摘要
目的分析外资医院全科及内科门诊外籍华人多躯体症状患者的躯体症状、躯体疾病、心理状态及医疗资源的使用等特点,探讨相关的因素。方法方便取样法选取2013年1-8月在上海东方国际医疗中心、2013年9月至2015年3月在上海百汇医疗中心全科及内科门诊收治的160例患者,进行躯体化症状量表(SSS)及抑郁症状严重程度九项量表(PHQ-9)和广泛性焦虑七项量表(GAD-7)自评。根据SSS得分,将SSS得分≥37分者设为多躯体症状组(SOM阳性组),将SSS得分<37分者设为对照组(SOM阴性组)。所有患者均在过去1年内有就医史,且常规接受30 min访谈和体检。结果 SOM阳性组中女性、无业、在华时间<6个月、国外出生、自费的患者比例,均显著高于SOM阴性组(P<0.05)。SOM阳性组患者的PHQ-9及GAD-7平均总分均高于SOM阴性组(P<0.05)。1年内门诊就诊次数以及症状持续时间>6个月的患者比例在SOM阳性组中显著高于SOM阴性组(P<0.05)。结论多躯体症状患者并没有更多明确诊断的躯体疾病,此类患者的抑郁焦虑程度更高、工作生活受影响的程度更大,抑郁焦虑分高及无商业医疗保险是多躯体症状的影响因素。
Objective To analyze multiple somatic symptoms,physical illness,psychological characteristics and facilities usage by Chinese patients with foreign nationalities,at GP and Internal Medicine Clinics at the foreign funded hospitals,on the purpose of symptoms improvement with effective cost. Methods Totally 160 patients were recruited from GP and internal medicine clinics in Shanghai East International Medical Center from January to August in 2013,and Parkway health Shanghai from September 2013 to March 2015,who were screened with self-rating Somatic Symptoms Scale（ SSS）,in addition to self-rating Depression scale of the Patient Health Questionnaire（ PHQ-9） and Generalized Anxiety Disorder（ GAD-7）. Based on the cut off value of 36 /37,160 patients were divided into somatic symptom group（ SOM ＋） and the control group（ SOM-）. All the subjects received 30 minutes of structural interview on current history,past medical history and physical examination. Results Female,jobless,less than 6 months of residing in China,born overseas,self-paid were more significant in SOM positive group（ SOM ＋） than in SOM negative group（ SOM-）（ P 〈 0. 05）. The average score of PHQ-9 and GAD-7 was more significant in SOM ＋ group than in SOM- group,as well as the frequency of outpatient visiting and the duration of symptoms longer than 6 months. There was significant difference of the somatic symptoms but not the physical disease in the two groups. Conclusion There were no more clearly diagnosed physical diseases in SOM ＋ group,in which patients have more severe depression and anxiety resulting dysfunction of life and working. Higher score of depression and anxiety or no commercial medical insurance could be predictors among Chinese of foreign nationalities in China.
出处
《临床军医杂志》
CAS
2016年第3期304-308,共5页
Clinical Journal of Medical Officers
关键词
全科
内科
外籍华人
多躯体症状
躯体化症状自评量表
抑郁症状严重程度九项量表
广泛性焦虑七项量表
G eneral pratice
Internal medicine
General outpatient clinic
Chinese of foreign nationality
Multiple somatic symptoms
Somatic symptom scale
Depression scale of patient health questionnaire 9-item
Generalized anxiety disorder 7-item
