摘要目的 研究导致骨科手术患者产生抑郁情绪的重要影响因素,并针对其提出合理的护理方案.方法 使用抑郁自评量表(SDS)、社会支持评定量表(SSRS)和自行设计问卷方法对198例骨科手术患者进行调查,回收有效问卷185份.对各项影响患者抑郁情绪的因素进行Logistic回归分析.结果 185例准备接受手术治疗的患者中合并抑郁105例占56.8％,105例抑郁患者中轻度抑郁70例占66.6％,中度抑郁30例占28.6％,重度抑郁5例占4.8％.本组患者手术前SDS评分为(37.59±8.74)分,与全国常模SDS评分(33.46±8.55)分相比显著升高；单因素和多因素Logistic回归分析显示,自费医疗、担心预后不良、担心诊疗水平、认为医护态度不好都是导致患者产生抑郁情绪的主要原因；而社会支持利用度水平较高则是防止患者抑郁的保护性因素.结论 针对骨科患者较为严重的抑郁心理,医务人员应该采取一定措施来提高患者的心理素质,从而达到提高身体素质的目的.

abstractsObjective To study the influencing factors which will lead to depression in patients undergoing orthopedic operation and put forward reasonable nursing countermeasures. Methods 198 patients with orthopaedic operation were investigated using the self-rating depression scale (SDS),social support rating scale (SSRS) and self-designed questionnaire.The influencing factors underwent Logistic regression analysis. Results 105 cases of patients with depression were found among 185 cases,accounting for 56.8％,and 70 cases(66.6％) with mild depression,30 cases(28.6％) with moderate depression,5 cases (4.8％) with severe depressive disorders.SDS score before operation was (37.59 ± 8.74),higher than (33.46 ± 8.55 ) of the national norm.Single factor and multiple factors Logistic regression analysis revealed that paying out-of-pocket for healthcare,worrying about poor prognosis,worrying about the diagnosis and treatment level,considering bad attitude of medical staff were main influencing factors for depression,while social support is a good way to protect patients against depression. Conclusions To cope with the serious depression of orthopedic patients,medical staff should take certain measures to improve patients' psychological quality,so as to achieve the purpose of improving their physical quality.