产妇的一般资料统计[例(%)]
表2 入住ICU的101例危重症孕产妇焦虑/抑郁的发生情况[例(%)]
表3 入住ICU危重症孕产妇焦虑/抑郁影响因素的单因素分析[例(%)]
表 4 入住ICU危重症孕产妇焦虑/抑郁总分及其影响因素的相关分析
表5 自变量赋值表
表6 入住ICU危重症孕产妇焦虑/抑郁发生的多元logistic回归分析
1
李洪菊. ICU综合征患者的护理 [J]. 现代医药卫生, 2008, 24(7): 1069-1070.
2
Hepp P, Hagenbeck C, Gilles J, et al. Effects of music intervention during caesarean delivery on anxiety and stress of the mother a controlled, randomised study [J]. BMC Pregnancy Childbirth, 2018, 18(1): 435.
3
兰明, 侯天飞, 周保锋, 等. 孕产妇分娩过程中精神心理状态变化及影响因素分析 [J]. 中国计划生育和妇产科, 2019, 11(12): 41-45.
4
Zigmond AS, Snaith RP. The hospital anxiety and depression scale [J]. Acta Psychiatr Scand, 1983, 67(6): 361-370.
5
Huskisson EC. Measurement of pain [J]. Lancet, 1974, 304 (7889) : 1127-1131.
6
甘艳微, 黄丽玲, 李慧, 等. 重症孕产妇临床特征及心理护理分析 [J]. 心理月刊, 2018, 13(7): 33.
7
Scragg P, Jones A, Fauvel N. Psychological problems following ICU treatment [J]. Anaesthesia, 2010, 56(1): 9-14.
8
何雪雪, 王锦能, 覃庆菊, 等. 心理干预对孕产妇焦虑抑郁的作用研究 [J]. 心理月刊, 2022, 17(2): 138-140.
9
杨业环, 黄星, 孙梦云, 等. 中国孕产妇不同时点抑郁状态转归及持续抑郁状态影响因素分析 [J]. 中华流行病学杂志, 2022, 43(1): 58-64.
10
Chowdhury ME, Ahmed A, Kalim N, et al. Causes of maternal mortality Decline in Matlab, Bangladesh [J]. Health Popul Nutr, 2009, 27(2): 108-123.
11
Gabrysch S, Campbell OM. Still too far to walk: literature review of the determinants of delivery service use [J]. BMC Pregnancy Childbirth, 2009, 9(1): 34.
12
Winkleby MA, Jatulis DE, Frank E, et al. Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. [J]. Am J Public Health, 1992, 82(6): 816-820.
13
Tunçalpö, Souza JP, Hindin MJ, et al; WHO Multicountry Survey on Maternal and Newborn Health Research Network. Education and severe maternal outcomes in developing countries: a multicountry cross-sectional survey [J]. BJOG, 2014, 121(Suppl 1): 57-65.
14
胡朝辉, 王清赞, 竺建辉, 等. 孕产妇产后焦虑抑郁情绪的相关因素探讨 [J]. 中国妇幼保健, 2017, 32(8): 1624-1626.
15
栾丹丹, 于秀荣, 刘永云. 新生儿重症监护病房住院早产儿母亲产后抑郁与早期泌乳量的相关性 [J]. 中国心理卫生杂志, 2018, 32(8): 625-629.
16
Walani SR. Global burden of preterm birth [J]. Int J Gynecol Obstet, 2020, 150(1): 31-33.
17
Platt MJ. Outcomes in preterm infants [J]. Public Health, 2014, 128(5): 399-403.
18
Novaes M, Aronovich A, Ferraz M, et al. Stressors in ICU: patients' evaluation. [J]. Intensive Care Med, 1997, 23(12): 1282-1285.
19
王宇, 马朋林, 刘京涛, 等. 疾病严重程度与ICU清醒危重患者心理状态关系的多中心研究 [J]. 中华医学杂志, 2008, 88(21): 1450-1453.
20
Oh J, Sohn JH, Shin CS, et al. Mutual relationship between anxiety and pain in the intensive care unit and its effect on medications [J]. J Crit Care, 2015, 30(5): 1043-1048.
21
Merskey H. International association for the study of pain: Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms [J]. Pain Suppl, 1986, 3: S1-S226.
22
Gatchel RJ, Peng YB, Peters ML, et al. The biopsychosocial approach to chronic pain: scientific advances and future directions [J]. Psychol Bull, 2007, 133(4): 581-624.
23
Mazaheri M, Roohafza HR, Mohammadi M, et al. The structural model of pain, cognitive strategies, and negative emotions in functional gastrointestinal disorders [J]. J Res Med Sci, 2016, 21(1): 107.
