诊断期乳腺癌患者心理痛苦状况的调查研究
|
摘要
目的调查诊断期乳腺癌患者的心理状况。方法选取2016年7-10月在我院住院的245例诊断期乳腺癌患者为研究对象,采用一般资料问卷和心理痛苦温度计量表(Distress thermometer,DT)进行横断面调查。结果诊断期乳腺癌患者心理痛苦状况明显高于国内癌症常模(χ~2=6.12,P<0.05),各维度得分从高到低依次为实际问题、情绪问题、交往问题、身体问题和宗教信仰,单因素分析显示乳腺良性疾病史对患者心理痛苦程度的影响,差异有统计学意义(P<0.05),引起心理痛苦前5位的条目为"经济问题""无时间精力照顾孩子/老人""无时间精力做家务""紧张"和"睡眠问题"。结论诊断期乳腺癌患者心理痛苦状况亟待关注,医护人员应针对知识信息缺乏、心理精神压力、失眠等问题为患者提供针对性的健康教育和心理疏导,以改善诊断期乳腺癌患者的身心健康状况。
Objective To study the psychological status of breast cancer patients in diagnosis period. Methods Using general information and psychological distress thermometer(Distress thermometer) questionnaire was used to investigate 245 cases inpatients before pathological diagnosis in the breast department. Results General psychological status of breast cancer patients in diagnosis stage was significantly higher than domestic norm(χ~2=6.12,P<0.05). The scores of sub-scales from high to low in the order is body, emotion, practice, communication and religious beliefs problems. Univariate analysis showed that history of mammary gland disease may affect the degree of psychological distress(P<0.05). 5 top items causing psychological distress included economic problems, no time or energy to take care of the children/old man, no time or energy to do housework, tension and sleep problems. Conclusions Psychological distress of breast cancer patients in diagnosis deserves attention. Nurses should pay more attention and provide suitable psychological counseling to help patients take positive coping measures, improve physical and psychological health of breast cancer patients.
Objective To study the psychological status of breast cancer patients in diagnosis period. Methods Using general information and psychological distress thermometer(Distress thermometer) questionnaire was used to investigate 245 cases inpatients before pathological diagnosis in the breast department. Results General psychological status of breast cancer patients in diagnosis stage was significantly higher than domestic norm(χ~2=6.12,P<0.05). The scores of sub-scales from high to low in the order is body, emotion, practice, communication and religious beliefs problems. Univariate analysis showed that history of mammary gland disease may affect the degree of psychological distress(P<0.05). 5 top items causing psychological distress included economic problems, no time or energy to take care of the children/old man, no time or energy to do housework, tension and sleep problems. Conclusions Psychological distress of breast cancer patients in diagnosis deserves attention. Nurses should pay more attention and provide suitable psychological counseling to help patients take positive coping measures, improve physical and psychological health of breast cancer patients.
引文
[1] Fitzmaurice C,Allen C,Barber R M,et al.Global,regional,and national cancer incidence,mortality,years of life lost,years lived with disability,and disability-adjusted life-years for 32 cancer groups,1990 to 2015:A systematic analysis for the global burden of disease study[J].JAMA oncology,2017,3(4):524.
[2] Miller K D,Siegel R L,Lin C C,et al.Cancer treatment and survivorship statistics,2016[J].CA:A Cancer Journal for Clinclans,2016,66(4):271-289.
[3] Poole K.The emergence of the ‘waiting game’:A critical examination of the psychosocial issues in diagnosing bre ast cancer[J].Journal of Advanced Nursing,1997,25(2):273-281.
[4] Psooy B J,Schreuer D,Borgaonkar J,et al.Patient navigation:improving timeliness in the diagnosis of breast abnormalities[J].Canadian Association of Radiologists Journal,2004,55(3):145.
[5] Syrowatka A,Motulsky A,Kurteva S,et al.Predictors of distress in female breast cancer survivors:a systematic review[J].Breast Cancer Res Treat,2017,165(2):229-245.
[6] Mcfarland D C,Shaffer K M,Tiersten A,et al.Prevalence of physical problems detected by the distress thermometer and problem list in patients with breast cancer[J].Psychooncology,2018,27(5):1394-1403.
[7] National Comprehensive Cancer Network.Distress management:Clinical practice guidelines[J].J Natl Compr Canc Netw,2003,1(3):344-374.
[8] 张叶宁,张海伟,宋丽莉,等.心理痛苦温度计在中国癌症病人心理痛苦筛查中的应用[J].中国心理卫生杂志,2010,24(12):897-902.
[9] Roth A J,Komblinth A B,Batel C I,et al.Rapid screening for psychological distress in men with prostate carcinoma:A pilot study[J].Cancer,1998,82(10):1904-1908.
[10] 王阳,范珊红,曹蕾,等.乳腺癌病人心理痛苦及其相关因素的研究[J].中华全科医学,2016,14(11):1912-1914.
[11] Folkman S,Lazarus R S,Gruen R J,et al.Appraisal,coping,health status,and psychological symptoms[J].J Pers Soc Psychol,1986 ,50(3):571-579.
[12] Heppner P P,Armer J M,Mallinckrodt B.Problem-solving style and adaptation in breast cancer survivors:A prospective analysis[J].J Cancer Surviv,2009,3(2):128-136.
