宫颈癌术后化疗期老年患者创伤后应激障碍与创伤后成长相关性分析
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摘要
目的探讨宫颈癌术后化疗期老年患者创伤后应激障碍与创伤后成长水平,并分析两者之间是否存在相关性。方法以2017年10月-2018年6月在新疆医科大学附属肿瘤医院妇科肿瘤病区收治的115例宫颈癌老年患者为研究对象,采用问卷调查收集所有研究对象的年龄、住址、慢性病史、组织学类型、病理分期、化疗疗程等临床资料以及创伤后成长与创伤后应激障碍评分情况,分析宫颈癌术后化疗期老年患者创伤后应激障碍与创伤后成长水平之间的相关性。结果115例宫颈癌术后化疗期老年患者创伤后应激障碍平均得分为(45.35±7.86)分,创伤后成长平均得分为(52.93±8.41)分;创伤后成长维度中除新的可能性与伤后应激障碍维度中的重新体验、麻木/回避和警觉性增高不具有相关性(P>0.05),其余各维度均与创伤后应激障碍总分及各维度具有相关性(P <0.05),创伤后成长水平可以独立解释创伤后应激障碍变异的19.2%。结论宫颈癌术后化疗期老年患者创伤后应激障碍与创伤后成长水平成负相关,提示医护人员应结合宫颈癌术后化疗期老年患者的特殊心理和生理特点,从多角度出发制定心理干预对策,通过促进创伤后成长水平的提升来预防或减轻创伤后应激障碍症状。
Objective To investigate the levels of post-traumatic stress disorder and post-traumatic growth in elderly patients with post-operative chemotherapy of cervical cancer and to analyze the correlation between them.Methods A total of 115 elderly patients with cervical cancer admitted to Department of Gynecologic Oncology,the Affiliated Tumor Hospital of Xinjiang Medical University from October 2017 to June 2018,and the questionnaire was used to collect the age,address,monthly income per capita,and chronic disease of all subjects.Clinical data ie,histological type,pathological stage,chemotherapy course,post-traumatic growth and post-traumatic stress disorder scores were gathered,and the correlation between posttraumatic stress disorder and post-traumatic growth in the elderly patients with cervical cancer after chemotherapy were analyzed.Results The average score of post-traumatic stress disorder in the elderly patients with cervical cancer after chemotherapy was(45.35±7.86),and the average post-traumatic growth score was(52.93±8.41);there was no correlation between the new possibility and the re-experience,numbness/evacuation and alertness in the post-traumatic stress dimension of the elderly patients with postoperative chemotherapy for cervical cancer(P >0.05).The rest were associated with the total score of post-traumatic stress disorder and each aspects(P <0.05),the score of post-traumatic growth could provide independent explanation for the 19.2% of the post-traumatic stress disorder.ConclusionPost-traumatic stress disorder in the elderly patients with cervical cancer after chemotherapy is negatively correlated with post-traumatic growth level,which suggests that medical staff should combine the special psychological and physiological characteristics of the elderly patients with postoperative chemotherapy for cervical cancer,and develop psychological intervention strategies from multiple perspectives to prevent or alleviate the symptoms of post-traumatic stress disorder by promoting the level of post-traumatic growth.
