影响胃癌患者化疗期间癌因性疲乏(CFS)的社会心理因素
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摘要
目的:分析影响胃癌患者化疗期间癌因性疲乏(CFS)的社会心理因素。方法:选取2014年5月至2017年于我院行化疗的胃癌患者90例及健康志愿者50例为研究对象,分别纳入观察组、对照组,对比两组基线资料,采用癌因性疲乏量表(CFS)评价癌因性疲乏程度,以艾森克人格问卷简式量表(EPQ-RSC)、社会支持评定量表(SSRS)、心理弹性量表简化版(CD-RISC)、汉密顿抑郁自评量表(HAMD)、汉密顿焦虑自评量表(HAMA)评估其社会心理状况,分析癌因性疲乏的影响因素及其与CFS评分相关性。结果:两组性别、年龄、文化程度、居住地、婚姻状况比较差异无统计学意义(P>0.05),观察组CFS评分、EPQ-RSC中P、E、N维度评分及HAMD、HAMA评分高于对照组(t=73.395,6.177,2.363,6.592,26.485,26.324;P<0.05),观察组SSRS客观支持度、支持利用度评分及CD-RISC评分较对照组低(t=-2.510,-3.379,-16.462;P<0.05);Logistic回归分析结果显示EPQ-RSC P维度、HAMD评分、HAMA评分是影响胃癌患者化疗期间癌因性疲乏的独立危险因素(OR=1.837,95%CI=1.592～2.119;OR=3.124,95%CI=1.207～8.085;OR=2.255,95%CI=1.240～4.098;P<0.05),而SSRS支持利用度评分、CD-RISC评分是其保护因素(OR=0.850,95%CI=0.835～0.866;OR=0.482,95%CI=0.356～0.653;P<0.05);相关分析显示,胃癌化疗患者CFS评分与EPQ-RSC、HAMD评分、HAMA评分呈正相关(r=0.432,0.298,0.221;P<0.05),CFS评分与SSRS支持利用度、CD-RISC评分呈负相关(r=-0.325,-0.321;P<0.05)。结论:社会心理因素是胃癌患者化疗期间发生癌因性疲乏的重要影响因素,应采取应对性社会心理干预措施改善其心理状况,降低癌因性疲乏发生率。
Objective:To analyze the psychosocial factors of cancer-induced fatigue(CFS)during chemotherapy in patients with gastric cancer.Methods:A total of 90 patients with gastric cancer treated with chemotherapy and 50 healthy volunteers in our hospital from May 2014 to 2017 were enrolled in the observation group and the control group respectively.The baseline data were compared between the two groups,and the cancer-induced fatigue scale(CFS)was used to assess the degree of cancer-induced fatigue in the two groups.The Eysenck Personality Questionnaire(EPQ-RSC),social support rating scale(SSRS)and simplified version of resilience Scale(CD-RISC),the Hamilton Depression Scale(HAMD)and the Hamilton Anxiety Rating Scale(HAMA)were used to assess the psychosocial status,and the influencing factors of cancer-induced fatigue and its correlation with CFS score were analyzed.Results:There were no significant differences in sex,age,educational level,place of residence and marital status between the two groups(P>0.05).The P,E and N dimension scores in CFS and EPQ-RSC and the scores of HAMD and HAMA in the observation group were higher than those in the control group(t=73.395,6.177,2.363,6.592,26.485,26.324;P<0.05).The SSRS objective support,support utilization score and CD-RISC score in the observation group were lower than those in the control group(t=-2.510,-3.379,-16.462;P<0.05).Logistic regression analysis showed that P dimension of EPQ-RSC,HAMD and HAMA scores were independent risk factors for cancer-induced fatigue during chemotherapy in patients with gastric cancer(OR 1.837,95% CI 1.592～2.119;OR3.124,95% CI 1.207～8.085;OR 2.255,95% CI 1.240～4.098,P<0.05),and the SSRS support utilization degree and CD-RISC score were the protective factors(OR 0.850,95%CI 0.835～0.866;OR 0.482,95%CI 0.356～0.653,P<0.05).The correlation analysis showed that the CFS score was positively correlated with EPQ-RSC,HAMD score and HAMA score(r=0.432,0.298,0.221,P<0.05)while the CFS was negatively correlated with SSRS support utilization degree and CD-RISC score(r=-0.325,-0.321,P<0.05).Conclusion:Psychosocial factors are the important influencing factors for cancer-induced fatigue during chemotherapy in patients with gastric cancer.The coping psychosocial intervention should be taken to improve their psychological status and reduce the incidence rate of cancer-induced fatigue.
