宫颈癌患者心理状况及生命质量研究

发布时间：2018-05-31 01:12

本文选题：宫颈癌 + 心理　；参考：《复旦大学》2008年硕士论文

【摘要】： 目的:本研究旨在了解宫颈癌患者的心理状况及生命质量,同时研究心理状况和生命质量和疾病相关因素之间的相互影响关系。方法: 1、研究对象:2007年1月到2008年1月,在复旦大学附属妇产科医院、虹口区妇幼保健所、江湾医院根据病史记录手术病理证实为宫颈癌或癌前病变的汉族妇女227例,要求患者本人了解病情,自愿参加调查,无精神疾病和意识障碍。以及年龄、学历、职业、婚姻状况相匹配的正常对照人群200例,签署知情同意书,确立为本研究对象。 2、研究方法:通过Zung抑郁自评量表(self-rating depression scale,SDS)Zung焦虑自评量表(self-rating anxiety scale,SAS)、特质应对方式问卷(trait coping style questionnaire,TCSQ)及宫颈癌患者生命质量测评量表FACT-Cx(Functional Assessment of Cancer Therapy-Cervix)和自行设计的多项目问卷调查以了解宫颈癌患者心理状况和生命质量及相关的影响因素。 3、数据处理和统计分析:采用SPSS15.0统计分析。描述生命质量水平在不同特征人群中的分布,采用单因素分析探讨潜在危险因素,显著性标准α=0.05。采用多元线性逐步回归法拟合与相关因素之间的数量关系模型,纳入标准为0.05,移除标准为0.10。结果 1、宫颈癌患者抑郁发生率为36.56%(83/227人),焦虑40.52%(92/227人)。宫颈癌组SDS、SAS评分均高于对照组。 2、影响宫颈癌患者抑郁症状的因素有年龄、经济负担、手术方式,而影响宫颈癌患者焦虑症状的因素有年龄、文化水平、癌症分期。手术切除子宫、年龄越大,经济状况差的患者抑郁症较明显,年龄小、分期越晚、文化程度高的患者焦虑症状较明显。 3、宫颈癌组积极应对得分与对照组比较,差异无统计学意义(P＞0.05);而消极应对得分明显高于对照组(P＜0.01),显示患者采取的消极应对方式较多。 4、宫颈癌组消极应对得分与SAS、SDS评分呈正相关(P＜0.05),即消极应对分高,抑郁、焦虑评分就高,心理状况就差;而宫颈癌组积极应对得分与SAS、SDS评分呈负相关(P＜0.05),即积极应对分高,抑郁、焦虑评分就低,心理状况就好。 5、宫颈癌患者平均生命质量评分为143.78±16.19(95%CI:141.66～145.17),FACT-G评分为93.95±12.16(95%CI:93.36～94.94)。 6、生命质量水平在年龄、居住地、分期、是否放化疗各水平之间的分布差异有统计学意义(P＜0.05)。回归分析结果提示,诊断时期别越晚,采用化放疗患者的总体生活质量评分越低。分期越晚,年龄越大的患者生理状况越差。年龄越大的患者医患关系分数越低。分期越晚,居住在农村的比上海本地的患者情绪状况评分低。年龄小、采用化放疗、分期越晚的宫颈癌患者的其他忧虑评分低。结论: 1、抑郁和焦虑是宫颈癌患者存在的症状,并受多种因素影响。因此,在宫颈癌患者治疗过程中,辅助有效心理干预措施减轻或消除心理症状具有重要意义。 2、宫颈癌患者采用消极应对方式较多,影响患者的心理状况,因此采取正确的积极的应对方式,正视自己的疾病,是改善心理状况的重要因素。 3、宫颈癌患者平均生命质量评分为143.78±16.19(95%CI:141.66～145.17),FACT-G评分为93.95±12.16(95%CI:93.36～94.94),肿瘤的临床分期和治疗方法是影响生活质量的重要因素,早期诊断宫颈癌、提高临床治疗效果对于宫颈癌患者的生活质量有帮助。
[Abstract]:Objective: the purpose of this study was to investigate the psychological status and quality of life of patients with cervical cancer, and to study the relationship between the psychological status and the quality of life and the factors associated with disease.
Method:
1, study subjects: from January 2007 to January 2008, in the Department of gynaecology and obstetrics hospital affiliated to Fudan University, Hongkou District maternal and child health care institute, and 227 cases of Han women who confirmed cervical cancer or precancerous lesion according to the medical history, Jiangwan hospital, according to the history of medical history, asked the patient to know the condition of the disease and voluntarily participate in the investigation, without mental illness and mental disorder. And the age, and the age. 200 healthy controls, matched by occupation and marital status, signed the informed consent form.
2, the research methods: the self rating Anxiety Scale (self-rating depression scale, SDS) Zung Anxiety Scale (self-rating anxiety scale, SAS), the trait coping style questionnaire (trait coping) and the quality of life assessment of cervical cancer patients and self quality assessment scale, and Self-Evaluation Questionnaire were adopted. A multi item questionnaire survey was designed to understand the psychological status, quality of life and related factors of cervical cancer patients.
3, data processing and statistical analysis: using SPSS15.0 statistical analysis to describe the distribution of the quality of life in different characteristics of the population, using single factor analysis to explore the potential risk factors. The significant standard alpha =0.05. adopts the multiple linear stepwise regression method to fit the quantitative relationship model between the related factors and the standard is 0.05, remove the standard. For 0.10.
