Fang Xue-Hui, Wu Qian, Tao Sha-Sha, Xu Zhi-Wei, Zou Yan-Feng, Ma Dong-Chun, Pan Hai-Feng, Hu Wen-Biao
Anhui Provincial Chest Hospital (Anhui Institute of Tuberculosis Control), Hefei, Anhui, 230022, People's Republic of China.
Anhui Provincial Chest Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230022, People's Republic of China.
J Multidiscip Healthc. 2022 Mar 29;15:595-603. doi: 10.2147/JMDH.S356160. eCollection 2022.
Pulmonary tuberculosis (TB) is an infectious disease caused by affecting multiple tissues and organs. It is one of the leading causes of death and is a social disease in China. Increasing studies have revealed that the state of mental health and the social support are associated with the morbidity, mortality and community transmission of pulmonary TB patients. However, the previous global TB control and research strategy focused almost solely on the biomedical aspects. Therefore, in this study, we evaluated the level of depression and explored potential factors, including social support domains and socio-demographic characteristics in pulmonary TB patients to research the mental health state and the association between social support and pulmonary TB, ultimately implementing a multilevel intervene.
A cross-sectional study was carried out to describe the status of depression and social support, and explore related factors associated with depression among pulmonary TB patients in Anhui Province, China. Five counties (districts) in Anhui Province, China were selected by simple random sampling method. Patients diagnosed with pulmonary TB eligible to the study criteria were investigated. A structured questionnaire composed of information on socio-demographic characteristics, self-rating depression scale (SDS) and social support rating scale (SSRS) was used to collect the data.
In this study, a total of 250 questionnaires were issued, and the effective questionnaires 237 were actually returned. Of the 237 patients with pulmonary TB, 71.3% of them were male and the mean age was 46.16 years (SD = 13.09). Depression symptoms were observed in 125 (52.7%) participants. Objective support ( = -0.192, =0.002) and subjective support ( = -0.158, = 0.015) had significantly negative effects on depression, while the effect of support utilization was not statistically significant. In contrast, being female ( = 0.119, = 0.036) and patients with positive sputum smear results ( = 0.140, = 0.014) were positively related to depression. Patients with monthly income between 500 and 999 were less likely to suffer from depression ( = -0.134, = 0.024) than those who were poorer. Additionally, both education level and marital status were found to be correlated with social support and depression state (all <0.05).
In summary, the prevalence of depressive symptoms in pulmonary TB patients were high in Anhui Province, China. Low levels of social support can be an important predictor of depression symptoms. Therefore, screening for depression among pulmonary TB patients in the primary care setting is greatly warranted. Furthermore, psychological interventions should focus on providing available and adequate social support in order to improve mental health of them.
肺结核是一种由[具体病原体]引起的传染病，可累及多个组织和器官。它是主要死因之一，在中国属于社会性疾病。越来越多的研究表明，心理健康状况和社会支持与肺结核患者的发病率、死亡率及社区传播有关。然而，以往的全球结核病控制和研究策略几乎完全集中在生物医学方面。因此，在本研究中，我们评估了肺结核患者的抑郁水平，并探讨了潜在因素，包括社会支持领域和社会人口学特征，以研究其心理健康状况以及社会支持与肺结核之间的关联，最终实施多层次干预。
开展一项横断面研究，以描述抑郁和社会支持状况，并探索中国安徽省肺结核患者中与抑郁相关的因素。采用简单随机抽样方法选取中国安徽省的五个县（区）。对符合研究标准的肺结核确诊患者进行调查。使用一份由社会人口学特征信息、自评抑郁量表（SDS）和社会支持评定量表（SSRS）组成的结构化问卷收集数据。
本研究共发放问卷250份，实际回收有效问卷237份。在237例肺结核患者中，71.3%为男性，平均年龄为46.16岁（标准差 = 13.09）。125例（52.7%）参与者存在抑郁症状。客观支持（ = -0.192， = 0.002）和主观支持（ = -0.158， = 0.015）对抑郁有显著负面影响，而支持利用的影响无统计学意义。相比之下，女性（ = 0.119， = 0.036）和痰涂片结果呈阳性的患者（ = 0.140， = 0.014）与抑郁呈正相关。月收入在500至999元之间的患者比收入更低的患者患抑郁症的可能性更小（ = -0.134， = 0.024）。此外，发现教育水平和婚姻状况均与社会支持及抑郁状态相关（均 <0.05）。
综上所述，在中国安徽省，肺结核患者中抑郁症状的患病率较高。社会支持水平低可能是抑郁症状的重要预测因素。因此，在基层医疗环境中对肺结核患者进行抑郁筛查非常有必要。此外，心理干预应侧重于提供有效的和充分的社会支持，以改善他们的心理健康。
