不同年龄女性乳腺癌患者手术前后负面情绪和生存质量调查研究
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摘要
目的调查不同年龄女性乳腺癌患者手术前后负面情绪和生存质量。方法选取2016年7月至2018年2月于本院行手术治疗的139例女性乳腺癌患者为研究对象,根据年龄分为青年组(<45岁,26例)、中年组(45～59岁,47例)及老年组(≥60岁,66例),分别于术前和术后6个月,采用汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、汉密尔顿抑郁量表-24项(Hamilton depression scale 24 items,HAMD-24)、乳腺癌患者生命质量测定调查表(quality of life questionnaire-breast cancer module 23,QLQ-BR23)评估三组患者焦虑、抑郁状况及生存质量。结果三组患者文化程度比较差异有显著性(P <0.05)。三组患者术前躯体性焦虑、精神性焦虑评分、HAMD-24总分、QLQ-BR23功能维度和症状维度标准分比较差异均无显著性(P_均> 0.05)。术后6个月,三组患者躯体性焦虑、精神性焦虑评分及HAMD-24总分均显著高于本组术前(P_均<0.05),QLQ-BR23功能维度和症状维度标准分均显著低于本组术前(P_均<0.05),青年组患者躯体性焦虑评分、QLQ-BR23功能维度标准分均显著低于中年组和老年组(P_均<0.05),精神性焦虑评分和QLQ-BR23症状维度标准分均显著高于老年组(P_均<0.05),HAMD-24总分显著高于中年组和老年组(P_均<0.05)。结论女性乳腺癌患者术后负面情绪明显加重,生存质量显著降低,其中老年患者以精神性焦虑为主,应更加关注其不适症状;中青年患者以躯体性焦虑和抑郁为主,应更加关注其身体功能变化。
Objective To investigate the negative emotion and quality of life before and after operation in female breast cancer patients with different ages. Method 139 female patients with breast cancer underwent operation from July 2016 to February 2018 were enrolled for the study and divided into youth group( < 45 years old, 26 cases), middle-aged group(45 ～ 59 years old, 47 cases) and elderly group( ≥ 60 years old, 66 cases) according to the age. Hamilton anxiety scale(HAMA), Hamilton depression scale-24 items(HAMD-24) and quality of life questionnaire-breast cancer module 23(QLQ-BR23) were performed to assess anxiety, depression and quality of life before operation and 6 months after operation respectively. Result There was significant difference in education level among three groups(P < 0.05). There were no significant differences in preoperative somatic anxiety, mental anxiety score, HAMD-24 total score, QLQ-BR23 functional dimension and symptoms dimension among the three groups(P_(all)>0.05). 6 months after operation, the scores of somatic anxiety, mental anxiety and total score of HAMD-24 in the three groups were significantly higher than those before operation(P_(all)< 0.05). The standard scores of QLQ-BR23 functional dimension and symptom dimension were significantly lower than those before operation(P_(all)< 0.05). The scores of somatic anxiety and QLQ-BR23 functional dimension in youth group were significantly lower than those inmiddle-aged group and elderly group(P_(all)< 0.05). The scores of divine anxiety and QLQ-BR23 symptom dimension were significantly higher than those ofelderly group(P_(all)< 0.05), and the total scores of HAMD-24 were significantly higher than those of middle-aged group and elderly group(P_(all)< 0.05). Conclusion Postoperative negative emotions of female breast cancer patients are significantly aggravated, and the quality of life decreased significantly after operation. Elderly patients have mainly psychotic anxiety and pay more attention on discomfort symptoms, while young patients pay more attention on somatic anxiety, depression and physical function changes.
Objective To investigate the negative emotion and quality of life before and after operation in female breast cancer patients with different ages. Method 139 female patients with breast cancer underwent operation from July 2016 to February 2018 were enrolled for the study and divided into youth group( < 45 years old, 26 cases), middle-aged group(45 ～ 59 years old, 47 cases) and elderly group( ≥ 60 years old, 66 cases) according to the age. Hamilton anxiety scale(HAMA), Hamilton depression scale-24 items(HAMD-24) and quality of life questionnaire-breast cancer module 23(QLQ-BR23) were performed to assess anxiety, depression and quality of life before operation and 6 months after operation respectively. Result There was significant difference in education level among three groups(P < 0.05). There were no significant differences in preoperative somatic anxiety, mental anxiety score, HAMD-24 total score, QLQ-BR23 functional dimension and symptoms dimension among the three groups(P_(all)>0.05). 6 months after operation, the scores of somatic anxiety, mental anxiety and total score of HAMD-24 in the three groups were significantly higher than those before operation(P_(all)< 0.05). The standard scores of QLQ-BR23 functional dimension and symptom dimension were significantly lower than those before operation(P_(all)< 0.05). The scores of somatic anxiety and QLQ-BR23 functional dimension in youth group were significantly lower than those inmiddle-aged group and elderly group(P_(all)< 0.05). The scores of divine anxiety and QLQ-BR23 symptom dimension were significantly higher than those ofelderly group(P_(all)< 0.05), and the total scores of HAMD-24 were significantly higher than those of middle-aged group and elderly group(P_(all)< 0.05). Conclusion Postoperative negative emotions of female breast cancer patients are significantly aggravated, and the quality of life decreased significantly after operation. Elderly patients have mainly psychotic anxiety and pay more attention on discomfort symptoms, while young patients pay more attention on somatic anxiety, depression and physical function changes.
