胃癌患者志气缺失综合征的影响因素分析
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摘要
目的探讨胃癌患者志气缺失综合征的影响因素。方法应用中文版志气缺失综合征量表(DS-MV)、医学应对方式问卷、社会支持量表及自制的一般资料调查表对2018年6—10月在某2所三级甲等医院住院的120例胃癌患者进行问卷调查。结果 120例患者志气缺失综合征得分为(35.47±12.54)分。单因素分析结果显示,120例患者不同的婚姻状况、文化程度、家庭人均月收入、疾病分期及主要照顾者的志气缺失综合征得分比较差异均有统计学意义(均P<0.05)。相关分析结果显示,120例患者屈服应对与志气缺失得分呈正相关(r=0.653,P<0.05),面对应对、主观支持、客观支持、对支持利用度及社会支持总分与志气缺失得分均呈负相关(r=-0.448、-0.425、-0.424、-0.329、-0.455,均P<0.05)。多元逐步回归分析结果显示,屈服应对、客观支持、婚姻状况均为志气缺失综合征发生的影响因素,共同解释胃癌患者志气缺失水平总变异的48.5%(P<0.01)。结论胃癌患者的志气缺失综合征水平较高,其受不同因素的影响,患者更易采取屈服的应对方式,因此医护人员应对患者进行心理干预,提高患者的生活质量。
Objective To explore the factors influencing demoralization syndrome in patients with gastric cancer.Methods A total of 120 gastric cancer patients who were hospitalized in 2 class-A hospitals between June 2018 and October 2018 were surveyed using the Demoralization Scale Mandarin Version(DS-MV),Medical Coping Modes Questionnaire(MCMQ),Social Support Revalued Scale(SSRS) and self-made general questionnaire.Results The demoralization score was(35.47±12.54) for the 120 gastric cancer patients.Univariate analysis showed that there were significant differences in demoralization score among patients with different marital status,education degree,monthly income,disease stage and primary caregiver(P<0.05).The correlation analysis showed that the demoralization score was positively correlated with yield coping style(r=0.653,P<0.05),but negatively related to face coping style,subjective support,objective support,support utilization and social support scores(r=-0.448,-0.425,-0.424,-0.329 and-0.455,respectively;P<0.05).Multiple stepwise regression analysis showed that yield coping style,objective support and marital status were the factors influencing demoralization syndrome,which accounted for 48.5% of the total variance of demoralization in gastric cancer patients.Conclusion Patients with gastric cancer have high levels of demoralization,which is affected by multiple factors.The patients are more likely to adopt a yield coping style.Therefore,medical staff should carry out psychological intervention to improve the quality of life of gastric cancer patients.
Objective To explore the factors influencing demoralization syndrome in patients with gastric cancer.Methods A total of 120 gastric cancer patients who were hospitalized in 2 class-A hospitals between June 2018 and October 2018 were surveyed using the Demoralization Scale Mandarin Version(DS-MV),Medical Coping Modes Questionnaire(MCMQ),Social Support Revalued Scale(SSRS) and self-made general questionnaire.Results The demoralization score was(35.47±12.54) for the 120 gastric cancer patients.Univariate analysis showed that there were significant differences in demoralization score among patients with different marital status,education degree,monthly income,disease stage and primary caregiver(P<0.05).The correlation analysis showed that the demoralization score was positively correlated with yield coping style(r=0.653,P<0.05),but negatively related to face coping style,subjective support,objective support,support utilization and social support scores(r=-0.448,-0.425,-0.424,-0.329 and-0.455,respectively;P<0.05).Multiple stepwise regression analysis showed that yield coping style,objective support and marital status were the factors influencing demoralization syndrome,which accounted for 48.5% of the total variance of demoralization in gastric cancer patients.Conclusion Patients with gastric cancer have high levels of demoralization,which is affected by multiple factors.The patients are more likely to adopt a yield coping style.Therefore,medical staff should carry out psychological intervention to improve the quality of life of gastric cancer patients.
引文
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[13] 钟凯,胡启彩,康汉珍,等.围绝经期女性社会支持状况及影响因素研究[J].护理学报,2016,23(12):44-47,48.
[14] LI Y C,HO C H,WANG H H.Demoralization in cancer patients and related factors in Taiwan[J].Cancer Nurs,2017,40(1):E54-E60.
[15] GRIFFITH J L.Hope modules:brief psychotherapeutic interventions to counter demoralization from daily stressors of chronic illness[J].Acad Psychiatry,2017,42(1):135-145.
[16] FANG C K,CHANG M C,CHEN P J,et al.A correlational study of suicidal ideation with psychological distress,depression,and demoralization in patients with cancer[J].Support Care Cancer,2014,22(12):3165-3174.
