家庭功能与社会支持对老年手术患者术前心理状态的影响

摘要

目的：了解老年手术患者家庭功能、社会支持、术前焦虑和抑郁状况，并探讨其相互关系。方法采用家庭功能评定量表（APGAR）、社会支持评定量表（SSRS）、焦虑自评量表（SAS）和抑郁自评量表（SDS）对术前老年患者进行调查，进行描述性分析和推断性分析。结果全部295例老年手术患者家庭功能良好208例（70．51％），家庭功能中度障碍67例（22．71％），家庭功能严重障碍20例（6．78％）；社会支持总分（40．42±9．03）分，其中主观支持（23．32±5．42）分，客观支持（9．45±3．73）分，支持利用度（7．65±1．86）分；术前焦虑152例（51．53％），抑郁98例（33．22％）。焦虑和抑郁发生率家庭功能良好组低于家庭功能障碍组（P＜0．05）；抑郁发生率社会支持高分组高于低分组（P＜0．05）；社会支持总分、主观支持、客观支持和支持利用度得分家庭功能良好组高于家庭功能障碍组（P＜0．05）。多因素Logistic回归分析显示术前心理异常影响因素有文化程度、是否患肿瘤性疾病、社会支持总分和家庭功能状况。结论老年手术患者术前存在一定程度的焦虑和抑郁情绪，术前焦虑和抑郁情绪与家庭功能和社会支持存在相关。%Objective To understand family function ,social support ,preoperative anxiety and depression status among elder‐ly operative patients ,and to explore their relationship .Methods 295 elderly preoperative patients were investigated by family AP‐GAR index (APGAR) ,social support rating scale (SSRS) ,self‐rating anxiety scale (SAS) and self‐rating depression scale(SDS) , descriptive and inferential analysis .Results Among 295 elderly preoperative patients ,there were 208 people with good family func‐tion ,accounting for 70 .51% ,67 people with moderate disability family function ,accounting for 22 .71% ,and 20 people with severe disability family function ,accounting for 6 .78% ;The total score of social support was 40 .42 ± 9 .03 and the scores of subjective support was 23 .32 ± 5 .42 ,objective support with 9 .45 ± 3 .73 and support availability with 7 .65 ± 1 .86 ;152 people were preoper‐ative anxiety ,accounting for 51 .53% ,98 people were preoperative depression ,accounting for 33 .22% .The rate of anxiety and de‐pression good family function group was lower than a family dysfunction group(P<0 .05) .The incidence of depression high social support group is higher than low group (P<0 .05);Among the scores of social support ,subjective support ,objective support and support availability ,we find that patients with family well‐functioning group was higher than patients with family dysfunction group (P<0 .05) .Multiple logistic regression analysis showed that influence factors of preoperative psychological abnormality had educa‐tion level ,whether the tumor diseases ,the total score of social support and family functioning condition .Conclusion Elderly preop‐erative patients have anxiety and depression to a certain extent .The anxiety and depression of patients were related to the family function and social support .We Should pay attention to the effect of farmily function and social support on mental health of elderly patients with operation ,and effective use .