引文
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[11]王轶珊,李云霞,田青,等.进展期乳腺癌术后多西他赛联合卡培他滨化疗同步放疗的临床研究[J].中国医学前沿杂志(电子版),2017,9(2):72-75.
[12]戴晓艳,邱涛,廖常菊,等.乳腺癌患者化疗后焦虑抑郁情绪及年龄对认知功能的影响分析[J].中国医学前沿杂志(电子版),2017,9(10):99-103.
[13]Axelsson M,L?tvall J,Cliffordson C,et al.Self-efficacy and adherence as mediating factors between person personality traits and health-related quality of life[J].Qual Life Res,2013,22(3):567-575.
[14]Von Ah D,Habermann B,Carpenter JS,et al.Impact of perceived cognitive impairment in breast cancer survivors[J].Eur J Oncol Nurs,2013,17(2):236-241.
[15]Torre LA,Bray F,Siegel RL,et al.Global cancer statistics,2012[J].CA Cancer J Clin,2015,65(2):87-108.
[16]许楠,张鹏彦,周冬仙,等.乳腺癌患者术后抑郁状况调查及危险因素分析[J].中国现代医学杂志,2015,25(34):68-72.
[17]王立新,薛锋.女性乳腺癌术后抑郁发生情况及相关危险因素分析[J].医学临床研究,2014,31(3):529-531.
[18]左彩凤.乳腺癌患者的年龄与心理特征、生活质量的相关性[J].健康必读(中旬刊),2013,12(1):378-378.
[19]李美和,关云娇,周宏,等.不同年龄乳腺癌患者心理韧性分析[J].包头医学院学报,2018,34(3):46-47.
[20]周春阳,李伟华.不同年龄乳腺癌患者病理特征及预后分析[J].健康研究,2018,38(2):175-177,181.
[2]乐小丽.心理干预对子宫肌瘤手术患者性功能及焦虑的影响分析[J].转化医学电子杂志,2017,4(4):87-88,90.
[3]张秋霞.乳腺癌患者心理障碍的原因分析及对策[J].大家健康(中旬版),2017,11(3):223-224.
[4]周立芝.女性乳腺癌住院患者术后抑郁状况及影响因素分析[D].保定:河北联合大学,2015.
[5]张贵成.不同年龄乳腺癌患者的临床病理分析[J].中国实用医药,2011,6(19):131-132.
[6]李国媛,王春梅.不同年龄乳腺癌病人疾病不确定感、社会支持和生活质量的对比性研究[J].护理研究,2013,27(15):1435-1436.
[7]王纯,楚艳民,张亚林,等.汉密尔顿焦虑量表的因素结构研究[J].临床精神医学杂志,2011,21(5):299-301.
[8]苏晖,江开达,徐一峰,等.抑郁症首次发病患者认知功能的研究[J].中华精神科杂志,2005,38(3):146-149.
[9]韦坚,杨春,温枚洁,等.QLQ-BR23量表调查乳腺癌化疗后的生命质量及其影响因素[J].微创医学,2015,10(6):723-726.
[10]郝飞,秦东强,刘平,等.保乳手术与改良根治术治疗早期乳腺癌的临床效果对比分析[J].转化医学电子杂志,2016,3(2):28-29.
[11]王轶珊,李云霞,田青,等.进展期乳腺癌术后多西他赛联合卡培他滨化疗同步放疗的临床研究[J].中国医学前沿杂志(电子版),2017,9(2):72-75.
[12]戴晓艳,邱涛,廖常菊,等.乳腺癌患者化疗后焦虑抑郁情绪及年龄对认知功能的影响分析[J].中国医学前沿杂志(电子版),2017,9(10):99-103.
[13]Axelsson M,L?tvall J,Cliffordson C,et al.Self-efficacy and adherence as mediating factors between person personality traits and health-related quality of life[J].Qual Life Res,2013,22(3):567-575.
[14]Von Ah D,Habermann B,Carpenter JS,et al.Impact of perceived cognitive impairment in breast cancer survivors[J].Eur J Oncol Nurs,2013,17(2):236-241.
[15]Torre LA,Bray F,Siegel RL,et al.Global cancer statistics,2012[J].CA Cancer J Clin,2015,65(2):87-108.
[16]许楠,张鹏彦,周冬仙,等.乳腺癌患者术后抑郁状况调查及危险因素分析[J].中国现代医学杂志,2015,25(34):68-72.
[17]王立新,薛锋.女性乳腺癌术后抑郁发生情况及相关危险因素分析[J].医学临床研究,2014,31(3):529-531.
[18]左彩凤.乳腺癌患者的年龄与心理特征、生活质量的相关性[J].健康必读(中旬刊),2013,12(1):378-378.
[19]李美和,关云娇,周宏,等.不同年龄乳腺癌患者心理韧性分析[J].包头医学院学报,2018,34(3):46-47.
[20]周春阳,李伟华.不同年龄乳腺癌患者病理特征及预后分析[J].健康研究,2018,38(2):175-177,181.