| Objectives In this study,a large comprehensive Class A public hospital（provincial sub-designated hospital）in Yunnan Province was taken as an example to investigate the mental health status of inpatients with chronic noncommunicable diseases during the novel coronavirus epidemic.Through the analysis of the mental health status of inpatients,the factors affecting their psychological status were discussed,especially whether the mental distress of inpatients with chronic diseases was aggravated under the background of the epidemic.Under the modern medical model,improvement strategies are proposed to effectively carry out the business process of improving the psychological feelings of patients,conduct psychological counseling,and promote the rapid and comprehensive recovery of hospitalized patients with chronic diseases,providing objective basis for optimizing the hospital management under sudden public health events.Methods This study adopts the method of combining quantitative research with qualitative research.In qualitative research,structured interview method was used to interview some patients and their families,department directors and head nurses,heads of medical departments,outpatient departments,infection management offices and other functional departments,to understand the mental health status and needs of chronic non-communicable disease inpatients in a comprehensive Grade A public hospital in Yunnan Province.A total of 510 inpatients with chronic non-communicable diseases in the department of respiratory,nephrology,cardiology,endocrinology,diabetes,oncology,hematology and other departments of a comprehensive Class A public hospital in Yunnan Province were selected as the research objects from October to December 2022 in a cross-sectional survey.General data questionnaire was used to investigate the basic situation.COVID-19 related psychological distress scale,coronavirus anxiety scale and COVID-19 fear scale were used to investigate from the emotional dimension of mental health.The Social Support Rating Scale,the Patient Health Questionnaire（PHQ-9）and the Generalized Anxiety Inventory（GAD-7）were investigated from the spiritual dimension of mental health.Survey results SPSS 19.0 was used for descriptive analysis of data,independent sample t test,one-way analysis of variance,Sperman correlation analysis,multiple linear stepwise regression analysis,and principal component analysis.Results1 Results of qualitative interview:Interview Inpatients with chronic noncommunicable diseases and their families,department directors and head nurses,as well as heads of functional departments such as the medical department,outpatient department and infection management office,were interviewed on issues related to physical and mental health,psychological counseling,and hospital epidemic prevention and control measures.Results Under the background of COVID-19 prevention and control,the hospital continuously optimized the business process of the hospital,improved the safety of the hospital environment,and did a good job in patient treatment and epidemic prevention and control,but at the same time,the change of treatment behavior caused by the epidemic prevention and control measures caused a large degree of psychological distress to patients.The inpatients with chronic diseases have great demand in receiving health education actively and providing psychological counseling services regularly.Front-line medical workers and functional departments hope that the hospital should optimize the treatment process,strengthen the psychological counseling of hospitalized patients with chronic diseases under the background of sudden public health events,and take multiple measures to promote the physical and mental health of patients.2.Quantitative survey results:2.1 In terms of the emotional dimension of the hospitalized patients with chronic noncommunicable diseases in the hospital under the background of the novel coronavirus epidemic,the average score of 510 hospitalized patients with chronic diseases in the COVID-19 psychological distress scale was 42.03±8.19,among which 72.55%（370/510）patients scored higher than the average score.The top three departments were medical oncology,rheumatology and immunology,and respiratory medicine.The interquartile interval of the coronavirus anxiety scale score was 0（0,3）,and the top three departments were rheumatology and immunology,respiratory medicine and oncology surgery.The average score of COVID-19 fear scale was 24.50±6.65,among which 53.73%（274/510）patients with scores higher than the average score accounted for the top three departments in the average score were rheumatology and immunology,surgical oncology and medical oncology.In terms of mental dimension,59.00%（301/510）of hospitalized patients with chronic noncommunicable diseases scored less than 33 points in total social support,indicating that the level of social support was generally average.The detection rates of anxiety and depression were 46.08%（235/510）and 57.06%（291/510）,respectively,and the severity of mental abnormality was mainly mild or moderate.The dimension of intelligence has not been analyzed.2.2 After multi-factor analysis,Among the 17 factors（P<0.05）affecting the emotional dimension of COVID-19 related psychological distress among inpatients with