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

ML/C DO VA BIEU HIEN LO AU
6 BENH N H A N C A O TUOI
Nghien ctru nay dirge tai trg bdi Quy Phat trien Khoa hpc va Cdng nghe Qudc gia
(NAFOSTED) trong 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 do 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 do 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 ai 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 3 (216), 3 - 201 7


1. Dat van 6e
Lo au la chuyen thucmg thdy trong dai s6ng ctia con nguoi va la phan ung
binh thuong khi 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 khi phai doi
mat vai nhung tinh hudng do. Nhung ndu qua lo au, nghT nggi den n6i mat an, mat
ngu, khong lam duoc cong viec hang ngay 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, do chii quan ciia than chu va khong th6 giai thich dugc. do mgt roi loan tam
than khac hoac do 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 trong 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 do 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 2 nhom Io au binh thuang va rdi loan Io au. Chinh vi vay. khi 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 nay.
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 3 (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.
2. 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 nay.
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 trong 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 1 den 20. Mdi eau bdi dupe eho diSm tir 1 ddn 4 theo tSn suAt xuk hien
trieu ehung (1 diem irng vdi khdng ed, 2 dicm - ddi khi cd, 3 didm - pbSn Idn thdi
gian la cd, 4 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 trong dien khao sat.
sau khi thu thap sd lieu tir thang do 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 1.
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' 3 (216), 3 - 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 do 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

<1,7

1,7-2,29

2,29 - 2,88

>2,88

3. Kct qua nghien ciiu
3.1. Mite do vd hieu hien lo au cua benh nhiin cao tuoi
- Mite dp lo du cua benh nhdn cao tuoi
Bdng 2: Mirc do lo du cua benh nhan

Mij-c do lo au

Nam (n = 59)
n

%

Nu(n = l l )
n

%

Khong lo au

4

6,78

0

0.00

Lo au mirc do nhe

10

16,95

3

27,27

Lo iiu mirc dd vira

44

74.58

7

63.64

Lo au mirc dp nang

1

1.69

1

9.09

Lo an mirc dp ral nang

0

0.00

0

0.00

59

1(10,00

II

1011,00

Tong
Trung binli dii'm

52,2 ± 7,83

p

<0.0I

54,2 ± 5,74

Sd lieu bang 2 cho Ihiiy, ly Ic % Irung binh lo iiu ciia nhom nu' la 54,2 d5.74 va cua nhom nam la 52.2 ± 7,83, nhu vay. neu nhin tdng Ihd thi d mirc dp lo
iiu vira. Phan tich kii;m dinh Chi binh phuong (/-') ve linh dpc lap cua 2 bijn sd
nam. nir vdi mirc dp lo au cho Ihay. cd su khae bict cd y nghTa ihong ke {-/lu =11.25; p < 0.01). Phan tich kT hon Ihco gidi linh cho thSy. ty le cac mirc dp lo
fiu nhe \a mirc dd lo au nang o nir cao hon nam (u Ic lo iiu mirc dp nhe d nu' la
27.27"ii v;i d nam la 16.95%. lo au mirc dp nang d nir la 9.09%. nam lii 1.69%)
Sir khiic nhau \'C ly le mi), ihco lac gia Dan J, Stein (2009). lien quan ddn sir

