乳腺癌患者的D型人格特征与生存质量及预后的相关性分析
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摘要
目的:探讨分析乳腺癌患者的D型人格特征与生存质量及预后的相关性。方法:选取本院收治的112例乳腺癌患者作为研究对象,对所选患者均进行问卷调查,采用14项D型人格量表(DS14)进行D型人格特征的测量,将合并有D型人格特征的患者纳入合并组,未合并D型人格特征的患者纳入未合并组。采用癌症患者生活质量评价量表(QLQ-C30)进行患者生存质量状况评估,研究分析所选患者D型人格特征与生存质量及预后的相关性。结果:所选112例乳腺癌患者中,D型人格特征的发生率为19. 64%。在生活水平、医疗保险、合并基础疾病方面,合并组与未合并组对比存在明显差异(P <0. 05)。术前,两组患者的功能指标与症状指标对比均无明显差异(P> 0. 05);术后6个月,合并组患者的功能指标均明显低于未合并组患者,症状指标均明显高于未合并组患者,两组对比存在明显差异(P <0. 05)。合并组患者的躯体功能、角色功能、认知功能、情绪功能及总健康状况与NA存在明显负相关性(P <0. 05),疲倦、失眠、食欲丧失、经济困难与NA存在明显正相关性(P <0. 05);合并组患者的角色功能、认知功能、情绪功能、社会功能及总健康状况与SI存在明显负相关性(P <0. 05),疲倦、疼痛、失眠、食欲丧失、经济困难与SI存在明显正相关性(P <0. 05)。两组患者术后1年及2年的生存率对比无差异(P> 0. 05),但合并组患者术后5年的生存率明显低于未合并组患者,对比存在明显差异(P <0. 05)。结论:D型人格特征与乳腺癌患者生存质量存在明显相关性,可作为预测乳腺癌患者生存质量恶化及不良预后的重要因素。
Objective: To investigate the correlation of type D personality characteristics of breast cancer patients with their quality of life and prognosis. Methods: The clinical data of 112 patients with breast cancer admitted in our hospital were retrospectively analyzed. All patients were assessed by various scales,including 14-item Type D Personality Scale( DS14) and European Organization for Research and Treatment of Cancer QLQ-C30 questionnaires.Patients with type D personality were included into the combined group and patients without D personality were included into the uncombined group. Then the correlation between the type D personality characteristics and quality of life and prognosis was analyzed. Results: The overall incidence rate of type D personality was 19. 64%. Statistic difference was found between the combined group and the uncombined group in terms of living standards,medical insurance,and combined underlying diseases( P < 0. 05). The functional indicators and symptom indicators had no difference between groups before operation( P > 0. 05). The combined group had lower functional indicators as well as higher symptom indicators than those of the uncombined group at the post-operative 6 months( P < 0. 05). The NA of the selected patients was negatively correlated with physical functioning,cognitive functioning,emotional functioning and global health( P < 0. 05),and was positively correlated with fatigue,insomnia,loss of appetite and economic difficulty( P < 0. 05). The SI of the selected patients was negatively correlated with role functioning,cognitive functioning,emotional functioning,social functioning and global health( P < 0. 05),and was positively correlated with fatigue,pain,insomnia,loss of appetite,and economic difficulty( P < 0. 05). 5-year survival rate in the combined group was significantly lower than that in the uncombined group( P < 0. 05),while no difference was found in the 1-,2-year survival rates( P > 0. 05). Conclusion: The type D personality is significantly correlated to the quality of life in breast cancer patients,which can be used as an important predictor for the poor quality of life and prognosis.