[13] 庞英,Fischer I,Koch M,et al.乳腺癌病人的心身症状与生活质量[J].中国心理卫生杂志,2013,27(4):257-261.
[14] Fradelos E C,Papathanasiou I V,Veneti A,et al.Psychological distress and resilience in women diagnosed with breast cancer in greece[J].Asian Pacific Journal of Cancer Prevention Apjcp,2017,18(9):2545.
[15] Kirillina M P,Loskutova K S,Innokent'eva A S,et al.Immunohistochemical reactions of primary neuroendocrine breast cancer[J].Bull Exp Biol Med,2015,158(3):368-370.
[16] Agarwal J,Powers K,Pappas L,et al.Correlates of elevated distress thermometer scores in breast cancer patients[J].Supportive Care in Cancer,2013,21(8):2125-2136.
[17] 沈傲梅,强万敏,陈育红,等.乳腺癌病人诊断期心理体验的质性研究[J].天津护理,2016,24(6):471-474.
[18] Bidstrup P E,Christensen J,Mertz B G,et al.Trajectories of distress,anxiety,and depression among women with breast cancer:Looking beyond the mean[J].Acta Oncologica,2015,54(5):789-796.
[19] 李霞,强万敏.青年乳腺癌病人根治术后真实体验的质性研究[J].护士进修杂志,2016,31(23):2174-2176.
[20] Greaney M L,Sprunck-Harrild K,Ruddy K J,et al.Study protocol for young & strong:A cluster randomized design to increase attention to unique issues faced by young women with newly diagnosed breast cancer[J].BMC Public Health,2015,15(1):37.
[2] Miller K D,Siegel R L,Lin C C,et al.Cancer treatment and survivorship statistics,2016[J].CA:A Cancer Journal for Clinclans,2016,66(4):271-289.
[3] Poole K.The emergence of the ‘waiting game’:A critical examination of the psychosocial issues in diagnosing bre ast cancer[J].Journal of Advanced Nursing,1997,25(2):273-281.
[4] Psooy B J,Schreuer D,Borgaonkar J,et al.Patient navigation:improving timeliness in the diagnosis of breast abnormalities[J].Canadian Association of Radiologists Journal,2004,55(3):145.
[5] Syrowatka A,Motulsky A,Kurteva S,et al.Predictors of distress in female breast cancer survivors:a systematic review[J].Breast Cancer Res Treat,2017,165(2):229-245.
[6] Mcfarland D C,Shaffer K M,Tiersten A,et al.Prevalence of physical problems detected by the distress thermometer and problem list in patients with breast cancer[J].Psychooncology,2018,27(5):1394-1403.
[7] National Comprehensive Cancer Network.Distress management:Clinical practice guidelines[J].J Natl Compr Canc Netw,2003,1(3):344-374.
[8] 张叶宁,张海伟,宋丽莉,等.心理痛苦温度计在中国癌症病人心理痛苦筛查中的应用[J].中国心理卫生杂志,2010,24(12):897-902.
[9] Roth A J,Komblinth A B,Batel C I,et al.Rapid screening for psychological distress in men with prostate carcinoma:A pilot study[J].Cancer,1998,82(10):1904-1908.
[10] 王阳,范珊红,曹蕾,等.乳腺癌病人心理痛苦及其相关因素的研究[J].中华全科医学,2016,14(11):1912-1914.
[11] Folkman S,Lazarus R S,Gruen R J,et al.Appraisal,coping,health status,and psychological symptoms[J].J Pers Soc Psychol,1986 ,50(3):571-579.
[12] Heppner P P,Armer J M,Mallinckrodt B.Problem-solving style and adaptation in breast cancer survivors:A prospective analysis[J].J Cancer Surviv,2009,3(2):128-136.
[13] 庞英,Fischer I,Koch M,et al.乳腺癌病人的心身症状与生活质量[J].中国心理卫生杂志,2013,27(4):257-261.
[14] Fradelos E C,Papathanasiou I V,Veneti A,et al.Psychological distress and resilience in women diagnosed with breast cancer in greece[J].Asian Pacific Journal of Cancer Prevention Apjcp,2017,18(9):2545.
[15] Kirillina M P,Loskutova K S,Innokent'eva A S,et al.Immunohistochemical reactions of primary neuroendocrine breast cancer[J].Bull Exp Biol Med,2015,158(3):368-370.
[16] Agarwal J,Powers K,Pappas L,et al.Correlates of elevated distress thermometer scores in breast cancer patients[J].Supportive Care in Cancer,2013,21(8):2125-2136.
[17] 沈傲梅,强万敏,陈育红,等.乳腺癌病人诊断期心理体验的质性研究[J].天津护理,2016,24(6):471-474.
[18] Bidstrup P E,Christensen J,Mertz B G,et al.Trajectories of distress,anxiety,and depression among women with breast cancer:Looking beyond the mean[J].Acta Oncologica,2015,54(5):789-796.
[19] 李霞,强万敏.青年乳腺癌病人根治术后真实体验的质性研究[J].护士进修杂志,2016,31(23):2174-2176.
[20] Greaney M L,Sprunck-Harrild K,Ruddy K J,et al.Study protocol for young & strong:A cluster randomized design to increase attention to unique issues faced by young women with newly diagnosed breast cancer[J].BMC Public Health,2015,15(1):37.