Chen Li, Jia Shoumei, Li Ping, Shi Zhongying, Li Yang
School of Nursing, Fudan University, No. 305, Feng Lin Road, Shanghai 200032, PR China.
School of Nursing, Fudan University, No. 305, Feng Lin Road, Shanghai 200032, PR China.
Arch Psychiatr Nurs. 2022 Jun;38:6-13. doi: 10.1016/j.apnu.2022.01.004. Epub 2022 Jan 29.
Depressive disorder is the most prevalent mental illness and is characterised by the presence of mental and somatic symptoms, with the latter affecting 65.0% to 98.2% of patients with their general function and quality of life.
The purpose of this study aimed to explore the experiences and coping strategies of somatic symptoms in Chinese patients with depressive disorder, and to gain new insight into the illness and the health care provided to patients.
Semi-structured, in-depth interviews were conducted with 15 patients diagnosed with depressive disorder according to international classification of diseases 10th revision. The interviews were transcribed verbatim and the thematic analysis was adapted to the data. MAXQDA10 software was used to organise, encode, classify, induce, and extract themes.
Four major themes were extracted from the interviews: (1) descriptions of symptoms; (2) perceptions of the symptoms; (3) symptom disturbance; and (4) coping strategies of symptoms. Within the first theme, patients identified the following sub-themes: complex experiences of somatic symptoms, which were mainly in the neuromuscular system, circulatory respiratory system, gastrointestinal system and some symptoms without obvious systemic classification; difficulty in locating symptoms accurately; and being not consistent with examination results. The second theme included patient's inadequate understanding of somatic symptoms; and denial of the link between physical discomfort and depression. Disturbance of somatic symptoms embraced three sub-themes: (1) Uncertainty about somatic symptoms; (2) Struggling with daily life; (3) Impact on social activities; (4) feeling a decrease in family support. Lastly, coping strategies taken by patients in the face of various symptoms mainly included relying on drug treatment, avoiding stressors, diverting attention, and compromise or acceptance.
Patients with depressive disorder experience a variety of somatic symptoms that have a negative impact on social function and reduce their quality of life. Patients did not have an adequate understanding of their physical discomfort and lacked effective coping strategies for these somatic symptoms. Professional staff should pay more attention to patients' somatic symptoms and focus on targeted symptom management to facilitate patient recovery.
抑郁症是最常见的精神疾病，其特征是存在精神和躯体症状，后者影响65.0%至98.2%的患者的总体功能和生活质量。
本研究旨在探讨中国抑郁症患者躯体症状的体验和应对策略，以获得对该疾病以及为患者提供的医疗保健的新见解。
根据国际疾病分类第10版，对15名被诊断为抑郁症的患者进行了半结构化的深入访谈。访谈内容逐字记录，并对数据进行了主题分析。使用MAXQDA10软件来组织、编码、分类、归纳和提取主题。
从访谈中提取了四个主要主题：（1）症状描述；（2）对症状的认知；（3）症状困扰；（4）症状应对策略。在第一个主题中，患者确定了以下子主题：躯体症状的复杂体验，主要存在于神经肌肉系统、循环呼吸系统、胃肠道系统以及一些无明显系统分类的症状；难以准确确定症状位置；以及与检查结果不一致。第二个主题包括患者对躯体症状的理解不足；以及否认身体不适与抑郁症之间的联系。躯体症状困扰包括三个子主题：（1）对躯体症状的不确定性；（2）与日常生活作斗争；（3）对社交活动的影响；（4）感觉家庭支持减少。最后，患者面对各种症状所采取的应对策略主要包括依靠药物治疗、避免压力源、转移注意力以及妥协或接受。
抑郁症患者经历了各种躯体症状，这些症状对社会功能产生负面影响并降低了他们的生活质量。患者对自己的身体不适没有充分的理解，并且缺乏针对这些躯体症状的有效应对策略。专业人员应更加关注患者的躯体症状，并专注于有针对性的症状管理，以促进患者康复。