TAP CHl TAM LY HOC, Sd 3 (216), 3 - 2017


khac nhau vd tinh each, mdi quan he xa hdi. Tac ddng ciia ydu td van hda len hai
gidi la khae nhau. Phu nil thudng cd dae didm tinh each thu ddng, quan tam
cham sdc cho ngudi than, d ciing dp tudi thi da sd phu nO ed sue khde ydu ban
nam gidi. Phu nil d dp tudi tren 65 thudng chju nhieu ap lire vd phung dudng
eho ngudi dm dau trong gia dinh, suy kiet sire khde, chung kien cai chdt cua
ngudi than, ly hdn, ly than, sdng mdt minh. Cac ydu td tren luong tac lln nhau,
gdp phin lam tang ty le mic rdi loan lo au d bdnh nhan nil eao tudi. Kdt qua
nghien euu tren cho thiy. lo au xuit hien nhieu ban d benh nhan Ida tudi eao, tir
75 - 80 tuoi (47,0%). Day la lua tudi gap nbidu sang chin tam ly bdi ap lire cao
vd benh tat. sire khde thd chat suy giam manh, cam thay cd don. kha nang tai
chinh thu hep va cai chet.
- Bieu hien lo du d benh nhdn cao tudi
Phan tich sd lieu khao sat cho thiy, cac trieu ehdng sinh ly ca the da
dang, tap trung chu yeu d he tim mach. tieu hda, than kinh, bieu hien tang qua
mirc hoat ddng. Cu the: tim dap nhanh chiem ty le cao nhit (93,0%) va phan
bd deu d cae nhdm tudi. Bdn lay khd vd ndng eiing cd ty le cao (79,0%i). Mat
thudng ndng va do la trieu chirng thudng gap (70,0%)). Trieu chirng khd thd ra.
hit vdo gap nhieu nhat d nhdm tudi 60 - 65. tir 66 tudi trd len trieu chirng nay

cd ty le giiim dan. Hoa mat, chdng mat va tay chdn run la hai trieu chirng gap
nhicu d nir (73.9%). Quan sat benh nhan cho thay, hp ludn than phien ve cac
cam giac day bung, khd lieu, cdn cao, ndng trong rudt. Nhicu ngudi cd bieu
hien lo au trong dien khao sat tra Idi rang, hp ludn phai di lieu tien, dac bict la
hay bi tao bdn. ITp thudng den kham d chuyen khoa lieu hda. Cac trieu chiing
ve tim mach, lieu hda la nhirng Irieu chung ea the thudng gap trong rdi loan lo
au.
Nghien cuu trudng hop hai benh nhan nay cho thay, hp deu ed mot sd
trieu ehung sinh ly co ihc bieu hien lo iiu phil hp)? vdi kdt qua khao sal sii lieu
chung vc benh nhan cao tudi trong dien nghien cuu.
- So sdnh bleu hien cdc trieu chicng sinh ly ca the bieu hien lo du theo
cdc nhdm benh nhdn cao tudi
Bung 3: Mice do xudt hien cdc Irieu chirng sinh ly ca thi biiu hien lo du
theo cdc nhom benh nhdn
Cae nhom
GIOI

16

DTH

Nlioin duoc so sanh

t

P

Niim

2 23

Nil

2,74

0,045

NO

2.f,7

TAP CHI TAM ly HOC, Sd 3 (216), 3 - 2017


Tuoi

Tinli Irang
hon nhan

liien song
Cling

Tir danh gia
linh Irang
sii'c l
60 65

2,62

66-74

0,39

66-74

2,50

75-80

0,91
0,51

>0,0S

75-80

2,76

60-65

S6ng cung va/chong

2,49

Mot minh

3,72

0,001

Lyhon

2,71

Song cung va/chong

2,43

0,001

Ly Ihan

2,55

Ly hon

2,09

0,027

Vg hoac chong chel

2,74

Song cung va/chong

3,65

0,000

iVIot minh

2,99

Ly than

1,96

0,05

Vo chong song cung
con. cliau

2,54

Song ciing chau

1,69

0.05

Chau

2,72

Song cung va/chong

1,58

0,05

Hp hang, nguoi than

2,90

Vo/chong CLing con,
chau

2,46

0,01
0,005

Klioe manh

2,25

< Binh thuang

2,90

Binh thuong

2,38

< Binh thuang

2,14

0,025

< Binh thuong

2,79

Yiu

3.17

0,045

Yiu

3,17

Khoe manh

3,15

0.005

Kct qua kiem dinh t-tcst vc phuang dien giai tinh va tuoi (xem bang 3)
cho thay, eo su khac biet ve muc do xuat hien cac trieu chung sinh ly ca the
bieu hien Io au giua nam (DTB = 2,23) va nu (D TB ^ 2,67). Benh nhan nu
xuiit hien nhieu Hon cac trieu chirng nay mot each co y nghTa so vai benh nhan nam
(t ^ 2.74: p - 0.045): khong co su khac bict \c muc do xuat hien cac trieu
chung sinh ly ca the bieu hien lo au giiJa cac nhom tuoi ciia benh nhan.
Phan tich so sanh tung cap bien bang kiem djnh t-lest theo phuang dien
tinh trang hon nhan cho thay, c6 sir khac bict co y nghTa thong ke vc muc do