Result
1, the incidence of depression in cervical cancer patients was 36.56% (83/227), and anxiety was 40.52% (92/227 people). The SDS and SAS scores in cervical cancer group were higher than those in control group.
2, the factors that affect the depressive symptoms of cervical cancer patients are age, economic burden, and surgical methods, and the factors affecting the anxiety symptoms of cervical cancer patients are age, cultural level, cancer stage. The older the hysterectomy, the older the patients with poor economic conditions are more obvious, the younger, the late stages and the higher level of education, the anxiety symptoms of the patients with high educational level are better than those of the patients. Obviously.
3, the positive coping score of cervical cancer group was compared with the control group, the difference was not statistically significant (P > 0.05), while the negative coping score was significantly higher than that of the control group (P < 0.01), which showed that the patients took more negative coping styles.
4, the negative coping score of cervical cancer group was positively correlated with SAS and SDS score (P < 0.05), that is, the negative coping score was high, depression, anxiety score was high, and the psychological status was poor; the positive coping score of cervical cancer group was negatively correlated with SAS and SDS score (P < 0.05), that is, positive coping height, depression, anxiety score were low, and psychological condition was good.
5, the average life quality score of cervical cancer patients was 143.78 + 16.19 (95%CI:141.66 - 145.17), and the FACT-G score was 93.95 + 12.16 (95%CI:93.36 - 94.94).
6, the level of life quality was statistically significant in age, residence, staging, or whether the levels of chemotherapy were distributed (P < 0.05). Regression analysis showed that the more late the diagnosis, the lower the overall quality of life for patients with chemotherapy. The more late the stages, the worse the age of the patients. The older the patients were. The lower the score of the doctor-patient relationship, the later the stages were lower in the rural areas than in the Shanghai local patients. The younger, the use of chemotherapy, the lower the other anxiety scores of the patients with cervical cancer in the later stages.
Conclusion:
1, depression and anxiety are the symptoms of cervical cancer and are affected by a variety of factors. Therefore, in the treatment of cervical cancer patients, it is of great significance to assist the effective psychological intervention to alleviate or eliminate the psychological symptoms.
2, patients with cervical cancer use more negative coping styles, affecting the psychological status of the patients, so taking the correct and positive coping style and facing their own diseases is an important factor in improving the psychological condition.
3, the average quality of life of cervical cancer patients was 143.78 + 16.19 (95%CI:141.66 to 145.17), and the FACT-G score was 93.95 + 12.16 (95%CI:93.36 to 94.94). The clinical stages and treatment methods of the tumor were important factors affecting the quality of life. The early diagnosis of cervical cancer and the improvement of the clinical treatment effect were helpful to the quality of life of the patients with cervical cancer.
【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2008
【分类号】：R737.33;R395

【参考文献】