chronic noncommunicable diseases in the hospital under the background of COVID-19,15 factors were entered into the regression equation,which were age,education background,marital status,long-term residence,monthly income,daily number of medication,number of complications,annual number of hospitalization,and average length of hospitalization per stay Number,self-care ability,delayed medical treatment,number of COVID-19 vaccine injections,other epidemic prevention and control measures taken by the hospital,no change in medical habits,face-to-face treatment with the doctor,unwilling to go to the hospital to take medicine on their own if it is impossible to go to the doctor.In the context of the novel coronavirus epidemic,12 of the 13 factors（P<0.05）affecting the emotional dimension of the fear of COVID-19 among the inpatients with chronic noncommunicable diseases in the hospital entered the regression equation.They are education background,long-term residence,monthly income,number of complications,annual hospitalization,self-care ability,showing health code travel code to take body temperature,showing nucleic acid test results,setting up vaccination sites for COVID-19,other epidemic prevention and control measures taken by hospitals,not willing to go to hospitals to take medicine on their own,and finding a doctor if it is impossible to do so,and satisfaction of hospitalized patients under the epidemic.After a multi-factor analysis,In the context of COVID-19,among the 12 factors（P<0.05）affecting the level of social support in the mental dimension of inpatients with chronic non-communicable diseases in the hospital,12 factors were entered into the regression equation,which were age,BMI value,marital status,long-term residence,distance from home to the hospital,number of complications,self-care ability,inpatient caregivers,and vaccination of COVID-19vaccine Needle times,nucleic acid test limit number,no change in medical habits face-to-face with doctors,reluctant to go to the hospital to consult relatives and friends.In the context of the novel coronavirus epidemic,12 factors（P<0.05）of the 12 factors affecting the mental dimension of anxiety in the inpatients with chronic non-communicable diseases in the hospital entered the regression equation,which were gender,long-term residence,number of complications,annual hospitalization,average length of hospitalization,treatment of the disease,self-care ability,inpatient caregivers,and nucleic acid detection limit No change in the habit of seeing a doctor face to face,not willing to go to the hospital to take medicine on their own if it is impossible to find a doctor,patient satisfaction evaluation under the epidemic situation;Among 13 factors（P<0.05）affecting the mental dimension of depression in patients with chronic non-communicable diseases in the hospital under the background of COVID-19,13 factors entered the regression equation,which are gender,BMI value,number of diseases,number of complications,annual hospitalization,average length of hospitalization,self-care ability,and the inpatient caregiver,nucleic acid test limit number,One patient and one attendant,no change in the habit of seeing a doctor face to face,reluctant to go to the hospital to take medicine by themselves,and find a doctor if it is impossible,patient satisfaction evaluation under the epidemic situation.2.3 According to the principal component analysis,COVID-19 related psychological distress in the emotional dimension of inpatients with chronic noncommunicable diseases in the hospital,All influencing factors can be explained by seven principal components,and the regression equation is as follows:YCOVID-19 related psychological distress=47.645-2.184*X first principal component+1.657*X second principal component+2.903*X third principal component+2.015*X fourth principal component+1.398*X fifth principal component+0.400*X sixth principal component-0.411*X The seventh principal component,the first principal component includes monthly wage income,education background,long-term residence,mainly reflects the residence and personal basic conditions of hospitalized patients with chronic diseases;The factors influencing the fear of COVID-19 in the emotional dimension of inpatients with chronic noncommunicable diseases in this hospital can be explained by five principal components,and the regression equation is as follows:YCOVID-19 fear scale=24.504-1.171*X first principal component+0.845*X second principal component+1.355*X third principal component+1.284*X fourth principal component-0.591*X fifth principal component,in which the first principal component included educational background,long-term residence,monthly wage income,It mainly reflects the basic situation of hospitalized patients with chronic diseases under the background of COVID-19.Because the score of the coronavirus anxiety scale showed skewed distribution,principal component analysis was not performed.The factors influencing the level of social support in the mental dimension of chronic non-communicable disease inpatients in this hospital can be explained by eight principal components.The regression equation is as follows:Y social support level=42.031+0.338*X first principal component-0.761*X second principal component+1.019*X third principal component-1.137*X fourth principal