恶性肿瘤患者创伤后应激障碍症状与应激相关因素的初步研究

发布时间：2018-11-19 13:59

【摘要】：目的：恶性肿瘤是威胁生命的创伤性生活事件,患者承受着巨大的心理压力,易导致创伤后应激障碍。本研究的目的是调查研究恶性肿瘤患者创伤后应激障碍症状特征和共病情况,并探讨创伤后应激障碍症状的影响因素,分析应对方式、社会支持、人格特征与创伤后应激障碍的关系,并进一步分析创伤后应激障碍作用规律。以期能够在此研究的基础上,对恶性肿瘤患者的创伤后应激障碍提出更有效、针对性的心理干预措施。方法：采用自制一般情况调查表和以下问卷对浙江省肿瘤医院215名恶性肿瘤患者进行调查研究,了解恶性肿瘤患者创伤后应激障碍症状与心理健康状况、相关的应激因素。 1、医学应对方式问卷(MCMQ),用以评估患者的应对方式。 2、社会支持评定量表(SSRS),用以评估患者可利用的外部资源。 3、艾森克人格问卷简式量表中国版(EPQ-RSC),用以评估患者独特而稳定的行为风格和思维方式。 4、创伤后应激障碍自评量表(PTSD-SS),用以评估患者创伤后心理症状,包括反复重现、警觉性增高、回避症状等。 5、症状自评量表(SCL-90),用以评估患者心理健康状况。数据输入计算机后采用SPSS15.0统计软件,作频数分析、相关分析(Pearson相关系数)和多元线性回归,检验水准为α=0.05。采用LISREL8.7作结构方程模型分析。结果： 1、恶性肿瘤患者创伤后应激障碍症状的总分以50、60为轻度异常、中重度异常的标准,有轻度异常者以上占30.5%,中重度异常以上24.7%。 2、创伤后应激障碍症状总分及不同维度与社会支持总分及客观支持、支持利用度,神经质存在一定程度的相关(P0.05)。 3、回归分析显示只有神经质最终进入回归方程,可解释因变量的27.4%。 4、结构方程模型显示神经质、社会支持对PTSD症状有明显影响,标准化路径系数达0.502,社会支持的标准化路径系数为0.148。 5、恶性肿瘤患者创伤后应激障碍症状与症状自评量表中的躯体化、强迫、抑郁、偏执因子存在相关(P0.05)。结论： 1、恶性肿瘤患者表现出较高的创伤后应激障碍症状,近三分之一患者呈现中高度异常,当引起临床重视。 2、社会支持对恶性肿瘤患者创伤后应激障碍症状起缓冲作用,其中客观支持、对支持的利用度是重要因素。 3、人格特征、社会支持能显著预测恶性肿瘤患者创伤后应激障碍症状,其中神经质(敏感、情绪化、易焦虑抑郁)是易感因素。 4、在应激相关因素中,人格特征是预测恶性肿瘤患者创伤后应激障碍症状的核心要素。社会支持、应对方式通过人格因素起作用。 5、恶性肿瘤患者存在创伤后应激障碍症状的同时伴发多种心理健康问题。
[Abstract]:Objective: malignant tumor is a life-threatening traumatic life event, patients are subjected to great psychological pressure, prone to lead to post-traumatic stress disorder. The purpose of this study was to investigate the symptoms and syndromes of post-traumatic stress disorder (PTSD) in patients with malignant tumors, and to explore the influencing factors, coping styles and social support. The relationship between personality traits and posttraumatic stress disorder (PTSD), and further analysis of posttraumatic stress disorder (PTSD). On the basis of this study, we can put forward more effective and targeted psychological intervention measures for post-traumatic stress disorder (PTSD) in patients with malignant tumor. Methods: 215 patients with malignant tumor in Zhejiang Cancer Hospital were investigated with self-made general information questionnaire and the following questionnaire to understand the symptoms and mental health status of post-traumatic stress disorder (PTSD) in patients with malignant tumor. Related stress factors. 1. The medical coping style questionnaire (MCMQ),) was used to evaluate the coping style of patients. 2. The Social support rating scale (SSRS),) was used to evaluate the external resources available to patients. Chinese version of Eysenck Personality questionnaire (EPQ-RSC) is used to evaluate patients' unique and stable behavior style and thinking style. 4. Post traumatic stress disorder self-rating scale (PTSD-SS) was used to evaluate the psychological symptoms of patients with post-traumatic stress disorder, including repeated recurrence, increased alertness, avoidance symptoms and so on. Symptom Checklist (SCL-90) was used to evaluate the mental health status of patients. After the data was input into the computer, SPSS15.0 statistical software was used to make frequency analysis, correlation analysis (Pearson correlation coefficient) and multivariate linear regression. The test level was 伪 = 0.05. LISREL8.7 is used for structural equation model analysis. Results: 1. The total score of the symptoms of post-traumatic stress disorder in malignant tumor patients was 50 ~ 60 as the standard of mild abnormal, moderate to severe abnormal, 30.5% of the patients with mild abnormality and 24.7m of moderate to severe abnormality. 2. The total scores and different dimensions of post-traumatic stress disorder symptoms were correlated with the total score of social support and objective support, the degree of support utilization and neuroticism to some extent (P0.05). 3. Regression analysis showed that only neuroticism finally entered the regression equation, which could explain 27.4% of dependent variables. 4. The structural equation model showed neuroticism, and social support had obvious influence on PTSD symptoms. The standardized path coefficient of social support was 0.502, and the standardized path coefficient of social support was 0.148. 5. Posttraumatic stress disorder symptoms in malignant tumor patients were correlated with somatization, compulsion, depression and paranoid ideation in SCL-90 (P0.05). Conclusion: 1. Malignant tumor patients showed high post-traumatic stress disorder symptoms, and nearly 1/3 patients showed moderate and high abnormality, which should be paid more attention to. 2. Social support acts as a buffer against symptoms of post-traumatic stress disorder (PTSD) in malignant tumor patients, among which objective support and utilization of support are important factors. 3. Personality characteristics and social support can predict the symptoms of post-traumatic stress disorder (PTSD) in malignant tumor patients, among which neuroticism (sensitive, emotional, anxiety and depression) is the predisposing factor. 4. Among the stress related factors, personality is the core factor in predicting the symptoms of post traumatic stress disorder in malignant tumor patients. Social support and coping style play a role through personality factors. 5. There are many mental health problems associated with posttraumatic stress disorder (PTSD) in patients with malignant tumor.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R395.1

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