24
Lumley M A, Cohen J L, Borszcz G S, et al. Pain and emotion: a biopsychosocial review of recent research [J]. J Clin Psychol, 2011, 67(9): 942-968.
25
McCleary JA. Irritable bowel syndrome pain-related behaviors and pain coping strategies as predictors of women's daily activities [D]. Philadelphia: Philadelphia College of Osteopathic Medicine, 2007: 99.
26
O'Donnell KJ, Glover V, Barker ED, et al. The persisting effect of maternal mood in pregnancy on childhood psychopathology [J]. Dev Psychopathol, 2014, 26(2): 393-403.
27
Carvalho B, Zheng M, Aiono-Le Tagaloa L. A prospective observational study evaluating the ability of prelabor psychological tests to predict labor pain, epidural analgesic consumption, and maternal satisfaction [J]. Anesth Analg, 2014, 119(3): 632-640.
28
程艳. ICU患者心理状况调查及护理干预疗效分析 [J]. 中国医药指南, 2013, 11(2): 650-651.
29
王索娅. 音乐治疗的基本概念 [J]. 中国听力语言康复科学杂志, 2020, 18(4): 318-320.
30
李莎, 骆琼, 贾海珍. 舍曲林联合音乐治疗对产后抑郁的临床疗效分析 [J]. 现代医药卫生, 2022, 38(2): 185-187.
31
郭颖, 胡健伟. 心理干预联合音乐治疗对孕产妇焦虑和抑郁的影响 [J]. 预防医学, 2019, 31(9): 953-955.
[1] 张熙东, 贾贺杰, 冯锐, 李路亚, 乔永志, 郑颖. 急诊患者家属焦虑的影响因素[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(05): 319-324.
[2] 李玲, 刘亚, 李培玲, 张秀敏, 李萍. 直肠癌患者术后肠道菌群的变化与抑郁症相关性研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 607-610.
[3] 高金红, 陈玉梅, 郭韵. 基于King互动达标理论的心理疏导在腹腔镜肝癌切除术患者的应用效果分析[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 517-520.
[4] 杜晨阳, 王勇, 段鑫, 柯文杰, 石念, 武英翔, 罗文. 腹腔镜下食管裂孔疝修补术后吞咽困难的危险因素分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 523-527.
[5] 袁雪涛, 王星傑, 黑赫, 田泓漪, 刘俊矣, 魏光兵, 李徐奇, 蒋正东. 不同材料疝补片对大鼠腹壁缺损修补术后行为学影响的实验研究[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(02): 154-160.
[6] 王玲, 樊文彬, 倪嘉淳, 蔡增进. 功能性便秘与焦虑抑郁共病的研究进展[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(05): 411-416.
[7] 汪毅仁, 江晓丹, 李佳曦, 赵天瑶, 李学民. 干眼的症状、体征与焦虑及抑郁相关性的临床研究[J/OL]. 中华眼科医学杂志(电子版), 2024, 14(04): 212-216.
[8] 唐小久, 胡曼, 许必君, 肖亚. 肥胖合并胃食管反流病患者严重程度与其焦虑抑郁及营养状态的相关性研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(04): 360-364.
[9] 王亚飞, 邓婷, 许江涛, 耿聃聃, 王小梅. 黄连温胆汤对伴焦虑抑郁的慢性萎缩性胃炎患者的效果[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(02): 155-158.
[10] 杨星, 刘梅, 刘思远, 张科. 胃肠癌患者术前焦虑情绪和术后苏醒期躁动情况及影响因素分析[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(02): 159-163.
[11] 白杰, 王唯一, 陈超, 王帆, 肖新如. 神经外科住培医师职业倦怠及影响因素研究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 662-670.
[12] 马云霞, 于金勇, 魏淑凤, 韩臣子. 耳穴疗法对肝气郁结型甲状腺结节合并焦虑抑郁的临床疗效观察[J/OL]. 中华临床医师杂志(电子版), 2024, 18(04): 348-354.
[13] 华丽, 仲卫冬, 胡根, 张丽英, 邵国益. 手术治疗胃食管反流病对患者生活质量和心理状态影响的研究[J/OL]. 中华胃食管反流病电子杂志, 2024, 11(03): 126-129.
[14] 张鑫, 刘志芬, 郭云童. 肥胖与抑郁症相关性的研究进展[J/OL]. 中华肥胖与代谢病电子杂志, 2024, 10(04): 255-260.
[15] 王丽娜, 吕书霞, 李亚男. 脑卒中偏瘫患者健康焦虑元认知与疾病接受度、恐惧疾病进展的相关性[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 434-440.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?