COVID-19 tedavisi alan hastalarda; dispne ağırlığı ile depresyon ve anksiyete belirtilerin arasında ilişki var mı?
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Dosyalar
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
GİRİŞ VE AMAC: Aralık 2019'dan günümüze, Coronavirüs hastalığı (COVID-19) hızla yayılmış ve pandemi haline dönmüştür. Virüs ilk başta yakın temas sırasında, genellikle hapşırma, konuşma veya öksürme gibi davranışlarla üretilen küçük damlacıklar yoluyla insanlar arasında yayılmaya başlar. COVID-19 hastalığı, birçok organ etkileyebildiği gibi hastaların psikiyatrik bozukluklarına neden olabilir. COVID-19 tanılı ve tedavi gören hastalarda anksiyete ve depresyonun da sürebileceğini düşünülmektedir. Çalışmamızın amacı, COVID-19 nedeniyle hastane yatışı olan hastalarda uzun dönemde (3-6 aylık) , bireylerin eğitim seviyesi, meslek, alkol kullanma, sigara kullanma, covid nedeniyle iş gücü kaybı gibi faktörleri dikkate alarak anksiyete ve depresyonun yaygınlığını araştırmaktır. Aynı zamanda post-covid dönemde efor dispnesi devam eden hastaları Medical Research Council Scale(MRCS) ve Hastane Anksiyete ve Depresyon ölçeği (HADÖ) kullanarak dispne şiddeti ile anksiyete ve depresyon arasındaki etkileşimi incelemeyi planladık. Ve buna göre riskli grupları gözlem altında tutulması, erken dönemde gerekli psikolojik destek verilmesi, yakından takip edilmesi uygun olacaktır . GEREKÇE VE YÖNTEM: Çalışma 10 Eylül 2020-10 Mart 2022 tarihleri arasında gerçekleştirildi. Selçuk Üniversitesi Göğüs Hastalıkları Ana Bilim Dalı COVID-19 kliniğinde yatan, daha önce tarafımızca belirlenen kriterlere göre uyan hastalar çalışmaya dahil edildi. Çalışmaya, gönüllü̈ olarak onam veren 537 hasta dahil edildi. Hastalara Medical Research Council Scale-MRCS ve Hastane Anksiyete ve Depresyon ölçeği (HADÖ) uygulandı. Tüm veriler bilgisayar ortamında SPSS 25.0 paket programı kullanarak analiz edilmiştir. Değişkenler, frekans "n", yüzde "%", aritmetik ortalama "X̄", standart sapma "Sd", medyan (min-maks) olarak özetlenmiştir. Kategorik veriler Ki-Kare testi ile karşılaştırılıp çoklu gruplarda gruplar arası farkı incelemek için Bonferroni düzeltmesi kullanılmıştır. Değişkenler arasındaki ilişkinin boyutunu değerlendirmek için Çoklu Doğrusal Regresyon Analizi yapılmıştır. Çalışmada istatistiksel olarak anlamlılık düzeyi p<0,05 olduğu durumlar kabul edildi. BULGULAR: Çalışmamız 537 hastayla tamamlandı. Hastaların 307'ü (%57) erkek, 230'u (%42) kadındı. Yaş ortalamaları açısından hastalar arasında çok anlamlı fark saptanmadı. Çalışmadan herhangi bir sebeple çıkarılan hasta olmadı. Hastaların medeni durumu sorgulandığında 537 hasta (%99,4) evli, 2 hasta (%0,4) dul ve bir hasta (%0,2) bekardı. Hastaların eğitim seviyesi sorgulandığında 76 hasta (%14,2) İlk okul, 328 hasta (%61,1) Lise ve 133 hasta (%24,8) Üniversite bitirdiğini görüldü. Hastaların mesleği sorgulandığında 104 hasta (%19,6) memur, 131 hasta (%24,7) İşçi ve 296 hasta (%55,7) İşsiz idi. SONUÇ: Hastalığı ağır geçirenlerde, dispne skoru yüksek olanlarda, ileri yaş olanlarda anksiyete ve depresyon skorlarını yüksek bulduk. COVID-19 pandemisinin yarattığı sosyal izolasyon, dispne skorununun yüksek olması, iş gücü kaybı yaşamaları bu kişilerde anksiyete ve depresyon skorlarının yüksek olmasına neden oldu. Covid-19 hastalığına yakalananların tedavi sonrası fiziksel sağlığı açısından takip edilmesi ne kadar önemliyse, psikolojik sağlığı açısından takip o kadar önemlidir. Riskli grupları gözlem altında tutulması, erken dönemde gerekli psikolojik destek alınması, yakından takip edilmesi uygun olacaktır, hastalığın kendi yarattığı ölüm korkusu, nefes darlığı nedeniyle salgılanan endojen katekolaminler, uygulanan tedaviler, entübasyon yada non-invaziv mekanik ventilasyon tedavisi, yoğun bakımda yatış ve ölümleri görüme gibi faktörlere bağlı bu hastalarda ciddi anksiyete ve depresyon riskini artmaktadır. Çalışmamız anksiyete ve depresyon açısından risk gruplarını bildirmesi açısından değerlidir. Bu derecede ağır pandeminin daha önce olmaması, hastalığın yeni olması gibi nedenlerle bu konuda daha falza çalışma yapılması gerekliliği bulunmaktadır. Çalışmamızın bundan sonraki çalışmalarla destekleneceğini ummaktayız.