Objective: To investigate the correlation of type D personality characteristics of breast cancer patients with their quality of life and prognosis. Methods: The clinical data of 112 patients with breast cancer admitted in our hospital were retrospectively analyzed. All patients were assessed by various scales,including 14-item Type D Personality Scale( DS14) and European Organization for Research and Treatment of Cancer QLQ-C30 questionnaires.Patients with type D personality were included into the combined group and patients without D personality were included into the uncombined group. Then the correlation between the type D personality characteristics and quality of life and prognosis was analyzed. Results: The overall incidence rate of type D personality was 19. 64%. Statistic difference was found between the combined group and the uncombined group in terms of living standards,medical insurance,and combined underlying diseases( P < 0. 05). The functional indicators and symptom indicators had no difference between groups before operation( P > 0. 05). The combined group had lower functional indicators as well as higher symptom indicators than those of the uncombined group at the post-operative 6 months( P < 0. 05). The NA of the selected patients was negatively correlated with physical functioning,cognitive functioning,emotional functioning and global health( P < 0. 05),and was positively correlated with fatigue,insomnia,loss of appetite and economic difficulty( P < 0. 05). The SI of the selected patients was negatively correlated with role functioning,cognitive functioning,emotional functioning,social functioning and global health( P < 0. 05),and was positively correlated with fatigue,pain,insomnia,loss of appetite,and economic difficulty( P < 0. 05). 5-year survival rate in the combined group was significantly lower than that in the uncombined group( P < 0. 05),while no difference was found in the 1-,2-year survival rates( P > 0. 05). Conclusion: The type D personality is significantly correlated to the quality of life in breast cancer patients,which can be used as an important predictor for the poor quality of life and prognosis.
引文
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[14]van Dooren FE,Verhey FR,Pouwer F,et al.Association of type Dpersonality with increased vulnerability to depression:Is there a role for inflammation or endothelial dysfunction?The maastricht study[J].Journal of Affective Disorders,2016,189(2):118-126.
[15]ZHANG JK,LI YS,JIN JZ,et al.Type D personality is associated with longer symptom duration,poor mental health status,and poor quality of life among rectal cancer patients[J].Chinese Journal of Bases and Clinics in General Surgery,2017,32(3):297-306.[张家魁,李永双,金俊哲,等.D型人格与直肠癌患者就诊延迟、精神状态及生存质量的关系[J].中国普外基础与临床杂志,2017,32(3):297-306.]
[16]WANG HY,LIANG YD,WEI YC.A comparative study of type Dpersonality and anxiety and depression in patients with cerebral infarction before and after intervention[J].Chongqing Medical College,2016,45(27):3845-3847.[王华英,梁应丹,韦云彩.脑梗死患者D型人格与焦虑抑郁情绪干预前后的对比研究[J].重庆医学,2016,45(27):3845-3847.]
[17]Wang LL,Hao S,Zhang S,et al.PTEN/PI3K/AKT protein expression is related to clinicopathological features and prognosis in breast cancer with axillary lymph node metastases[J].Human Pathology,2017,48(5):61-69.
[18]Liu K,Song CF,Cheng SZ,et al.Correlations of nurse intention to continue work contracts,social support and type D personality[J].Modern Clinical Nursing,2016,15(9):6-11.
[19]MENG F,GUO HN,CUI YL,et al.Correlation between type Dpersonality and cognitive fusion in 388 employees of state-owned enterprises[J].Chinese Journal of Industrial Hygiene and Occupational Diseases,2016,34(2):95-98.[孟菲,郭慧娜,崔云龙,等.388名国有企业职工D型人格与认知融合的关系[J].中华劳动卫生职业病杂志,2016,34(2):95-98.]
[20]Tang Q,Zhou Z,Chen J,et al.Correlation of metastasis characteristics with prognosis in gastric mixed adenoneuroendocrine carcinoma:Two case reports[J].Medicine,2017,96(50):9189-9351.
[2]LI LY,LI SC,WANG YP,et al.Mediating effects of cognitive coping on neuroticism to quality of life in females with breast cancer[J].Chin J Clin Psychol,2016,24(2):271-273.[李玲艳,李诗晨,王瑜萍,等.认知应对在女性乳腺癌患者神经质人格与生活质量关系中的中介作用[J].中国临床心理学杂志,2016,24(2):271-273.]