Objective:To analyze the psychosocial factors of cancer-induced fatigue(CFS)during chemotherapy in patients with gastric cancer.Methods:A total of 90 patients with gastric cancer treated with chemotherapy and 50 healthy volunteers in our hospital from May 2014 to 2017 were enrolled in the observation group and the control group respectively.The baseline data were compared between the two groups,and the cancer-induced fatigue scale(CFS)was used to assess the degree of cancer-induced fatigue in the two groups.The Eysenck Personality Questionnaire(EPQ-RSC),social support rating scale(SSRS)and simplified version of resilience Scale(CD-RISC),the Hamilton Depression Scale(HAMD)and the Hamilton Anxiety Rating Scale(HAMA)were used to assess the psychosocial status,and the influencing factors of cancer-induced fatigue and its correlation with CFS score were analyzed.Results:There were no significant differences in sex,age,educational level,place of residence and marital status between the two groups(P>0.05).The P,E and N dimension scores in CFS and EPQ-RSC and the scores of HAMD and HAMA in the observation group were higher than those in the control group(t=73.395,6.177,2.363,6.592,26.485,26.324;P<0.05).The SSRS objective support,support utilization score and CD-RISC score in the observation group were lower than those in the control group(t=-2.510,-3.379,-16.462;P<0.05).Logistic regression analysis showed that P dimension of EPQ-RSC,HAMD and HAMA scores were independent risk factors for cancer-induced fatigue during chemotherapy in patients with gastric cancer(OR 1.837,95% CI 1.592～2.119;OR3.124,95% CI 1.207～8.085;OR 2.255,95% CI 1.240～4.098,P<0.05),and the SSRS support utilization degree and CD-RISC score were the protective factors(OR 0.850,95%CI 0.835～0.866;OR 0.482,95%CI 0.356～0.653,P<0.05).The correlation analysis showed that the CFS score was positively correlated with EPQ-RSC,HAMD score and HAMA score(r=0.432,0.298,0.221,P<0.05)while the CFS was negatively correlated with SSRS support utilization degree and CD-RISC score(r=-0.325,-0.321,P<0.05).Conclusion:Psychosocial factors are the important influencing factors for cancer-induced fatigue during chemotherapy in patients with gastric cancer.The coping psychosocial intervention should be taken to improve their psychological status and reduce the incidence rate of cancer-induced fatigue.
引文
[1]杨皓,张广元,殷朔,等.原发性胃癌患者术后疲劳综合征的药物治疗方案研究[J].西部医学,2016,28(4):473-475
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[10]张雪飞.实施聚焦问题模式干预对癌症患者癌因性疲乏和生命意义的影响[J].中国健康心理学杂志,2014,22(11):1622-1624,1625
[11]丁金霞,王婷,王维利,等.化疗期癌症患者癌因性疲乏与生命质量的研究[J].中华疾病控制杂志,2015,19(5):462-465
[12]宋均仿,叶雪梅,彭梦苗,等.心理护理对肝癌患者癌疲乏性、负面情绪及生活质量的影响[J].护理实践与研究,2016,13(22):147-148
[13]李建,胥润,吴雪莲,等.心理社会治疗对胃癌患者焦虑、抑郁情绪及免疫功能的影响[J].肿瘤学杂志,2016,22(9):722-726
[14]李建,胥润,吴雪莲,等.心理社会因素与胃癌的关系[J].现代肿瘤医学,2017,25(12):1942-1945
[15]李雪,左迪,张欢,等.喉癌化疗患者癌因性疲乏与人格的相关性[J].中国健康心理学杂志,2015,23(2):181-183
[16]倪晓东,苏亮,黄晶梦,等.乳腺癌化疗患者的人格和心理健康变化及其与癌因性疲乏的相关性分析[J].国际精神病学,2017,44(1):112-115
[17]姬艳博,许翠萍,于晓霞,等.心理弹性在肿瘤患者积极应对与疲乏关系中的中介作用[J].中国实用护理杂志,2016,32(23):1809-1813
[2]蒋超南,李振炎,袁秀红,等.胃癌术后患者化疗期间癌因性疲乏与其缓解方式的相关性分析[J].护理学报,2016,23(8):64-67
[3]韩歌,赫晓宏,兰锐,等.全程分期护理对胃癌老年患者化疗期癌因性疲乏、依从性的改善研究[J].现代消化及介入诊疗,2017,22(2):291-293
[4]苏慧,沈燕,沈学丽,等.系统性护理对胃癌化疗患者癌因性疲乏、自我效能及生活质量的影响[J].国际护理学杂志,2017,36(8):1088-1090
[5]安采华,杨琴,李莉,等.胃癌术后患者癌因性疲乏与自我效能感的相关性研究[J].现代预防医学,2016,43(13):2398-2401
[6]彭艳.心理及运动护理对胃癌患者癌因性疲乏及生活质量的影响[J].深圳中西医结合杂志,2016,26(11):179-180
[7]中华人民共和国国家卫生和计划生育委员会.胃癌规范化诊疗指南(试行)[J].中国医学前沿杂志(电子版),2013,5(8):56-63
[8]金梅,王维利,丁金霞,等.胃癌化疗期患者心理困扰和疾病感知与希望水平的关系[J].广东医学,2015,36(3):447-450
[9]廖玉麟,徐宏涛,周煜,等.营养状况及心理因素对胃癌患者半年生存率及生存质量的影响[J].中国现代医生,2016,54(10):30-33
[10]张雪飞.实施聚焦问题模式干预对癌症患者癌因性疲乏和生命意义的影响[J].中国健康心理学杂志,2014,22(11):1622-1624,1625
[11]丁金霞,王婷,王维利,等.化疗期癌症患者癌因性疲乏与生命质量的研究[J].中华疾病控制杂志,2015,19(5):462-465
[12]宋均仿,叶雪梅,彭梦苗,等.心理护理对肝癌患者癌疲乏性、负面情绪及生活质量的影响[J].护理实践与研究,2016,13(22):147-148
[13]李建,胥润,吴雪莲,等.心理社会治疗对胃癌患者焦虑、抑郁情绪及免疫功能的影响[J].肿瘤学杂志,2016,22(9):722-726
[14]李建,胥润,吴雪莲,等.心理社会因素与胃癌的关系[J].现代肿瘤医学,2017,25(12):1942-1945
[15]李雪,左迪,张欢,等.喉癌化疗患者癌因性疲乏与人格的相关性[J].中国健康心理学杂志,2015,23(2):181-183
[16]倪晓东,苏亮,黄晶梦,等.乳腺癌化疗患者的人格和心理健康变化及其与癌因性疲乏的相关性分析[J].国际精神病学,2017,44(1):112-115
[17]姬艳博,许翠萍,于晓霞,等.心理弹性在肿瘤患者积极应对与疲乏关系中的中介作用[J].中国实用护理杂志,2016,32(23):1809-1813
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