先兆流产住院患者心理调查及危险因素分析

摘要

目的 调查先兆流产住院患者的心理状态,并探讨引起心理性亚健康状态相关危险因素.方法 选用症状自评量表(SCL-90)对2013年3月至2015年12月住院的先兆流产患者进行心理访谈,评估心理状态.根据SCL-90调查结果,对总症状指数(GSI)>160患者定义为心理性亚健康状态,分别对GSI>160及各单项因子分>2分患者采用Logistic回归分析相关危险因素.结果 共有450例先兆流产住院患者参与调查,有效调查403例.被调查者GSI、躯体化因子、抑郁、焦虑、恐怖、精神病性因子均高于全国常模,差异具有统计学意义(P<0.05);通过多因素Logistic回归分析发现,SCL-90量表中GSI与流产、不孕史、阴道出血存在显著相关性(P<0.05);躯体化因子与流产史、不孕史、阴道出血、腹痛存在显著相关性(P<0.05);抑郁、焦虑、恐怖因子均与流产史、不孕史存在显著相关性(P<0.05);精神病性因子与流产史、不孕史、腹痛、月经失调存在显著相关性(P<0.05).结论 先兆流产住院患者存在一定程度心理性亚健康状态,且阴道出血、不孕史、流产史是主要危险因素,需要加强此类人群的心理健康教育.%Objective To evaluate the psychological status of hospitalized patients with early threatened abortion and to explore the related risk factors. Methods The SCL-90 was used to interview the patients with early threatened abortion who were hospitalized from March 2013 to December 2015 in Hangzhou Traditional Chinese Medicine Hospital. The mental state was evaluated. According to the results of the survey,global severity index (GSI)> 160 patients were defined as psychological disorders,the GSI>160 and the factor scores> 2 logistic regression analysis of the relevant risk factors. Results A total of 450 hospitalized patients with early threatened abortion were involved in the investigation and 403 cases were investigated. GSI and single factor(somatization,depression,anxiety,phobic anxiety and psychotics)were higher than those of the national norm(P<0.05). There were significant correlations between GSI and miscarriage,infertility,and vaginal bleeding(P<0.05). Multivariate logistic regression analysis showed significant correlation between somatization symptoms and history of abortion,infertility,vaginal bleeding and abdominal pain(P<0.05). Depression and anxiety were significantly associated with history of abortion and infertility(P<0.05). There was significant correlation between psychosis and history of abortion,infertility,abdominal pain and menstrual disorders(P<0.05). Conclusion The patients with early threatened abortion have a certain degree of psychological disorder. The history of vaginal bleeding,infertility and history of abortion is the main risk factor,and it is necessary to strengthen the mental health education of such people.