肺癌患者的疾病感知与创伤后成长
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摘要
目的研究肺癌患者的疾病感知(IP)特点与创伤后成长。方法选择疾病感知问卷中文修订版(CIPQ-R)对肺癌患者进行IP评价,选择创伤后成长评定量表(PTGI)对患者患病后的心理成长进行评估,并对患者的IP以及创伤后成长进行相关性分析。结果肺癌患者CIPQ-R严重后果因子、个人控制性因子、治疗控制性因子、情绪陈述因子分数偏高。Pearson偏相关分析显示疾病急慢性因子与严重后果因子、疾病周期性因子和情绪陈述因子呈正相关性(r=0.49、0.34、0.20,P<0.05),与个人控制性因子呈负相关(r=-0.28,P<0.05)。疾病严重后果因子与治疗控制性因子、情绪陈述因子呈正相关(r=0.26、0.35,P<0.05);疾病相关性因子与疾病周期性因子和情绪陈述因子呈负相关性(r=-0.31、﹣0.42,P<0.05);肺癌患者创伤后成长总均分为(50.27±15.78)。CIPQ-R量表中治疗控制性因子与PTGI量标中精神变化维度、欣赏生活维度呈正相关性(r=0.31、0.29,P<0.05),疾病周期性因子与新的可能性维度呈正相关性(r=0.29,P<0.05)。结论肺癌患者具有一定的负性IP,但在治疗疾病的过程中心理层面上有不同程度的成长,改变对疾病的认识可以促进患者心理的成长与康复。
Objective To study the characteristics of illness perception and posttraumatic growth in lung cancer patients. Methods The Chinese revision of the illness perception questionnaire(CIPQ-R) was used to evaluate the illness perception of lung cancer patients. Posttraumatic growth inventory(PTGI) was selected to evaluate the psychological growth of patients,and the correlation between the patient's disease perception and post-traumatic growth was analyzed. Results The scores of consequence factor,personal control factor,treatment control factor and emotional representations factor in CIPQ-R of lung cancer patients were higher(17.84±4.30,18.73±3.47,17.13±3.50,16.67±5.36). Pearson partial correlation analysis showed that timeline acute/chronic factor was positively correlated with consequence factor,timeline cyclical factor and emotional representations factor(r=0.49,0.34,0.20,P<0.05),and negatively correlated with personal control factor(r=-0.28,P<0.05). Consequences factor was positively correlated with treatment control factor and emotional representation factor(r=0.26,0.35,P<0.05). Illness coherence factor was negatively correlated with timeline cyclical factor and emotional representation factor(r=-0.31,-0.42,P<0.05). The total average score of posttraumatic growth inventory in lung cancer patients was(50.27±15.78). In the CIPQ-R scale,there was a positive correlation between the treatment control factor and mental change dimension and enjoying life dimension in the PTGI scale(r=0.31,0.29,P<0.05). The timeline cyclical factor was positively correlated with the new possibility dimension(r=0.29,P<0.05). Conclusion Lung cancer patients have a certain degree of negative illness perception. However,there are varying degrees of psychological growth of the patients during the treatment of disease. Changing the illness perception can promote the growth and rehabilitation of lung cancer patients.
Objective To study the characteristics of illness perception and posttraumatic growth in lung cancer patients. Methods The Chinese revision of the illness perception questionnaire(CIPQ-R) was used to evaluate the illness perception of lung cancer patients. Posttraumatic growth inventory(PTGI) was selected to evaluate the psychological growth of patients,and the correlation between the patient's disease perception and post-traumatic growth was analyzed. Results The scores of consequence factor,personal control factor,treatment control factor and emotional representations factor in CIPQ-R of lung cancer patients were higher(17.84±4.30,18.73±3.47,17.13±3.50,16.67±5.36). Pearson partial correlation analysis showed that timeline acute/chronic factor was positively correlated with consequence factor,timeline cyclical factor and emotional representations factor(r=0.49,0.34,0.20,P<0.05),and negatively correlated with personal control factor(r=-0.28,P<0.05). Consequences factor was positively correlated with treatment control factor and emotional representation factor(r=0.26,0.35,P<0.05). Illness coherence factor was negatively correlated with timeline cyclical factor and emotional representation factor(r=-0.31,-0.42,P<0.05). The total average score of posttraumatic growth inventory in lung cancer patients was(50.27±15.78). In the CIPQ-R scale,there was a positive correlation between the treatment control factor and mental change dimension and enjoying life dimension in the PTGI scale(r=0.31,0.29,P<0.05). The timeline cyclical factor was positively correlated with the new possibility dimension(r=0.29,P<0.05). Conclusion Lung cancer patients have a certain degree of negative illness perception. However,there are varying degrees of psychological growth of the patients during the treatment of disease. Changing the illness perception can promote the growth and rehabilitation of lung cancer patients.