xuat hien cac trieu chung nay giua nhom benh nhan a mot minh vai nhom benh
nhan song cung va/chong (t ^ 3.72: p -0.001) va nhom benh nhan ly th^in (t ^ 1.69.
p ^ 0.05); Cjiira nhom benh nhan ly hon vai nhom benh nhan song cung vg/eh6na
(t - 2.43; p - 0.001) va nhom benh nhiin Iy than (t - 2.09; p = 0.05); Giu'a nhom
benh nhan vg/chong chet vai nhom benh nhan song eiing vg/chdng (t = 3.65;
p - 0.000) va nhom benh nhan Iy than (t --" 1.94: p = 0.027). Nhom benh nhan o
mgt minh eo mire do xuat hien cae trieu chirng sinh Iy co th6 biC-u hien lo au
nhiCu nhat {DTB - 2.99), tiep den la cac nhom ly hon (DTB - 2.71). nhom
vg/ch5ng chet (DTB ^ 2.74). Mirc do xuat hien eac trieu chirng sinh Iy co the-

TAP CHI TAM LYHOC, So 3 (216). 3-2U17


bidu hien lo au it hon la nhdm benh nhan sdng ciing vp/ehdng (DTB = 2.49) va
nhdm ly than (DTB = 2,55). Sir khac biet giira cac nhdm tren ed the giai thich
nhu sau: Nhirng ngudi eao tudi d mpt minh khi dau dm thudng cang thing, lo
ling ban vi hp khdng ed ngudi than Up giiip ngay dem, nguai giup da khac nhu
hang xdm cung khdng thd d ben canh hp thudng xuyen. Quan sat mdt so benh
nhan budn riu, suy sup cho thiy, bp thudng la nhifng ngudi ed va/chdng chet
hoac sdng cd dan. Nhirng benh nhan ly hdn cung lo au nhidu bdi hp thidu ving
ngudi ban ddi tin cay dd chia sc, cham sdc, la chd dua eho hp ca ve tinh than va
vat chit. Nhirng benh nhan ly than mac dii khdng cdn chung sdng vdi nhau
nhung van cdn chia sc vdi nhau vd cac vin de gia dinh. Dae bict ngudi cao ludi
hay nhin ve qua khir, hp thudng mang an nghTa cua nhirng ngudi da giup dd
minh trude kia ndn vp/ehdng ly than khi dm dau vin giup nhau it nhicu. Vi vay.
benh nhan ly than cd muc dp xuat hidn cac trieu chimg sinh ly ea the bieu bien
Io au it him so vdi nhdm benh nhan d mpt minh va ly hdn. Benh nhan sdng eiing
vp/chdng thudng nhan dupe su chain sdc. trp giup iin nhau, do vay, lo au ciia hp
d mite dp nhe hon so vdi cac nhdm khae.
Kidm dinh 1-lest theo timg cap bien ve phuang dien sdng ciing cho thay,

