已婚脊髓损伤患者婚姻结局的调查及影响因素分析

Marital outcome and its influencing factors of married patients with spinal cord injury

中文关键词:  脊髓损伤  婚姻结局  影响因素

英文关键词:Spinal cord injuries  Marital outcome  Influencing factors

中文摘要:

  【摘要】 目的：研究已婚脊髓损伤患者的婚姻状况及伤后夫妻关系的影响因素。方法：以2016年1月1日～2016年5月31日在我院住院的已婚脊髓损伤患者为对象进行横断面调查。根据纳入标准（①经CT或MRI确诊脊髓损伤合并截瘫或四肢瘫患者；②伤前结婚的患者，性别、年龄不限；③愿意参与本研究）和排除标准[①受伤时合并有脑外伤、精神疾病（如认知功能障碍）；②伤后结婚的患者]，共有115例患者纳入本研究。采用问卷调查法进行资料的收集。问卷调查的内容包括性别、年龄、文化程度、受伤时的结婚年限、受伤前的家庭月收入、伤前子女个数、伤后性生活满意度、伤后夫妻关系变化及神经损伤的平面。将伤后婚姻关系按“感情升温、无变化、下降、离异”四个分类计数，对四组间定性资料采用有序多分类资料的秩和检验，对性生活满意度的组间比较采用方差分析。按“升温或无变化、下降或离异”两个分类计数，采用Logistic回归分析方法对已婚脊髓损伤患者婚姻结局因素进行分析。结果：在115例脊髓损伤患者中，13例（11.3%）伤后感情升温，43例（37.4%）感情无变化，40例（34.8%）感情下降，19例（16.5%）离异。按四分类计数进行分析，受伤时的不同结婚年限会影响伤后夫妻关系分布，经组间两两比较，仅4～6年组与10年及以上组的比较差异有统计学意义（P<0.05），通过比较这两组的平均秩次，10年及以上组的伤后夫妻关系较好；性别、年龄、文化程度、神经损伤的平面、受伤前的家庭月收入、伤前子女个数的伤后夫妻关系分布差异无统计学意义（均P＞0.05）；伤后患者的性生活满意度平均为3.2，表现为比较不满意，“升温、无变化、下降、离异”四种夫妻关系的性生活满意度比较差异有统计学意义（P<0.05），无变化组的性生活满意度均高于感情下降组和离异组（P<0.05），男性与女性比较差异无统计学意义（P＞0.05）。按照两分类计数对以上因素进行分析，单因素分析显示神经损伤的平面、受伤前的家庭月收入、伤后性生活满意度对婚姻关系有影响（均P<0.05）。多因素分析显示，神经损伤的平面、伤后性生活满意度（均P<0.05）对婚姻关系有影响。以颈椎为参照，胸椎、腰椎损伤的伤后夫妻关系恶化的概率分别是颈椎损伤的4.126倍和3.619倍。结论：已婚脊髓损伤患者的离婚率为16.5%，婚姻结局受到多因素影响，其中性生活满意度和神经损伤的平面是较为重要的因素。

英文摘要:

  【Abstract】 Objectives： To study the marital status of patients with spinal cord injury and its influencing factors on marital relationship after injury. Methods： A cross-sectional survey was conducted on the married patients with spinal cord injury admitted to our hospital from January 1, 2016 to May 31, 2016. According to the inclusion criteria: ①confirmed by CT or MRI with spinal cord injury and with paraplegia or quadriplegia, ②married patients before the injury, gender and age are not restricted, ③willing to participate in this study, and exclusion criteria:①associated with brain trauma, mental illness(such as cognitive dysfunction), ②married patients after injury, a total of 115 patients were included in the study. Questionnaires were used to collect data. The questionnaire included gender, age, educational level, the number of marriage years before injury, the monthly family income before injury, the number of children before the injury, the life satisfaction after injury, the change of husband and wife relationship and the nerve injury. The outcome of post-injury marital relationship was analyzed according to the four-class count analysis defined as emotional warming, no change, decline and divorce. The qualitative data among the four groups were analyzed by rank sum test of ordered multi-classification data. The comparisons of sex life satisfaction among groups were analyzed by ANOVA. According to the two-class count analysis of warming or no change, descent or divorce, Logistic regression analysis was used to analyze the marital outcome factors of married spinal cord injury patients. Results： In 115 patients with spinal cord injury, 13(11.3%) chose feelings to heat up, 43(37.4%) chose feelings no change, 40(34.8%) chose feeling down, 19(16.5%) chose divorce. According to the four-class count analysis, the number of marriage years before injury affected the distribution of marital relations after injury. By comparison between two groups, only the difference between 4-6 years group and 10 years and above group was statistically significant. By comparing the average rank of the two groups, the marital relations after injury in the 10 years and above group was better. There was no significant difference in the distribution of marital relations after injury among these factors, such as gender, age, educational level, nerve injury plane, the monthly income before injury, the number of pre-injury children(P>0.05). The average satisfaction of sexual life of the spinal cord injury patients was 3.2, which was shown to be less satisfactory. There were significant differences(P<0.05) in sexual satisfaction among the four-class count analyses of emotional warming, no change, decline and divorce. The sexual satisfaction of no change group was higher than that of feeling down group and divorce group(P<0.05). There was no statistically significant difference(P>0.05) in sexual satisfaction between male and female. The above factors were analyzed according to the two-class count analysis, univariate analysis showed that the level of nerve injury, monthly family income before injury and post-injury sexual satisfaction had significant effects on marital relations(P<0.05). Multivariate analyses showed that the level of satisfaction and the sexual satisfaction after injury(P<0.05) had significant effects on the marital relationship. Cervical spine injury as a reference, thoracic, lumbar damage after injury, the probability of deterioration of the relationship after the marital injury were 4.126 times and 3.619 times. Conclusions: The divorce rate of married spinal cord injury patients was 16.5%. Marital outcome is affected by many factors. The most important factors are the satisfaction of sexual life and the plane of nerve injury.