Mức độ và biểu hiện lo âu ở bệnh nhân cao tuổi

ML/C DO VA BIEU HIEN LO AU BENH N H A N C A O TUOI Nghien ctru dirge tai trg bdi Quy Phat trien Khoa hpc va Cdng nghe Qudc gia (NAFOSTED) de tai: Hoat dong tif cham soc site kttde tam than cua ngirdi cao tuoi: Thifc trang - giai pttap trcj giup tii ctiam soc sire khde tam than cOa ngirdi cao tuoi tai cong dong; Ma sd: QG.16.45; PGS.TS Hoang Mdc Lan lam chu nhiem PGS.TS Hoang Mdc Lan ON Nguyen Lan Nguyen Klioa Tdm ly hgc, Trudng Dgi hgc Khoa hoc Xd ligi vd Nhdn vdn Dgi hgc Qudc gia Ha Ndi TOM TAT Kel qud nghien ciru 70 ngudi benh cao luoi dang dieu tri lai Khoa Tieu hda - Benh vien Bach Mai Hd Noi dd cho Ihdy ngicm benh co mirc lo du vica phdi nhom 75 - HO tuoi CO ty le rdi loan lo du cao Khong co su khdc biet cd y nghia thong ke ve miic lo du giiia nam va nir Co sic khdc biel va cdc trieu chimg sinh ly ca the bieu hien lo du giica cdc nhdm benh nhdn theo lieu chi tinh trgng hon nhdn hien dang vong vdi hoac lieu chi lie ddnh gid ve link Irang sice khoe cua ho Cdc trieu chicng sinh ly co the hieu hiHn lo du lap Irung chii yeu d he lim mach, tieu hda, thdn kinh Ndi dung io du da dang, io du ve benh Idl vd Idi chinh chiem ty le cao nhdt, tiep den id lo ve thicc phdm d nhiem Til- khoa: Lo du, Rai loan lo du: Ngicdi cao ludi Ngdynhdnbdi- [9/9l20\6; Ngdy duyet dang bdi: 25/2/2017 ABSTRACT Study on 70 elderly patients having Ireatmenl in Gastroenterology of Bach Mai Haipilal in Hanoi shoved that Ihe patients have medium level of anxiety the rale olpeople experiencing anxiety was highest among patients aged 75 - 80 There wa\ no slatislically significanl differena: in anxiety level between men and women Differences in physiological anxiety symptoms were documented by marilal sialics, cohabitants and their self-evaluated health The physiological anxiety symptoms are mainly /ound in cardiovascular digestive and nermiis systems The is.siies ahum which patients were worried were various The most common worries were about illness and finance, followed by poiluled foods Key words: Anxiety Anxiety disorder Hie elderly TAP CH! JAM LV HOC Sd (216), - 201 Dat van 6e Lo au la chuyen thucmg thdy dai s6ng ctia nguoi va la phan ung binh thuong c6 mot kho khan, cSng thang, mot hoan canh ngang Irai, de dpa Lo au mot chut co thd khidn ca nhan tinh lao hon va tap trung hon phai doi mat vai nhung tinh hudng Nhung ndu qua lo au, nghT nggi den n6i mat an, mat ngu, khong lam duoc cong viec hang thi la hk thuang va co the bj roi loan lo au (Anxiety Disorder) R6i loan lo au la su sp hai qua mirc, khong co nguyen nhan, chii quan ciia than chu va khong th6 giai thich dugc mgt roi loan tam than khac hoac mgt benh ca thd Lo au co thd la bien chung ciia dieu tri ho?c xuat phat tu nhan dinh tidu circ vd tien lugng bdnh cua minh Bdnh nhan cam thay sg hai, lo lang ve tuong lai dd cau, kho tap trung tu tuang cang thang van dgng, bon chon, diing ngdi khong yen dau dau, kho midng danh nguc (Nguyen Sinh Phuc, 2013) N6i lo ciia nhung nguai mac rdi loan lo au thuang lidn quan ddn nhung van dd ciia doi song thuang nhat hoac nhu'ng van de khong may quan trgng ma hg co thd nhan thuc dugc, song rat kho co thd kiem soat no Lo au la loai roi loan tam Iy thuang gap nhat Da so truang hgp ca nhan bict la co bdnh, vice cham soc ca ban la tu bdnh nhan va gia dinh xii tri a nha (Robert L Leahy, 2012) Bdnh Io au thay a mgi nguai mgi giai, mgi luoi nhung nu giai thuong bi bdnh nhieu gap doi Nghien cuu ciia Meimberg (1999) (dan theo David.Nutl va James Ballcnge 2003) cho thay khong co su khac bict nhieu ve ngi dung Io au giua nhom Io au binh thuang va rdi loan Io au Chinh vi vay xem xet vd lo au bdnh Iy ndn chu trgng vao viec tim hieu xem benh nhan lo au nhu thd nao han la lo au vd dieu gi (i nguai cao tudi tir 60 tuoi tra idn cung vai su gia tang cac bdnh thirc the, cac rdi loan tam Iy thmmg gap la tram cam va lo au Dac dicm bdnh ly cua nguai cao tuoi la mac nhicu bdnh cung mgt liic nhu tang huydt ap, su\' tim, nhdi mau ca tim tai bien mach mau nao dai thao duong, Alzheimer, Parkinson Ciie benh xuong \a khap, benh phoi, phe quan, ung thu Hau