cd su khae biet cd y nghia thdng ke ve mire dp xuat hien cac trieu chimg sinh ly
ca the bieu hien lo au giira nhdm vp/chdng sdng cung eon, chau vdi nhdm vp/
chdng sdng eung chau (t ^ 1.69: p = 0,05) va nhdm vp/chdng sdng cung hp hang,
ngudi than (1 ^ 2.46; p = 0.01); giira nhdm sdng ciing vp/chdng vdi nhdm vp/ehdng
sdng ciing chau (t ^ 1.58; p -^ 0.05). Ndi mpt ctich khae, nhdm vp/chdng sdng
ciing hp hang (DTTi = 2,90), ngudi thiin cd mirc dp xuat hien cac trieu chung
sinh ly ea the bieu hien lo au nhieu nhat, tiep den la nhdm vp/ehdng sdng cimg
chtiu (DTB - 2,72) va it hon cii la nhdm vp/chdng sdng ciing con. chau (DTTJ ^ 2,54)
va vp/chdng sdng eung nhau (DTB = 2,49). Theo y kien eua mpt sd benh nhiin, hp
sdng cung con. chau thi nhan dupe su chain sdc. quan tam khdng nhirng eua con
mil cdn ciia chau. su chung sdng Irong gia dinh vdi nhicu ngudi rudl thit. dac
biel vdi cac con. giiip hp yen lam ban khi mac benh. Tuy nhien, ciing cd y kien
cho rang, khi cac con. chiiu eua hp sdng thieu thdn, van cdn ciin tro giup kinh Ic
lii' bd, mc giii hoac con. chau hu hdng thi ndi lo cua hp cang tang them do vira
phai lo chira benh cho ban than, vira phai lo cho ca con. chau. Mpl sd vp/chdng
sdng ciing vdi chau cam thiiy lo nhieu hon khi phai didu Iri d benh vicn vi cac
chau chua the di lam kiem sdng, viin ciin phai dupe nudi an. hpc. vi khdng cd
cac con ben eanh de nhd ca\' luc \\\ii\ giii.
Phan lich so sanh Ihco Iirng cap bien vc phuong dien benh nhiin lu danh
gia sire khdc cho thay. cd su khtic hict cd y nghia thdng ke nhu sau: nhdm benh
nhiin tu danh gia sire khdc dudi mii'c binh thuimg xuit hien cac trieu chimg sinh
ly ca the bic-u hien lo au nhicu hon cd y nghia Ihdng kc so vdi nhdm lu diinh gia

TAP CHI TAM LV HOC, Sd3 (216), 3-2017


khde manh (t = 2,90; p = 0,05) va nhdm tir danh gia siic khde binh thudng (t = 2,14;
p = 0,025). Dac biet, nhdm tu danh gia sire khde yeu bieu hien lo au nhieu ban
cd y nghTa thdng ke so vdi nhdm tu danh gia khde manh (t = 2,90; p = 0,05) va
nhdm tu danh gia sire khde binh thudng (t = 3,17; p = 0,045). So lieu didu tra

tren cho thiy, tu danh gia bi quan ve tinh trang sue khde ed anh hudng den mirc
dp Io au nhidu hon d ngudi benh eao tudi. Nhu vay, gia dinh, dae biet ngudi ban
ddi rat cd y nghTa ddi vdi benh nhan eao tudi. Tinh cam gia dinh, tinh thuang
yeu, sir kinh trpng, quan tam, cham sdc, giup dd, ddng vien, khieh le cua nhiing
thanh vien trong gia dinh se giup cho hp giam di cam giac cd dan, bi quan, giiip
hp bdt di lo au ve tinh trang cua ban than.
3.2. Npi dung to au ciia benh nhan cao tuoi

Bdng 4: Ngi dung lo du ciia benh nhdn
Nu'
(n = l l )

(%)

Nam
(n = 59)

(%)

Tong so
(n = 70)

(%)

Lo ve benh liit ciia ban than

9

81,8

53

89,8

62

88,5

Lo ve thuc pham 6 nhiem

6

54.5

31

52,5

37

52.8

Lo vc tai chinh ciia ban than,
gia dinh

7

63,6

40

67,7

47

67,1

Lo ve su on dinh, an loan noi a

7

63,6

25

42,3

32

32,8

Lo ve nguoi than trong gia dinh

6

54,5

23

38,9

29

12,8

Lo ve su CO don. trong trai ciia
ban thiin

2

18.1

0

0.0

2

2,85

Noi dung lo au

So lieu bang 4 eho thay, Io au ve benh tat chiem ty !c cao nhat 88,5%. Lo
vc tai chinh eo ty le eao tiep theo 67,1%. Co han 1/2 benh nhan lo ve thuc
pham o nhiem (52,8%). Lo ve ngucri than trong gia dinh va su co dan, trong
trai chiem ty le thap (12,8% va 2,85%o). Dieu nay cho thay. mot phan xuat phat
tir su an tam, ki vgng, mong dgi su dap tra an tinh, "bao hieu'" cua con, chau
ddi vai ong ba, cha me. Phong van mot so benh nhan, chung toi thu duge eae y
kien phan anh su Io au eua hg nhu sau: "Cdng nhieu tuoi cang phdt sinh nhieu
benh. boi vdy kho co the chua khoi'; "Khong biet nai dieu tri, chdm soc benh