INTRODUCTION AND PURPOSE:From December 2019 to the present, the Coronavirus disease (COVID-19) has spread rapidly and turned into a pandemic. The virus first begins to spread between people during close contact, usually through tiny droplets produced by behavior such as sneezing, talking or coughing. COVID-19 disease can affect many organs and cause psychiatric disorders in patients. It is thought that anxiety and depression may continue in patients diagnosed and treated with COVID-19. The aim of our study is to investigate the prevalence of anxiety and depression in patients hospitalized due to COVID-19 in the long term (3-6 months), taking into account factors such as individuals' education level, occupation, alcohol use, smoking, loss of work force due to covid. At the same time, we planned to examine the interaction between dyspnea severity and anxiety and depression using the Medical Research Council Scale (MRCS) and the Hospital Anxiety and Depression Scale (HADS) in patients with continued exertional dyspnea in the post-covid period. And accordingly, it would be appropriate to keep risky groups under observation, to provide necessary psychological support in the early period, and to follow them closely. RATIONALE AND METHOD: The study was carried out between 10 September 2020 and 10 March 2022. Patients who were hospitalized in the COVID-19 clinic of the Selçuk University Department of Chest Diseases and met the criteria previously determined by us were included in the study. 537 patients who voluntarily gave consent were included in the study. Medical Research Council Scale-MRCS and Hospital Anxiety and Depression Scale (HADS) were applied to the patients. All data were analyzed in computer environment using SPSS 25.0 package program. Variables are summarized as frequency "n", percent "%", arithmetic mean "X̄", standard deviation "Sd", median (min-max). Bonferroni correction was used to compare the categorical data with the Chi-Square test and examine the difference between groups in multiple groups. Multiple Linear Regression Analysis was performed to evaluate the extent of the relationship between the variables. Cases with a statistical significance level of p<0.05 were accepted in the study. RESULTS: Our study was completed with 537 patients. Of the patients, 307 (57%) were male and 230 (42%) were female. There was no significant difference between the patients in terms of mean age. No patient was excluded from the study for any reason. When the marital status of the patients was questioned, 537 patients (99.4%) were married, 2 patients (0.4%) were widowed, and one patient (0.2%) was single. When the education level of the patients was questioned, it was seen that 76 patients (14.2%) completed primary school, 328 patients (61.1%) graduated from high school and 133 patients (24.8%) graduated from university. When the professions of the patients were questioned, 104 patients (19.6%) were civil servants, 131 patients (24.7%) were workers and 296 patients (55.7%) were unemployed. CONCLUSION: We found high anxiety and depression scores in patients with severe disease, high dyspnea scores, and advanced age. Social isolation caused by the COVID-19 pandemic, high dyspnea score, and loss of work force caused these people to have high anxiety and depression scores. The more important it is to follow-up the patients with Covid-19 in terms of their physical health after treatment, the more important it is in terms of their psychological health. It would be appropriate to keep the risky groups under observation, to receive the necessary psychological support in the early period, to follow closely, the fear of death caused by the disease itself, endogenous catecholamines secreted due to shortness of breath, the treatments applied, intubation or non-invasive mechanical ventilation treatment, hospitalization in the intensive care unit and seeing deaths. The risk of serious anxiety and depression increases in these patients due to factors such as Our study is valuable in terms of reporting risk groups in terms of anxiety and depression. Due to the fact that such a severe pandemic has not occurred before and the disease is new, more studies are required on this subject. We hope that our work will be supported by future studies.