Objective To investigate the levels of post-traumatic stress disorder and post-traumatic growth in elderly patients with post-operative chemotherapy of cervical cancer and to analyze the correlation between them.Methods A total of 115 elderly patients with cervical cancer admitted to Department of Gynecologic Oncology,the Affiliated Tumor Hospital of Xinjiang Medical University from October 2017 to June 2018,and the questionnaire was used to collect the age,address,monthly income per capita,and chronic disease of all subjects.Clinical data ie,histological type,pathological stage,chemotherapy course,post-traumatic growth and post-traumatic stress disorder scores were gathered,and the correlation between posttraumatic stress disorder and post-traumatic growth in the elderly patients with cervical cancer after chemotherapy were analyzed.Results The average score of post-traumatic stress disorder in the elderly patients with cervical cancer after chemotherapy was(45.35±7.86),and the average post-traumatic growth score was(52.93±8.41);there was no correlation between the new possibility and the re-experience,numbness/evacuation and alertness in the post-traumatic stress dimension of the elderly patients with postoperative chemotherapy for cervical cancer(P >0.05).The rest were associated with the total score of post-traumatic stress disorder and each aspects(P <0.05),the score of post-traumatic growth could provide independent explanation for the 19.2% of the post-traumatic stress disorder.ConclusionPost-traumatic stress disorder in the elderly patients with cervical cancer after chemotherapy is negatively correlated with post-traumatic growth level,which suggests that medical staff should combine the special psychological and physiological characteristics of the elderly patients with postoperative chemotherapy for cervical cancer,and develop psychological intervention strategies from multiple perspectives to prevent or alleviate the symptoms of post-traumatic stress disorder by promoting the level of post-traumatic growth.
引文
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[13]林静,王影,韩小岛.晕轮效应护理对老年宫颈癌PICC化疗患者负性情绪及功能锻炼依从性的影响[J].实用临床医药杂志,2018,22(16):80-82.
[14]常碧如,李田田,解倩,等.晚期癌症患者创伤后应激障碍、感恩与创伤后成长的关系[J].中华行为医学与脑科学杂志,2017,26(4):374-378.
[15]吴婷,黄孟秋,侯云霞,等.肺癌化疗患者创伤后成长现状及影响因素分析[J].护理学报,2018,25(14):5-9.
[2] ZHANG Y,BORDERS T F,ROHER J E.Correlates of intent to seek unnecessary pap tests among elderly women[J].Womens Health Issues,2007,17(6):351-359.
[3] OCHOA C,GRAU A C,VIVES J,et al.Positive psychotherapy for distressed cancer survivors:posttraumatic growth facilitation reduces posttraumatic stress[J].Int J Clin Health Psy,2017,17(1):28-37.
[4]彭青,李雪,张雪,等.112例宫颈癌术后化疗期患者创伤后成长水平及影响因素分析[J].护理学报,2018,25(3):5-10.
[5]周晖,白守民,林仲秋.《2018NCCN宫颈癌临床实践指南(第一版)》解读[J].中国实用妇科与产科杂志,2017,5(12):6-11.
[6]金秋霞,柯紫薇,卢燕飞,等.创伤后应激障碍与护士心理资本的相关性研究[J].中国实用护理杂志,2017,32(9):704-707.
[7] TEDESCHI R G,CALHOUN L G.The posttraumatic growth inventory:measuring the positive legacy of trauma[J].J Trauma Stress,1996,9(3):455-461.
[8] HO S M,CHAN C L,HO R T.Posttraumatic growth in chinese cancer survivors[J].Psychol Oncol,2004,13(6):377-389.
[9]汪际,陈瑶,王艳波,等.创伤后成长评定量表的修订及信效度分析[J].护理学杂志,2011,26(14):26-28.
[10] GARVEY G,CUNN J,JANDA M,et al.Psychological distress among Indigenous Australian cancer survivors[J].Supportive Care Cancer,2018,26(6):1737-1746.
[11]葛华,孔田甜,关素珍,等.创伤后应激患者心理弹性水平的研究[J].川北医学院学报,2014,29(1):270-273.
[12]钟碧珍,冯彤玉,陈翠荣,等.宫颈癌患者创伤后成长与心理弹性、自我效能的关系研究[J].中国临床护理,2016,8(3):207-209.
[13]林静,王影,韩小岛.晕轮效应护理对老年宫颈癌PICC化疗患者负性情绪及功能锻炼依从性的影响[J].实用临床医药杂志,2018,22(16):80-82.
[14]常碧如,李田田,解倩,等.晚期癌症患者创伤后应激障碍、感恩与创伤后成长的关系[J].中华行为医学与脑科学杂志,2017,26(4):374-378.
[15]吴婷,黄孟秋,侯云霞,等.肺癌化疗患者创伤后成长现状及影响因素分析[J].护理学报,2018,25(14):5-9.