[17] REBLIN M,DONALDSON G,ELLINGTON L,et al.Spouse cancer caregivers’burden and distress at entry to home hospice:the role of relationship quality[J].J Soc Pers Relat,2015,33(5):666-686.
[18] 梁寅寅,甘秀妮,王玉琼.癌症患者失志综合征的研究进展[J].护理学杂志,2016,31(23):89-92.
[19] 邓莉莎,庞英,何毅,等.恶性肿瘤患者志气缺失的发生及影响因素分析[J].医学与哲学,2017,38(8):75-79.
[20] LI Y C,YEH P C,CHEN H W,et al.Posttraumatic growth and demoralization after cancer:the effects of patients’ meaning-making[J].Palliat Support Care,2015,13(5):1449-1458.
[21] VEHLING S,OECHSLE K,KOCH U,et al.Receiving palliative treatment moderates the effect of age and gender on demoralization in patients with cancer[J].PLoS One,2013,8(3):e59417.
[2] CHEN W,ZHENG R,BAADE P D,et al.Cancer statistics in China,2015[J].CA Cancer J Clin,2016,66(2):115-132.
[3] 曾倩,崔芳芳,宇传华,等.中国癌症发病、死亡现状与趋势分析[J].中国卫生统计,2016,33(2):321-323.
[4] BREWER B W,CASPARI J M,YOUNGWERTH J,et al.Demoralization in medical illness:feasibility and acceptability of a pilot educational intervention for inpatient oncology nurses[J].Palliat Support Care,2017,16(5):503-510.
[5] MEHNERT A,VEHLING S,H?CKER A,et al.Demoralization and depression in patients with advanced cancer:validation of the German version of the demoralization scale[J].J Pain Symptom Manage,2011,42(5):768-776.
[6] GRASSI L,COSTANTINI A,KISSANE D,et al.The factor structure and use of the Demoralization Scale(DS-IT)in Italian cancer patients[J].Psycho-Oncology,2017,26(11):1965-1971.
[7] ROBINSON S,KISSANE D W,BROOKER J,et al.A systematic review of the demoralization syndrome in individuals with progressive disease and cancer:a decade of research[J].J Pain Symptom Manage,2014,49(3):595-610.
[8] VEHLING S,MEHNERT A.Symptom burden,loss of dignity,and demoralization in patients with cancer:a mediation model[J].Psycho-Oncology,2013,23(3):283-290.
[9] KISSANE D W,WEIN S,LOVE A ,et al.The Demoralization Scale:a report of its development and preliminary validation[J].J Palliat Care,2004,20(4):269-276.
[10] 洪晓琪,陈虹汶,张義芳,等.癌症病人失志量表中文版之信效度檢測[J].内科學誌,2010,21:427-435.
[11] FEIFEL H,STRACK S,NAGY V T.Coping strategies and associated features of medically ill patients[J].Psychosom Med,1987,49(6):616-625.
[12] 沈晓红,姜乾金.医学应对方式问卷中文版701例测试报告[J].中国行为医学科学,2000,9(1):18-20.
[13] 钟凯,胡启彩,康汉珍,等.围绝经期女性社会支持状况及影响因素研究[J].护理学报,2016,23(12):44-47,48.
[14] LI Y C,HO C H,WANG H H.Demoralization in cancer patients and related factors in Taiwan[J].Cancer Nurs,2017,40(1):E54-E60.
[15] GRIFFITH J L.Hope modules:brief psychotherapeutic interventions to counter demoralization from daily stressors of chronic illness[J].Acad Psychiatry,2017,42(1):135-145.
[16] FANG C K,CHANG M C,CHEN P J,et al.A correlational study of suicidal ideation with psychological distress,depression,and demoralization in patients with cancer[J].Support Care Cancer,2014,22(12):3165-3174.
[17] REBLIN M,DONALDSON G,ELLINGTON L,et al.Spouse cancer caregivers’burden and distress at entry to home hospice:the role of relationship quality[J].J Soc Pers Relat,2015,33(5):666-686.
[18] 梁寅寅,甘秀妮,王玉琼.癌症患者失志综合征的研究进展[J].护理学杂志,2016,31(23):89-92.
[19] 邓莉莎,庞英,何毅,等.恶性肿瘤患者志气缺失的发生及影响因素分析[J].医学与哲学,2017,38(8):75-79.
[20] LI Y C,YEH P C,CHEN H W,et al.Posttraumatic growth and demoralization after cancer:the effects of patients’ meaning-making[J].Palliat Support Care,2015,13(5):1449-1458.
[21] VEHLING S,OECHSLE K,KOCH U,et al.Receiving palliative treatment moderates the effect of age and gender on demoralization in patients with cancer[J].PLoS One,2013,8(3):e59417.