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目的分析职业病患者心理健康状况,探讨应用心理干预措施的效果。方法以整群随机抽样方法抽取本省5家职业病专科医院共526名住院职业病患者为研究对象,在实施心理干预前后采用症状自评量表(SCL-90)、医院焦虑抑郁量表(HAD)进行评定式问卷调查,与国内常模比较,分析职业病患者的心理健康状况和心理干预效果。结果实施心理干预前,职业病患者SCL-90总分(162.34±54.21)高于全国常模(P<0.05),其中,躯体化(1.89±0.78)、焦虑(1.78±0.46)、抑郁(1.92±0.68)、敌对(1.92±0.57)、偏执(1.51±0.87)等5个因子分均高于全国常模(P<0.05或P<0.01);而HAD焦虑维度评分(10.82±2.32)接近阳性(≥11分)水平。实施心理干预后,职业病患者SCL-90总分(135.35±40.32)和躯体化(1.67±0.53)、强迫症状(1.56±0.49)、焦虑(1.51±0.35)、抑郁(1.67±0.62)、敌对(1.59±0.49)、恐怖(1.19±0.54)、偏执(1.38±0.62)、精神病性(1.22±0.39)等8个因子分均较实施前下降(P<0.05);SCL-90总分、总均分、阳性项目数、阳性项目均分与躯体化、焦虑、抑郁等3个因子分仍高于全国常模(P<0.05或P<0.01)。HAD的焦虑(7.38±2.27)、抑郁(3.51±1.86)评分均低于实施前水平(P<0.05),焦虑、抑郁维度阳性率均较实施前下降(P<0.001)。结论职业病患者普遍存在心理卫生问题,职业病治疗过程中给予心理干预措施有助于改善负性情绪和心理障碍,促进患者的治疗和康复。
Objective To analyze the mental health of patients with occupational diseases and to explore the effect of psychological interventions. Methods A total of 526 inpatients with occupational diseases in 5 occupational hospitals in our province were selected as the study objects by cluster sampling method. The self-rating anxiety scale (SCL-90) and the hospital anxiety and depression scale (HAD) were used before and after psychological intervention Evaluation of the questionnaire, compared with the domestic norm, analysis of mental health status and psychological intervention in patients with effects. Results Before psychological intervention, the total score of SCL-90 in occupational disease patients was significantly higher than that of national norm (162.34 ± 54.21) (1.89 ± 0.78), anxiety (1.78 ± 0.46) and depression 0.68), hostility (1.92 ± 0.57), paranoid (1.51 ± 0.87) were all higher than the national norm (P <0.05 or P <0.01), while the HAD anxiety dimension score was (10.82 ± 2.32) ≥11 points) level. After psychological intervention, the total scores of SCL-90 in occupational diseases were 135.35 ± 40.32 and 1.67 ± 0.53, 1.56 ± 0.49, 1.51 ± 0.35, 1.67 ± 0.62, 1.59 ± 0.49), terror (1.19 ± 0.54), paranoid (1.38 ± 0.62) and psychotic (1.22 ± 0.39), all of which were significantly lower than before (P <0.05) Points, positive items, positive items and somatization, anxiety, depression and other three factors still higher than the national norm (P <0.05 or P <0.01). HAD anxiety (7.38 ± 2.27), depression (3.51 ± 1.86) were lower than pre-implementation levels (P <0.05), anxiety and depression dimensions were lower than before (P <0.001). Conclusion Psychological health problems are common in occupational diseases. Psychological intervention in the treatment of occupational diseases can help to improve negative emotions and psychological disorders and promote the treatment and rehabilitation of patients.