The Current Status And Experience Of Psychological Distress In Outpatient Patients With Pulmonary Nodules

Objective:To understand the inner experience of outpatient patients with pulmonary nodules by investigating the current situation of psychological distress.To provide basis for individualized nursing and early psychological intervention for outpatient patients with pulmonary nodules.Methods: In the quantitative study,a total of 158 patients with pulmonary nodules who were admitted to the cardiothoracic surgery outpatient department of a third-class A hospital in Hefei from January 2019 to December 2020 were selected as the research subjects by the convenience sampling method in the quantitative study.The quantitative study used a general information questionnaire and a psychological distress screening tool.The general information questionnaire included gender,age,marital status,education level,per capita family monthly income,occupation,medical payment method and treatment method.Psychological difficulties screening tool includes a Thermometer(Distress Thermometer,DT)and List(Problem List,PL),DT is a marked 0 ～ 10,a total of 11 scale(0 = no,10 = extremely disturbed)the visual simulation of the single item scale,PL is including physical problems,family problems,practical problems,emotional problems,four dimensions,covers the psychological Distress of 50 items specific issues.Qualitative interview was conducted on 9outpatient patients with pulmonary nodules whose DT score was ≥4 points.An in-depth interview was conducted around the interview outline to analyze the real experience of patients’ psychological distress and the related causes of psychological distress.Results:(1)The score of psychological distress was divided into the cut-off value of DT greater than or equal to 4.The incidence of psychological distress in outpatient patients with pulmonary nodules was 41.1%(65/158),and the average score was(3.68±2.26).Univariate analysis of DT scores of outpatients with pulmonary nodules showed that there were significant differences in psychological distress scores among patients with different ages,marital status,education,family income,occupation and medical payment methods(P <0.05).Multiple linear regression analysis showed that age,education level,marital status and occupation were the factors that affected DT score(P < 0.05).(2)Specific problems of psychological distress(PL)are mainly reflected in the lack of relevant knowledge of the disease,economic pressure,inconvenience of medical treatment,worry,tension,fear and anxiety,and the proportion of specific problems of psychological distress in the seven aspects is more than 50%.Univariate analysis of PL scores of outpatients with pulmonary nodules showed that there were significant differences in psychological distress scores among patients with different ages,education levels,family income,occupations and medical payment methods(P <0.05).Multiple linear regression analysis showed that age,education level and occupation were the factors that affected PL score(P < 0.05).(3)In the qualitative interview,the psychological distress experience of outpatient patients with pulmonary nodules includes fear,disappointment,complaint and self-accusation;The causes of psychological distress experience are as follows: family role change and economic pressure;Lack of assistance from health care workers.Conclusion:Outpatient patients with pulmonary nodules have common psychological distress,and different demographic characteristics,including age,marital status,education level,occupation,are the factors that affect the score of psychological distress.The specific problems of the patients’ psychological distress are mainly reflected in the lack of relevant knowledge of the disease,economic pressure,medical inconvenience,worry,tension,fear and anxiety,among which age,education level and occupation are the factors that affect the score of the specific problems of psychological distress.Medical staff should pay attention to patients’ psychological experience,give outpatient patients with pulmonary nodules a comprehensive disease-related knowledge education,give emotional care and counseling,and provide patients with supportive measures to facilitate medical treatment.