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目的探索肺结核患者确诊时的负性情绪及影响因素,为针对性干预提供依据。方法选择浙江省2个县的结核病定点门诊,对就诊的440例患者进行问卷调查,并随机抽取20例进行半结构化定性访谈。运用单因素卡方检验分析患者情绪反应及其影响因素。结果回收有效问卷437份,有效定性访谈19例。得知患肺结核时,患者出现担心、震惊、自责、无助和羞愧等负性情绪发生率分别为58.58%、29.75%、20.37%,10.98%和35.70%。负性情绪原因主要是年轻患者不相信自己得病或认为结核病是“不治之症”等。50岁以上人群震惊(40.26%)、担心(58.44%)、自责(38.96%)发生率相对较高(P<0.05);离婚或丧偶人群担心(95.24%)、震惊(61.90%)、自责(61.09%)、无助(42.86%)发生率较高(P<0.05);农民群体震惊(48.89%)、担心(70.37%)、自责(43.70%)发生率相对较高(P<0.05)。定性访谈中,6例患者有怀疑情绪,其中5例<35岁;6例患者有担心情绪;各有2例患者羞愧自责及悲观,均>38岁。结论肺结核患者确诊时容易发生负性情绪,老年患者、离婚、丧偶及农民等人群发生率相对较高。
Objective To explore the negative emotions and the influencing factors in the diagnosis of pulmonary tuberculosis patients and provide the basis for targeted intervention. Methods TB clinics in two counties in Zhejiang Province were selected. A total of 440 patients were investigated by questionnaire, and 20 cases were randomly selected for semi-structured qualitative interview. Using univariate chi-square test to analyze the patients emotional response and its influencing factors. RESULTS: 437 valid questionnaires were collected and 19 valid qualitative interviews were conducted. When suffering from pulmonary tuberculosis, the incidence of negative emotions such as worry, shock, self-blame, helplessness and shame were 58.58%, 29.75%, 20.37%, 10.98% and 35.70%, respectively. The main reason for the negative emotions is that young patients do not believe they are sick or think tuberculosis is “incurable disease” and so on. (50.24%), fear (58.44%) and self-blame (38.96%) were relatively higher (P <0.05); those who were divorced or widowed (95.24%) were shocked (61.90% (61.09%) and helpless (42.86%) (P <0.05). The peasant population was shocked (48.89%), worried (70.37%) and self-blame (43.70% 0.05). In the qualitative interview, 6 patients were suspicious, of which 5 were <35 years old; 6 patients were worried about their emotions; 2 patients each were self-blame and pessimistic, both of whom were> 38 years old. Conclusions The diagnosis of tuberculosis is prone to negative emotions. The incidence of elderly patients, divorce, widowers and peasants is relatively high.