component+0.389*X fifth principal component-1.074*X sixth principal component+1.271*X seventh principal component+0.110*X The eighth principal component,in which the first principal component includes long-term residence,distance from home to hospital and monthly wage income,which mainly reflects the residence and personal income of hospitalized patients with chronic diseases;The influencing factors of depression in the emotional dimension of chronic non-communicable disease inpatients in this hospital can all be explained by five principal components.The regression equation was as follows:Y patient’s health questionnaire=6.557+0.836*X firstprincipal component+1.344*X second principal component+1.832*X third principal component+0.189*X fourth principal component+0.170*X fifth principal component.The first principal component includes no change in habit of going to the hospital to see a doctor face to face,unwilling to go to the hospital to take medicine on their own,and then go to the doctor,which mainly reflects the change of medical habits of hospitalized patients with chronic diseases under the background of the novel coronavirus epidemic.The influencing factors of anxiety in the emotional dimension of inpatients with chronic noninfectious diseases in this hospital can all be explained by five principal components,Y generalized anxiety scale=5.018+0.777*X first principal component+1.210*X second principal component+0.710*X third principal component+1.501*X fourth principal component+0.241*X fifth principal component.The first principal component includes no change in the habit of going to the hospital to see a doctor face to face and not willing to go to the hospital to take medicine by themselves,which mainly reflects the change in the medical habits of hospitalized patients with chronic diseases under the background of the novel coronavirus epidemic.2.4 According to Sperman grade correlation analysis,the grade coefficient rsof mental health emotional dimension and mental dimension of chronic disease inpatients in a comprehensive Grade A public hospital in Yunnan Province was 0.233,indicating a positive correlation between emotional health and mental health.Conclusions1.Under the background of the novel coronavirus epidemic,the mental health status of the inpatients with chronic noncommunicable diseases in the hospital is not optimistic.Under the modern medical model,the emotional dimension of the mental health of the inpatients with chronic noncommunicable diseases is positively correlated with the mental dimension,and is positively correlated with anxiety and depression,and negatively correlated with social support.The good emotional health of patients with chronic noncommunicable diseases in this hospital promotes good mental health.2.In terms of the emotional dimension of mental health,the majority of patients scored higher than the average score on the scale of COVID-19 related psychological distress,indicating that patients had a high degree of psychological distress affected by the novel coronavirus epidemic.The top three departments were medical oncology,rheumatology and immunology,and respiratory medicine.The top three departments on the coronavirus anxiety scale were rheumatology and immunology,respiratory medicine and oncology surgery.More than half of the patients’COVID-19fear scale score was higher than the average score.The top three departments were rheumatology and immunology,oncological surgery and oncological medicine.In the aspect of spiritual dimension,the social support level of patients was general;The detection rate of anxiety and depression in hospitalized patients with chronic noncommunicable diseases was higher than that of patients with chronic diseases in non-epidemic period,and the severity of mental symptoms was mainly mild or moderate.The dimension of intelligence has not been analyzed.3.Among the factors affecting the mental health status of inpatients with chronic non-communicable diseases in the hospital under the background of COVID-19,the factors related to the emotional dimension include different departments,age,education background,marital status,residence,monthly income,times of taking medicine per day,number of diseases,average number of hospitalizations per year,average length of hospitalization,self-care ability,number of complications,delay in seeking medical treatment due to COVID-19,The number of COVID-19 vaccination,hospital epidemic prevention and control measures,changes in admission procedures,changes in medical habits,showing health code,travel code,taking body temperature,showing nucleic acid test results,setting COVID-19 vaccination sites,satisfaction with medical treatment during the epidemic;Factors related to mental dimension include age,BMI value,marital status,residence,distance from home to hospital,gender,number of disease complications,self-care ability,number of hospitalized caregivers,number of diseases,average number of hospitalizations per year,average length of stay,treatment methods,number of COVID-19 vaccine vaccinations,limit number of nucleic acid tests,and medical habits Changes,one patient and one attendant,changes in admission procedures,satisfaction with medical treatment during the epidemic;The dimension of intelligence has not been analyzed. |
PDF Full Text Request