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浙江省人感染H7N9禽流感疫情流行期间公众负面心理特征研究
作者:张人杰 姜婷婷 李娜 王臻 刘碧瑶 方乐 张新卫

摘要:

目的  研究浙江省人感染H7N9禽流感疫情流行期间公众的认知和情绪反应特征,为突发公共卫生事件下的群体心理干预提供科学依据。方法  于2013年3月至2014年4月,采用分层整群抽样方法,选取浙江省杭州、嘉兴、丽水市3个地区19个区(县)的57个街道(乡镇)作为调查现场。采用方便抽样方法抽取2 319名一般大众人群;采用普查法筛选390名H7N9禽流感患者密切接触人员,其中,患者家属109名,医务人员281名。调查对象的纳入标准为:年龄>10岁;能够独立或在调查人员询问下完成问卷。本研究共计调查2 709名对象,使用H7N9禽流感风险感知和应对问卷、负面情绪问卷对其开展问卷调查,了解其对疾病的认知情况以及疫情相关负面情绪特征。采用Spearman相关分析法对公众风险感知和应对与负面情绪的相关性进行分析。结果  2 709名调查对象中有95.10%(2 576名)的公众对疾病的风险有不同程度的感知,91.00%(2 465名)的公众采取了疫情应对措施。调查对象在抑郁、神经衰弱、恐惧、强迫-焦虑、疑病5个维度负面情绪的阳性率分别为36.40%(986名)、37.21%(1 008名)、79.70%(2 159名)、33.41%(905名)、27.69%(750名)(χ2= 1 935.89,P<0.001);患者家属、医务人员及一般大众人群抑郁得分的P50P25~P75)分别为0.50(0.00~ 0.83)、0.17(0.00~0.67)、0.17(0.00~0.50)分(H=7.27,P=0.030);神经衰弱得分分别为0.20(0.00~0.60)、0.2(0.00~0.40)、0.00(0.00~0.20)分(H=64.74,P<0.001);恐惧得分分别为0.83(0.33~1.17)、0.33(0.17~ 0.67)、0.33(0.17~0.83)分(H=30.03,P<0.001);强迫-焦虑得分分别为0.17(0.00~0.50)、0.00(0.00~ 0.33)、0.00(0.00~0.17)分(H=51.82,P<0.001)。一般大众人群中,女性的神经衰弱、恐惧、强迫-焦虑得分的P50P25~P75)分别为0.00(0.00~0.20)、0.50(0.17~0.83)、0.00(0.00~0.17)分,高于男性[0.00(0.00~0.20)、0.33(0.00~0.67)、0.00(0.00~0.17)分](χ2值分别为5.26、27.52、8.29,P值均<0.05);医务人员中,女性的抑郁、神经衰弱、恐惧、强迫-焦虑、疑病得分分别为0.33(0.00~0.67)、0.20(0.00~0.40)、0.50(0.17~0.83)、0.00(0.00~0.33)、0.00(0.00~0.50)分,高于男性[0.00(0.00~0.50)、0.00(0.00~0.40)、0.33(0.17~0.50)、0.00(0.00~ 0.17)、0.00(0.00~0.00)分](χ2值分别为7.22、7.97、14.46、4.93、5.22,P值均<0.05);患者家属中,自评时心理状况不好的家属抑郁和神经衰弱得分分别为0.50(0.08~0.96)、0.30(0.00~0.55)分,高于心理状况好的家属[分别为0.17(0.00~0.83)、0.20(0.00~0.60)分](χ2值分别为12.95、11.20,P值均<0.05)。Spearman相关分析显示,调查对象风险感知程度与抑郁、神经衰弱、恐惧、疑病情绪均呈正相关,相关系数分别为0.07、0.07、0.08、0.04(P值均<0.05);风险应对水平与抑郁、神经衰弱、恐惧、强迫-焦虑、疑病均呈正相关,相关系数分别为0.09、0.09、0.12、0.05、0.04(P值均<0.05)。结论  公众对人感染H7N9禽流感疫情的关注程度较高,存在一定程度疫情相关负面情绪,其中女性、年龄≥60岁、初中及以下文化程度、从事农业劳动、自评时身心健康状况不佳的人群负面情绪最为显著;公众风险感知和应对与抑郁、神经衰弱、恐惧、疑病均呈正相关。

关键词:禽流感;公共卫生;心理过程;公众;负面情绪

Abstract:

Objective  To evaluate the cognition and emotional response of the public in Zhejiang province during the epidemic of human H7N9 avian influenza and provide scientific support for group psychological intervention under public health emergency.Methods  57 communities in 19 counties from Hangzhou, Jiaxing and Lishui district of Zhejiang province were selected as survey sites using stratified clustered sampling method from March, 2013 to April, 2014. 2 319 ordinary civilians were chosen using convenience sampling method and 390 individuals who had close contact history with H7N9 avian influenza patients, 109 family members of patients and 281 medical workers, were selected using census method. The inclusion criteria for subjects were: subjects aged over 10 years; could complete the questionnaire independently or with the help of the investigators. A total of 2 709 subjects were surveyed by avian influenza risk perception and response questionnaire, negative emotion questionnaire was also used to see their cognition and negative emotion related to the disease. Spearman correlation analysis was used to analyze the interrelationship between public risk perception, response and negative emotions.Results  95.10% (2 576)of the subjects have sensed the risk of epidemic and 91.00% (2 465) of the subjects have taken preventive measures in 2 709 subjects. The positive rate for depression, neurasthenia, fear, anxiety and hypochondriasis were 36.40% (986) , 37.21% (1 008) , 79.70% (2 159) , 33.41% (905) , 27.69% (750) respectively (χ2=1 935.89, P<0.001) ;the P50(P25-P75) of the depression scores of patients' family members, medical workers and the general public were 0.50 (0.00-0.83), 0.17 (0.00-0.67), 0.17 (0.00-0.50) (H= 7.27, P=0.03) ; the neurasthenia scores were 0.20 (0.00-0.60), 0.2 (0.00-0.40), 0.00 (0.00-0.20) (H= 64.74, P<0.001) ; fear scores were 0.83 (0.33-1.17), 0.33 (0.17-0.67), 0.33 (0.17-0.83) (H=30.03, P< 0.001) ; anxiety scores were 0.17(0.00-0.50), 0.00(0.00-0.33), 0.00(0.00-0.17) (H=51.82, P<0.001). The neurasthenia, fear, anxiety scores (P50(P25-P75)) for females among the public were 0.00(0.00-0.20), 0.50(0.17-0.83), 0.00(0.00-0.17), which were higher than those of male's (0.00(0.00-0.20), 0.33(0.00-0.67), 0.00(0.00-0.17)) (χ2 values were 5.26, 27.52, 8.29, P<0.05); Among medical staff, the depression, neurasthenia, fear, anxiety and hypochondriasis scores for females were 0.33(0.00-0.67), 0.20(0.00-0.40), 0.50(0.17-0.83), 0.00(0.00-0.33), 0.00(0.00-0.50) respectively, which were higher than those of males'(0.00(0.00-0.50), 0.00(0.00-0.40), 0.33(0.17-0.50), 0.00(0.00-0.17), 0.00(0.00-0.00))(χ2 values were 7.22, 7.97, 14.46, 4.93, 5.22, P<0.05); for the family members of the patients who were in poor mental conditions when doing self-assessment, their depression and neurasthenia scores were 0.50(0.08-0.96), 0.30(0.00-0.55), which were higher than those of people in good mental conditions(0.17(0.00-0.83), 0.20(0.00-0.60)) (χ2 values were 12.95, 11.20, P<0.05). Spearman correlation analysis showed that the subjects' risk perception level was positively correlated with depression, neurasthenia, fear, and hypochondriasis, with the correlation coefficients 0.07, 0.07, 0.08, 0.04, respectively (P<0.05) ; the subjects' risk response level was also positively related with depression, neurasthenia, fear, anxiety and hypochondriasis, and the correlation coefficients were 0.09, 0.09, 0.12, 0.05, 0.04, respectively (P<0.05).Conclusion  The general public was highly concerned about the epidemic of H7N9 avian influenza and developed certain levels of negative emotions. The female, equal or over 60 years old, those with poor educational level, agricultural related occupation and poor physical and psychology health were risk factors of disease related negative emotions. The subject's risk perception and response level was positively related with depression, neurasthenia, fear and hypochondriasis.

Key words: Influenza in birds;Public health;Mental processes;Public;Negative emotions

发表日期:2015/12

引用本文:

图/表:

  • 10.3760/cma.j.issn.0253-9624.2015.12.011.T001:表1 浙江省2 709名调查对象基本特征

    10.3760/cma.j.issn.0253-9624.2015.12.011.T001:表1 浙江省2 709名调查对象基本特征

  • 10.3760/cma.j.issn.0253-9624.2015.12.011.T002:表2 浙江省2 709名调查对象负面情绪各维度得分情况及阳性率比较

    10.3760/cma.j.issn.0253-9624.2015.12.011.T002:表2 浙江省2 709名调查对象负面情绪各维度得分情况及阳性率比较

  • 10.3760/cma.j.issn.0253-9624.2015.12.011.T003:表3 浙江省2 709名不同人群负面情绪各维度得分情况[P50(P25~P75)]

    10.3760/cma.j.issn.0253-9624.2015.12.011.T003:表3 浙江省2 709名不同人群负面情绪各维度得分情况[P50(P25~P75)]

  • 10.3760/cma.j.issn.0253-9624.2015.12.011.T004

    10.3760/cma.j.issn.0253-9624.2015.12.011.T004

  • 10.3760/cma.j.issn.0253-9624.2015.12.011.T005

    10.3760/cma.j.issn.0253-9624.2015.12.011.T005

  • 10.3760/cma.j.issn.0253-9624.2015.12.011.T006

    10.3760/cma.j.issn.0253-9624.2015.12.011.T006

  • 10.3760/cma.j.issn.0253-9624.2015.12.011.T007:表7 浙江省2 709名调查对象风险感知和应对与负面情绪的Spearman相关分析结果(r值)

    10.3760/cma.j.issn.0253-9624.2015.12.011.T007:表7 浙江省2 709名调查对象风险感知和应对与负面情绪的Spearman相关分析结果(r值)

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