| 其他摘要 | With the development of psychosomatic medicine and bio-psycho-social medical model, the relationship between physical diseases and mental health has been paid more and more attention by doctors,patients and their families. Allergic Rhinitis (AR) is a chronic disease with increasing morbidity. Its recurrent episodes not only bring patients financial burden and physical pain, but also threaten their mental health and well-being of patients. Therefore, exploring the psychosomatic relationship of AR patients can provide an important basis for doctors to accurately evaluate the psychosomatic state of patients and improve the effectiveness of diagnosis and treatment.Based on the stress theory of psychosomatic medicine, the current study explored the mental health and related effects of patients with allergic rhinitis. Firstly, the mental health of AR patients in China is evaluated from different viewpoint, and the related factors that may affect their mental health are discussed. Symptom Checklist-90 (SCL-90), State-Trait Anxiety Inventory (STAI) and Minnesota Muliphasic Personality Inventory (MMPI) were used to evaluate the mental health of AR patients. Study 1A found that the results of SCL-90 of two AR samples 10 years apart were significantly worse than the existing Chinese norm, mainly reflected in somatization, compulsive symptoms, anxiety, hostility and psychosis, etc. Nasal itching and nasal obstruction were the main clinical symptoms affecting mental health. Study 1B showed that AR combined with asthma is an indepentant factor affecting mental health. The results of STAI study 1C showed that AR type had no correlation with anxiety, but was associated with the severity of rhinitis symptoms. Study 1D showed that nasal obstruction predicted anxiety in AR patients, but not in VMR patients. Study 1E found that the MMPI results of AR patients were significantly different from those of healthy people in terms of suspicious, depression, hysteria, hypomania, social introversion and explicit anxiety, revealing that AR patients had the personality traits of suspicious, exaggerated condition, more anxiety, more irritability and desire to be lone. Study 1 explored the mental health status of AR patients in China from different angles, comprehensively clarified the impact of AR on patients' mental health, which providing empirical evidence for AR psychosomatic medical research and clinical psychosomatic treatment.The second part of the study explored the impact of rhinitis symptoms in seasonal allergic patients on their physical and mental health and work behavior. Specifically, the experienced sampling method was used to collect data.A total of 76 cases of AR rhinitis patients with autumn pollen allergy was invited as the research objects. A 2-week WeChat questionnaire survey was conducted on the network platform during the pollen season and the dynamic change trend of AR patients’ rhinitis symptoms on sleep, mood change and spill over into work were evaluated. The results of multiple paths analysis showed that rhinitis symptoms were significantly aggravated with the increase of pollen concentration, which affected insomnia and a negative mood the next morning, leading to unethical behavior at work. Meanwhile, the results of indirect effect analysis showed that rhinitis symptoms indirectly affected patients' negative mood and unethical behavior of the following day through insomnia. In short, with the dispersal of pollen grains in autumn, AR patients have worse nasal symptoms, resulting in insomnia and negative mood, followed by an increase in unethical behaviors at work. Additional analysis found that most of the AR patients showed poor medication compliance. This provides the possibility of taking medication as the target of intervention.In the third part, 96 patients with pollen allergy in spring were recruited and randomly divided into four groups for medication compliance intervention. The interventions of the four groups were as follows: reminding the patients to take medicine, informing the patients of pollen concentration the next day, reminding-informing intervention, and no intervention (control group). The intervention information was sent to the subjects by mobile phone WeChat every night. The patients reported the medicine taking, the nasal cavity cleaning and mask wearing behaviors. The results showed that the group with medication reminder had the better curative effect than other groups. Instead, the pollen information becomes a factor that interferes with the regular medication. It is suggested that the professional reminder medication can improve patients’ medication compliance, while too much information may interfere with medication compliance.In summary, the current study first focuses on the mental health characteristics of patients with allergic rhinitis, and clarifies the effects of allergic disease on mental health. Further, we explore the dynamic negative effects of symptoms in AR patients on mental health and work behavior, through experienced sampling method and path analysis in pollen season. Finally, reminding patients to taking medicine via mobile phone is an effect strategy to improve patient's medication compliance. This study can provide a theoretical basis for doctors to fully understand the physical and mental state of AR patients, and improve the effectiveness of diagnosis and treatment from the perspective of psychosomatic medicine. |
修改评论