口腔扁平苔藓患者心理痛苦程度及影响因素的调查研究

doi:10.7518/gjkq.2023042

摘要/Abstract

摘要：

目的调查口腔扁平苔藓（OLP）患者的心理痛苦程度并分析其影响因素。方法采用一般资料问卷、心理痛苦温度计（DT）及广泛性焦虑量表（GAD-7）对符合纳入标准的236例OLP患者进行横断面调查，采用SPSS 26.0软件对调查结果进行统计分析。结果 236例OLP患者心理痛苦得分为3.17±2.64，其中有显著心理痛苦（≥4分）的患者97例（41.1%），轻度心理痛苦（1~3分）的患者90例（38.1%）；引起其心理痛苦的主要问题为口腔疼痛（47.5%）、担忧（41.5%）、睡眠障碍（39.4%）等；经多元线性回归分析，疾病类型（糜烂型和非糜烂型）、焦虑、年龄、无时间精力做家务、睡眠障碍、腹泻、水肿、鼻子干燥/充血是心理痛苦的独立影响因素。结论 OLP患者普遍存在不同程度的心理痛苦，糜烂型、伴有焦虑情绪和（或）睡眠障碍的患者心理痛苦程度更高。医护人员应加强对OLP患者心理痛苦的评估，及时识别存在显著心理痛苦的患者，以便采取合理有效的干预措施。

关键词: 口腔扁平苔藓, 心理痛苦, 焦虑, 横断面调查

Abstract:

Objective This study aims to investigate the degrees of psychological distress in patients with oral lichen planus (OLP) and analyze the influencing factors. Methods We conducted a cross-sectional survey of 236 OLP patients who met the inclusion criteria using a general information questionnaire, distress thermometer (DT) and generalized an-xiety disorder-7 (GAD-7). We used SPSS 26.0 for statistical analysis of the survey results. Results The psychological pain score of all patients was 3.17±2.64, including 97 patients (41.1%) with significant psychological pain (≥ 4 points) and 90 patients (38.1%) with mild psychological pain (1-3 points). The main causes of psychological distress were oral pain (47.5%), worry (41.5%), and sleep disturbance (39.4%). Multiple regression analysis showed that disease type (erosion, non-erosion), anxiety, age, lack of time and energy to do housework, sleep disturbance, diarrhea, edema, and dry nose/congestion were independent factors for psychological distress. Conclusion Patients with OLP generally suffered from var-ying degrees of psychological distress, and those with erosion, anxiety, and/or sleep disturbance had a higher degree of psychological pain. Medical staff should strengthen the evaluation of psychological pain in patients with OLP and identify those with significant psychological distress in a timely manner to carry out reasonable and effective intervention.

Key words: oral lichen planus, psychological distress, anxiety, cross-sectional survey

中图分类号:

R 781.5

何静,胡明佳,肖宁,李佳,孙婉昕,吕凌,刘帆. 口腔扁平苔藓患者心理痛苦程度及影响因素的调查研究[J]. 国际口腔医学杂志, 2023, 50(3): 308-313.

He Jing,Hu Mingjia,Xiao Ning,Li Jia,Sun Wanxin,Ling Lü,Liu Fan. Investigation on the degree of psychological distress and its influencing factors in patients with oral lichen planus[J]. Int J Stomatol, 2023, 50(3): 308-313.

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心理痛苦程度	DT/分	例数	构成比/%	累积构成比/%
无心理痛苦	0	49	20.8	20.8
轻度痛苦	l~3	90	38.1	58.9
中度痛苦	4~6	71	30.1	89.0
重度痛苦	7~9	18	7.6	96.6
极度痛苦	10	8	3.4	100

具体问题		例数	频率/%
实际问题	无时间精力照顾孩子/老人	43	18.2
	无时间精力做家务	20	8.5
	经济问题	31	13.1
	交通出行	19	8.1
	工作/上学	40	16.9
	周围环境	11	4.7
交往问题	与孩子/老人相处	33	14.0
	与伴侣相处	44	18.6
	与亲友相处	22	9.3
	与医护人员相处	4	1.7
情绪问题	抑郁	25	10.6
	恐惧	21	8.9
	孤独	14	5.9
	紧张	65	27.5
	悲伤	15	6.4
	担忧	98	41.5
	对日常生活丧失兴趣	14	5.9
	睡眠障碍	93	39.4
	记忆力下降/注意力不集中	91	38.6
躯体问题	外表/外形	10	4.2
	洗澡/穿衣	1	0.4
	呼吸	8	3.4
	排尿改变	8	3.4
	便秘	27	11.4
	腹泻	7	3.0
	进食	53	22.5
	疲乏	35	14.8
	水肿	8	3.4
	发烧	1	0.4
	头晕	17	7.2
	消化不良	20	8.5
	口腔疼痛	112	47.5
	恶心	8	3.4
	鼻子干燥/充血	19	8.1
	性	1	0.4
	皮肤干燥	21	8.9
	手/脚麻木	12	5.1
	身体活动受限	2	0.8
精神/宗教问题	失去寄托	0	0.0

分组因素		例数	DT/分	F/t值	P值*
性别	男	68	2.62±2.48	t=-2.040	0.042
	女	168	3.39±2.68	t=-2.040	0.042
年龄/岁	<45	68	2.63±2.44	t=-1.985	0.048
	≥45	168	3.38±2.69	t=-1.985	0.048
文化程度	小学及以下	61	3.82±2.75	F=2.734	0.044
	初中	74	3.34±2.62
	高中及大专	68	2.62±2.51
	本科及以上	33	3.17±2.64
OLP类型	非糜烂型	135	2.56±2.42	t=-4.191	<0.001
	糜烂型	101	3.97±2.72	t=-4.191	<0.001
焦虑	无	152	2.16±2.01	t=-8.460	<0.001
	有	84	4.99±2.68	t=-8.460	<0.001

自变量	回归系数	标准误	标准化回归系数	t值	P值
常量	0.741	0.468		1.583	0.115
焦虑	1.740	0.354	0.316	4.917	<0.001
OLP类型	0.959	0.299	0.18	3.205	0.002
年龄	0.743	0.347	0.128	2.142	0.033
无时间精力做家务	1.312	0.567	0.139	2.313	0.022
睡眠障碍	0.638	0.316	0.118	2.021	0.045
腹泻	2.072	0.884	0.133	2.344	0.020
水肿	1.870	0.934	0.128	2.002	0.047
鼻子干燥/充血	1.389	0.599	0.143	2.317	0.022

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