INTRODUCTION AND PURPOSE:From December 2019 to the present, the Coronavirus disease (COVID-19) has spread rapidly and turned into a pandemic. The virus first begins to spread between people during close contact, usually through tiny droplets produced by behavior such as sneezing, talking or coughing. COVID-19 disease can affect many organs and cause psychiatric disorders in patients. It is thought that anxiety and depression may continue in patients diagnosed and treated with COVID-19. The aim of our study is to investigate the prevalence of anxiety and depression in patients hospitalized due to COVID-19 in the long term (3-6 months), taking into account factors such as individuals' education level, occupation, alcohol use, smoking, loss of work force due to covid. At the same time, we planned to examine the interaction between dyspnea severity and anxiety and depression using the Medical Research Council Scale (MRCS) and the Hospital Anxiety and Depression Scale (HADS) in patients with continued exertional dyspnea in the post-covid period. And accordingly, it would be appropriate to keep risky groups under observation, to provide necessary psychological support in the early period, and to follow them closely. RATIONALE AND METHOD: The study was carried out between 10 September 2020 and 10 March 2022. Patients who were hospitalized in the COVID-19 clinic of the Selçuk University Department of Chest Diseases and met the criteria previously determined by us were included in the study. 537 patients who voluntarily gave consent were included in the study. Medical Research Council Scale-MRCS and Hospital Anxiety and Depression Scale (HADS) were applied to the patients. All data were analyzed in computer environment using SPSS 25.0 package program. Variables are summarized as frequency "n", percent "%", arithmetic mean "X̄", standard deviation "Sd", median (min-max). Bonferroni correction was used to compare the categorical data with the Chi-Square test and examine the difference between groups in multiple groups. Multiple Linear Regression Analysis was performed to evaluate the extent of the relationship between the variables. Cases with a statistical significance level of p<0.05 were accepted in the study. RESULTS: Our study was completed with 537 patients. Of the patients, 307 (57%) were male and 230 (42%) were female. There was no significant difference between the patients in terms of mean age. No patient was excluded from the study for any reason. When the marital status of the patients was questioned, 537 patients (99.4%) were married, 2 patients (0.4%) were widowed, and one patient (0.2%) was single. When the education level of the patients was questioned, it was seen that 76 patients (14.2%) completed primary school, 328 patients (61.1%) graduated from high school and 133 patients (24.8%) graduated from university. When the professions of the patients were questioned, 104 patients (19.6%) were civil servants, 131 patients (24.7%) were workers and 296 patients (55.7%) were unemployed. CONCLUSION: We found high anxiety and depression scores in patients with severe disease, high dyspnea scores, and advanced age. Social isolation caused by the COVID-19 pandemic, high dyspnea score, and loss of work force caused these people to have high anxiety and depression scores. The more important it is to follow-up the patients with Covid-19 in terms of their physical health after treatment, the more important it is in terms of their psychological health. It would be appropriate to keep the risky groups under observation, to receive the necessary psychological support in the early period, to follow closely, the fear of death caused by the disease itself, endogenous catecholamines secreted due to shortness of breath, the treatments applied, intubation or non-invasive mechanical ventilation treatment, hospitalization in the intensive care unit and seeing deaths. The risk of serious anxiety and depression increases in these patients due to factors such as Our study is valuable in terms of reporting risk groups in terms of anxiety and depression. Due to the fact that such a severe pandemic has not occurred before and the disease is new, more studies are required on this subject. We hope that our work will be supported by future studies.
Açıklama
Anahtar Kelimeler
COVID-19, Anksiyete, Depresyon, Dispne, Mrcs, Anxiety, Depression, Dyspnea
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Shalabi, M. Y. M. (2022). COVID-19 tedavisi alan hastalarda; dispne ağırlığı ile depresyon ve anksiyete belirtilerin arasında ilişki var mı? (Uzmanlık Tezi). Selçuk Üniversitesi, Tıp Fakültesi, Konya.
