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目的探讨耐药肺结核患者的心理行为特征及应对方式,寻找出其存在的心理问题,为改善临床护理工作提供理论依据。方法选取结核科住院耐药结核患者152例为研究对象,应用《医学应对问卷(MCMQ)中文版调查表》,结果和全国常模数据进行比较。结果不同年龄、居住地分布间耐药肺结核患者面对、回避、屈从间比较,差异无统计学意义(P>0.05)。男性患者面对评分低于女性(P<0.05),而回避评分高于女性(P<0.05),但屈从评分比较,差异无统计学意义(P>0.05)。患者月收入≥3 000元的面对评分高于月收入<3 000元人群(P<0.05),而回避、屈从评分比较,差异无统计学意义(P>0.05)。患者病程≥2年面对评分低于<2年(P<0.05),而回避评分高于病程<2年患者(P<0.05),而屈从评分比较,差异无统计学意义(P>0.05)。有配偶的患者面对评分高于无配偶(P<0.05),高中及以上文化程度患者面对评分高于初中及以下(P<0.05),而回避和屈从评分与有无配偶和文化程度高低关系不大(P>0.05)。耐药结核患者的MCMQ量分与全国常模比较,面对应对方式量分低于国内常模,差异有统计学意义(P<0.05),回避和屈服应对方式量分高于国内常模,差异均有统计学意义(P<0.05)。结论耐药结核患者存在着不同程度的心理问题,性别、月收入、病程、配偶、文化程度等对患者心理行为及应对方式产生一定影响,医学应对方式上多采用回避和屈服的应对方式,而较少采用面对应对方式,所以对耐药肺结核患者进行心理疏导及健康教育是护理工作中必不可少的环节。
Objective To investigate the psychological behavior and coping style of patients with drug-resistant pulmonary tuberculosis (TB) and to find out their existing psychological problems and provide a theoretical basis for improving clinical nursing. Methods A total of 152 cases of drug-resistant tuberculosis in tuberculosis inpatients were selected as research objects. The questionnaire of Chinese version of Medical Resolve Questionnaire (MCMQ) was used and the results were compared with the data of the national norms. Results There was no significant difference in face-to-face treatment, avoidance and submission among drug-resistant pulmonary tuberculosis patients with different age and residence distribution (P> 0.05). The score of male patients was lower than that of women (P <0.05), while the avoidance score was higher than that of women (P <0.05). However, there was no significant difference between them (P> 0.05). Patients with monthly income ≥ 3000 yuan face score higher than the monthly income of <3000 yuan (P <0.05), while avoidance, submission score comparison, the difference was not statistically significant (P> 0.05). Patients’ duration of illness ≥ 2 years, face-to-face scores were less than 2 years (P <0.05), while avoidance scores were higher than those with courses <2 years (P0.05), but there was no significant difference between them (P0.05) . The face-to-face scores of spouses were higher than those of non-spouses (P <0.05). The scores of face-to-face education in high school and above education were higher than those in junior high school and below (P <0.05) Little relationship (P> 0.05). Compared with the national norm, the MCMQ scores of the patients with drug-resistant TB were lower than that of the domestic norm (P <0.05), and the scores of avoidance and yield responses were higher than that of the national norm, The differences were statistically significant (P <0.05). Conclusions Patients with drug-resistant TB have different degrees of psychological problems. Gender, monthly income, course of disease, spouse and educational level have a certain impact on their psychological behavior and coping style. Medical coping styles often adopt avoidance and yielding coping styles. However, Face less coping style, so psychological counseling and health education for patients with drug-resistant pulmonary tuberculosis is an essential part of nursing work.