cua han thdn^': "Bdc sT co hdnh dpng doi xir khdc biel vol nguai gid mang
benh, coi nhe nhimg kho khdn ciia ho'''': "Nguai gia co nhieu benh, phdi chira
benh lau ddt nhung khong co dii tien de chira benli': "Ngudi gid co chira benh
hay khong roi cung chet". Co su khae nhau co y nghTa thong kc giu'a nam va
nCr ve su Io lang eho nguai thjin Irong gia dinh. su eo dan, irong trai eiia ban

TAP CHI TAM LY HOC, So 3 (216), 3 - 2017


than. Ty le nil lo vd hai ndi dung nay cao ban nam (,x\]) -• 4.95; p < 0,05 va
X^()) = 5,58; p < 0,05). So lieu tren cho thiy, da sd benh nhan cao tudi co mdi lo
au chu ydu ve nhiing gi lien quan ddn siic khdc eua ban than. Vi vay, can quan
tam giiip benh nhan eao tudi cd them hidu bidt vd benh, vS sire khde cua ban
than va kha nang cd thd chira benh dd hp cd the giam bdt su lo au ve benh tat
va sdng ddi sdng khde manh, ed ich nhu mpi ngudi.
4. Ket luan
Kdt qua nghien cim eua chiing tdi phii hop vdi nghien cim eiia Dan J. Stein
(2009) vd rdi loan lo au cd ty Id cao d nhdm tir 75 tadi trd len va d nil gidi nhieu
hon nam gidi. Ndi dung lo au da dang, lo au ve benh tat va tai chinh chicm tV le
eao nhat. Cae trieu chimg sinh ly ca thd da dang, tap trung chu yeu d be tim mach,
lieu hda, than kinh vdi cac bieu hien nhu: kho thd ra, hit vdo. tim dap nhanh
chiem ty le cao nhat; bdn lay khd vd ndng, mdi thudng ndng va do la trieu chimg
thudng gap; hoa mdt, chdng mat va tay chdn run la hai trieu chimg gap nhieu d
nil. Bang ke eac trieu chimg lo au cua Zung giup lam sang Id dac diem lo iiu d
benh nhan cao tudi, niing cao nhan thirc ve hoan canh cupc sdng dang tac ddng
den hp. Ket qua nghien cim gdp phiin giup cho cdng tac chain sdc sire khde, chira
tri va trp giiip tam ly - xa hdi cho ngudi cao tudi ed lo au. TYong bdi eanh d nude
la cd nhicu ngudi cao tudi trong xii hdi. gia dinh (dng ba. cha mc...) thi mpi ngudi
ciin quan liim den nhirng bieu hien lo tiu va khd khan cua ngudi eao ludi. khieh le
con. chau quan lam nhicu ban loi sire khde cua dng ba, cha mc se giup hp an

hucrng tudi gia vdi niem vui ciia cupc sdng.
Tai lieu tham khao
1. NguyCn Van Nhan, \'guycn .Sinh Phiic. Cdc trdc nghiem lain ly Idm sdng. NXB
Quan dpi nhan dan, 2004
2. Ngu>cn Sinh Phiic. Giao Irinh ('hcim .siic sire khoe ldm llidn. NXIi Lao ddng - Xa hdi
2013.
3. Robert L. Leahy. 'IhodI khoi lo ldng vd sir hai, NXBTirdiC-n B,ich khoa, 2012.
4 I3an J, Slcin. Generalizedaiixiely disorders. Textbook of anxielv. American Psychiatric
Publishing. Inc. 2009
5. David Null and James Ballcnge. Generalized .Anxiety Disorder. Anxielv
MassachuscHs. USA, 2003

Disorders

6, \'gii\cn Vinh N'goc. hups //WVM\ siicl
TAP CHi TAM LV HOC, .So 3 (216). 3 - 2017