引文
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[16] Foster N E,Bishop A,Thomas E,et al.Illness perceptions of low back pain patients in primary care:what are they,do they change and are they associated with outcome[J].Pain,2008,136(1-2):177-87.
[17] Stacey F G,ames E L,Chapman K,et al.A systematic review and meta-analysis of social cognitive theory-based physical activity and/or nutrition behavior change interventions for cancer survivors [J].J Cancer Surviv,2015,9(2):305-38.
[2] Meuleman Y,Chilcot J,Dekker F W,et al.Health-related quality of life trajectories during predialysis care and associated illness perceptions [J].Health Psychol,2017,36 (11):1083-91.
[3] Weinman J,Petrie K J,Moss-Morris R.The illness perception questionnaire:a new method for assessing cognitive representation of illness [J].Psychol Health,1996,11 (3):431-45.
[4] MossMorris R,Weinman J,Petrie K.The revised illness perception questionnaire (IPQ-R) [J].Psychol Health,2002,17(1):1-16.
[5] 曹召伦,汪凯,叶珺.慢性HBV感染患者的疾病认知[J].中国临床心理学杂志,2007,15(1):71-3.
[6] Tdku K,Cann A,Calhoun L G,et al.The factor structure of the posttraumatic growth inventory:a comparison of five models using confirmatory factor analysis [J].J Trauma Stress,2008,21 (2):158-64.
[7] Koutrouli N,Anagnostopoulos F.Potamianos G.Posttraumatic stress disorder and posttraumatic growth in breast cancer patients:a systematic review [J].Women Health,2012,52 (5):503-16.
[8] Tedeschi R G,Calhoun L G.The posttraumatic growth inventory:Measuring the positive legacy of trauma [J].J Trauma Stress,1996,9(3):455-71.
[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):26-8.
[10] 王丽君,宇传华,张志将,等.中国居民1987-2014年肺癌死亡趋势分析[J].中国公共卫生,2017,33(1):42-6.
[11] Jemal A,Siegel R,Xu J,et al.Cancer statistics,2010 [J].CA Cancer J Clin,2010,60(5):277-300.
[12] Detterbeck F C,Boffa D J,Kim A W,et al.The eighth edition lung cancer stage classification [J].Chest,2017,151(1):193-203.
[13] Leventhal H,Leventhal E A,Contrada R J,et al.Self-regulation of health and behavior:a perceptual-cognitive approach [J].Psychol Health,1998,13 (4):717-33.
[14] Thong M S,aptein A A,Vissers P A,et al.Illness perceptions are associated with mortality among 1552 colorectal cancer survivors:a study from the population-based PROFILES registry [J].J Cancer Surviv,2016,10 (5):898-905.
[15] Hoseini L,Lotfi Kashani F,Akbari S,et al.Model development of illness perception and consequences in breast cancer patients [J].Asian Pac J Cancer Prev,2016,17 (S3):185-90.
[16] Foster N E,Bishop A,Thomas E,et al.Illness perceptions of low back pain patients in primary care:what are they,do they change and are they associated with outcome[J].Pain,2008,136(1-2):177-87.
[17] Stacey F G,ames E L,Chapman K,et al.A systematic review and meta-analysis of social cognitive theory-based physical activity and/or nutrition behavior change interventions for cancer survivors [J].J Cancer Surviv,2015,9(2):305-38.