CAJ | 학술논문

　　背景：对肾移植患者待肾期间的心理学征象进行量化评估，分析该人群应对方式，对其进行相对应的个性化临床心理干预，有利于患者积极面对现实和疾病。目的：通过对等待肾移植患者的心理应激状态进行调查，分析不同社会因素对患者应对方式的影响，探讨相应的临床心理干预对策。方法：随机抽取2009年2月至2010年8月在解放军第309医院器官移植中心泌尿二科等待肾移植患者58例及非等待肾移植患者60例进行调查，采用目前通用的医学应对问卷的形式要求患者填写心理调查问卷表，应用多因素Logistic回归方法分析不同社会因素对患者应对方式及其心理应激状态的影响。结果与结论：调查结果显示等待肾移植患者的“回避”和“屈服”量表得分明显高于非等待肾移植患者(P <0.05)；但两组的“面对”量表得分差异无显著性意义(P>0.05)。说明等待肾移植患者较非等待肾移植患者所承受的心理压力大，可能与等待肾移植患者病程长、花费大、担心移植后排斥等因素有关。多因素 Logistic回归分析发现患者的性别、文化程度、收入、费用支付方式和年龄均可影响等待肾移植患者的“面对”(斗争)、“回避”和“屈服”(接受)量表得分，其中文化程度在大专以上的患者“面对”量表得分高；年收入6万元以下的患者“回避”和“屈服”量表得分高。可见等待肾移植患者的收入与文化程度是影响其应对方式和心理应激状态的主要因素，对患者进行合理的临床个体化护理干预，有利于患者积极面对疾病，可减少移植对患者的心理损害。
　　배경：대신이식환자대신기간적심이학정상진행양화평고，분석해인군응대방식，대기진행상대응적개성화림상심리간예，유리우환자적겁면대현실화질병。목적：통과대등대신이식환자적심리응격상태진행조사，분석불동사회인소대환자응대방식적영향，탐토상응적림상심리간예대책。방법：수궤추취2009년2월지2010년8월재해방군제309의원기관이식중심비뇨이과등대신이식환자58례급비등대신이식환자60례진행조사，채용목전통용적의학응대문권적형식요구환자전사심리조사문권표，응용다인소Logistic회귀방법분석불동사회인소대환자응대방식급기심리응격상태적영향。결과여결론：조사결과현시등대신이식환자적“회피”화“굴복”량표득분명현고우비등대신이식환자(P <0.05)；단량조적“면대”량표득분차이무현저성의의(P>0.05)。설명등대신이식환자교비등대신이식환자소승수적심리압력대，가능여등대신이식환자병정장、화비대、담심이식후배척등인소유관。다인소 Logistic회귀분석발현환자적성별、문화정도、수입、비용지부방식화년령균가영향등대신이식환자적“면대”(두쟁)、“회피”화“굴복”(접수)량표득분，기중문화정도재대전이상적환자“면대”량표득분고；년수입6만원이하적환자“회피”화“굴복”량표득분고。가견등대신이식환자적수입여문화정도시영향기응대방식화심리응격상태적주요인소，대환자진행합리적림상개체화호리간예，유리우환자적겁면대질병，가감소이식대환자적심리손해。
BACKGROUND:To evaluate the psychological characteristics of the patients waiting for renal transplantation in order to analyze coping style, thus perform the corresponding personalized clinical psychological intervention which is conductive for patients to face reality and disease. OBJECTIVE:To investigate the psychological characteristics of the patients waiting for renal transplantation and to analyze the effect of different social factors on the coping style of patients and to explore the corresponding clinical mental intervention method METHODS:Fifty-eight patients waiting for renal transplantation and 60 patients without renal transplantation were randomly selected from Second Department of Urology, Organ transplantation Center, the 309th Hospital of PLA between February 2009 and August 2010, the patients were required to fil in a psychological questionnaire form using the currently general used medical response. The effect of social factors on the coping style and psychological stress status was analyzed with multi-factor Logistic regression analysis. RESULTS AND CONCLUSION:From the questionnaire survey, the evasive and yielding value scores of the patients waiting for renal transplantation were significantly higher than those of the patients without renal transplantation (P<0.05), but there was no significant difference of confrontation score between the patients (P>0.05). It indicated that the psychological pressure of the patients waiting for renal transplantation was bigger that of the patients with out renal transplantation, which may related with course of the disease, cost and the rejection after transplantation for the patients has to endured. Multi-factor Logistic regression analysis showed that sex, education, income, payment methods and age of the patients were al related with the confrontation, evasive and yielding scores, as those with technical secondary school education or better got the best confrontation score while those with annual income less than 60 000 yuan got the highest score in evasive and yielding styles. The results show that income and education level of patients are the main factors that affect the coping style and psychological stress status of the patients waiting for renal transplantation, treating the patients with reasonable renal clinical care interventions can help the patients face to the disease positively and can reduce the damage of transplantation to the psychology of the patients.