qua la bdnh tat lam thay ddi manh mc va sau sac tam ly va nhan each cua nguoi benh Bdnh cang nang cang keo dai thi Io au a nguai cao tuoi cang tram trgng Thue Id, vide chan doan Io au a nguai cao tudi thuang la kho va hay bi bd qua, dan den da so nguoi cao tudi CO cac bieu hien Io au ma khong duge chan doan va dieu tri thoa dang (David Nutl va James Ballengc 2003) Theo so lieu bao cao ciia Tdng cue Thdng kc (Didu tra dan sd va nha a giua ky nam 2014) hien ca nuac co hon 9.4 Iridu nguai eao tudi, chicm 10.45% dan sd Cac rdi loan lo au can hoang loan \'a cac am anh sg gay tac dgng xau rat km ddn cugc song ciia nhdm ngudi cao tudi Mdt nghien ciru mdi day tai Vicn Lao khoa Viet Nam (dan (heo Nguydn VTnh Ngoc 2015) cho thay, ty Ic benh nhan tram cam kdt hgp vdi lo au d cac bdnh nhan cao ludi nam vicn la rat cao len tdi 40% (6) VSn dd du phdng benh tam thcin ndi chung va lo au ndi rieng \'e ca bcin la rat ydu Vi vay, chn lang cudng TAP CHi TAM LYHOC, So (216), 3-2017 bidu bidt v6 bieu hien va mue dp lo au each thiie du phdng, ling phd vdi lo au de cd thd giam bdt hau qua :^u keo dai d ngudi cao tudi Bdi tuo'ng, khach th£ va phuwng phap nghiSn cuu Ddi tupng nghien cuu la bi£u hien v4 miic dp lo au d bdnh nhan cao tudi bi roi loan tieu hda, viem da day, la trang, viem gan, nhSm muc dich nang eao sir hidu bidt vi dac didm lo au d benh nhan cao tudi Khach thd nghien ciiu: 70 benh nhan dupe chan doan xac djnh rdi loan lo au theo trie nghiem Zung, tir 60 ddn 80 tudi, trung binh la 62,5 ± 11,2 tudi Benh nhan dupe phan chia theo eae nhdm tudi: 28 ngudi: 60 - 65 tudi (40,0%), 32 ngudi: 66 - 74 tudi (45,8%) va 10 ngudi: 75 - 80 tudi (14,2%) Benh nhan nam la 59 ngudi, nir la 11 ngudi Nghien ciiu dupe tiSn hanh tu thang 5/2016 den thang 8/2016, tai Khoa Tieu hda - Benh vicn Bach Mai Nghidn ciiu dupe thuc hidn theo md ta cat ngang, su dung Thang Danh gia miic dp lo au eua Zung (Nguyin Van Nhan, 2004; Nguyen Sinh Phuc, 2013) Thang Banh gia lo au cua Zung dupe Td chiic Y td The gidi thira nhan la rapt trac nghiem danh gia trang thai lo au hieu qua Day la thang tu danh gia md ta mdt sd trieu chiing sinh ly cua ca thd bidu hien lo i\x, dupe su dung rdng rai eac nghien ciru Dich td hpc va da dupe su dung nghien ciiu d Viet Nam Thang gdm 20 eau hdi ve cac trieu chiing, dupe danh sd thu tu tir den 20 Mdi eau bdi dupe eho diSm tir ddn theo tSn suAt xuk hien trieu ehung (1 diem irng vdi khdng ed, dicm - ddi cd, didm - pbSn Idn thdi gian la cd, didm - hau het thdi gian la cd) Tdng didm gidi han tir 20 ddn 80 va danh gia chia lam cae mire dp: + Khdng lo iiu: < 40 didm + Lo au mirc dp nhe: 41-50 didm + Lo au mirc dp vira: 51 - 60 didm + Lo au mirc dp nang: 61 - 70 didm + Lo au mirc dp rat nang: 71 - 80 didm De so sanh giira eac nhdm benh nhan (theo eac tieu chi gidi tinh tudi tinh trang hdn nhan, su chung sdng, sir tu danh gia vd sue khde) vd miic dp xuat hien eiia cae trieu chirng lo au eua benh nhan eao tuiii dien khao sat sau thu thap sd lieu tir thang eua Zung mire dp xuSt bien cua cac trieu chung lo au dupe xae dinh khoang didm trung binh (D LB) nhu so lieu bang Phuang phap didu tra bang bang hdi, phdng vSn sau nghien ciru trudng hpp dupe tien hanh nhim tim hieu vd ndi dung lo au va nhirng thdng tin chi tidt ve dac diem lo au cua benh nhan eao tudi Cae sd lieu dupe thu thap tir cac TAP CHI TAM LV HOC, Sd' (216), - 2017 phuang phap neu tren dupe xii ly bSng phin mdm SPSS 18.0 Phan tich sd lieu bang cae phep toan thdng kd: So sanh eae gia tri trung binh bang t-test, so sanh % bing x2 Bdng 1: Mice diem ddnh gid mice bleu hien cdc trieu chicng lo du Dicm trung binh Do lech chuan (SD) it btcu hien Btcu hien Ihinh thuang Bieu hien trung binh Bieu hien nhieu 2,51 0,59 2,88 Kct qua nghien ciiu 3.1 Mite vd hieu hien lo au cua benh nhiin cao tuoi - Mite dp lo du cua benh nhdn cao tuoi Bdng 2: Mirc lo du cua benh nhan Mij-c lo au Nam (n = 59) n % Nu(n = l l ) n % Khong lo au 6,78 0.00 Lo au mirc nhe 10 16,95 27,27 Lo iiu mirc dd vira 44 74.58 63.64 Lo au mirc dp nang 1.69 9.09 Lo an mirc dp ral nang 0.00 0.00 59 1(10,00 II 1011,00 Tong Trung binli dii'm 52,2 ± 7,83 p