[3]WANG QZ.The impact on quality of life of comprehensive nursing on postoperative chemotherapy in breast cancer patients[J].Chinese Journal of Coal Industry Medicine,2017,20(1):77-80.[王巧珍.综合护理干预对乳腺癌患者术后化疗期生活质量的影响[J].中国煤炭工业医学杂志,2017,20(1):77-80.]
[4]Hattori S,Kikuchi E,Kosaka T,et al.Relationship between increased expression of the axl/gas6 signal cascade and prognosis of patients with upper tract urothelial carcinoma[J].Ann Surg Oncol,2016,23(2):1-8.
[5]XU X,LIU L.Associations of type D personality and perceived social support with post-traumatic stress disorder symptoms in patients with hematological malignancies[J].Journal of China Medical University,2018,47(5):32-41.[徐昕,刘利.血液系统恶性肿瘤患者D型人格、领悟社会支持与创伤后应激障碍症状的关系[J].中国医科大学学报,2018,47(5):32-41.]
[6]WANG HY,LIN P,GAO XQ,et al.A study on the relationship between type D personality and plaque vulnerability[J].Journal of Nursing Science,2016,31(3):22-26.[王旖旎,林平,高学琴,等.D型人格与冠状动脉粥样硬化斑块稳定性关系研究[J].护理学杂志,2016,31(3):22-26.]
[7]Greenwood HI,Dodelzon K,Katzen JT.Impact of advancing technology on diagnosis and treatment of breast cancer[J].Surgical Clinics of North America,2018,98(4):703-723.
[8]LIU GH,WANG C,MA ZW,et al.Research progress on type Dpersonality and cardiovascular and cerebrovascular diseases[J].Chinese Nursing Research,2018,28(11):42-47.[刘国辉,王辰,马志伟,等.D型人格与心脑血管疾病的研究进展[J].护理研究,2018,28(11):42-47.]
[9]LIU HF,HAN H,HAN YH.A preliminary study on the relationship between type D personality and unexplained infertility[J].Chinese Journal of Reproductive Health,2017,28(5):456-457.[刘鹤玢,韩晗,韩延华.D型人格与不明原因不孕症关系初探[J].中国生育健康杂志,2017,28(5):456-457.]
[10]LI Y,HUANG LZ.Disease cognition and medical coping style of coronary heart disease patients with type-D personality[J].Chinese Journal of Modern Nursing,2017,23(10):42-46.[李妍,黄伶智.D型人格冠心病患者疾病认知和医学应对方式的研究[J].中华现代护理杂志,2017,23(10):42-46.]
[11]ZHANG JK,LI YS,JIN JZ,et al.Type D personality is associated with poor quality of life and prognosis among rectal cancer survivors[J].Modern Oncology,2017,25(3):415-422.[张家魁,李永双,金俊哲,等.直肠癌患者D型人格与生存质量及预后的关系[J].现代肿瘤医学,2017,25(3):415-422.]
[12]CHENG FM,LIN P,GAO XQ,et al.Research progress of type Dpersonality for the occurrence and development of coronary heart disease[J].Chinese Journal of Modern Nursing,2017,23(10):53-58.[程方满,林平,高学琴,等.D型人格:冠心病发生发展的重要危险因素[J].中华现代护理杂志,2017,23(10):53-58.]
[13]GAO L,MEI RH,ZHOU YF,et al.Self adjustment for mental health of freshmen with type D personality in a medical college[J].Chinese Preventive Medicine,2017,36(8):565-567.[高立,梅瑞华,周艳芳,等.某医学院校D型人格新生心理健康自我调整状况调查研究[J].中国预防医学杂志,2017,36(8):565-567.]
[14]van Dooren FE,Verhey FR,Pouwer F,et al.Association of type Dpersonality with increased vulnerability to depression:Is there a role for inflammation or endothelial dysfunction?The maastricht study[J].Journal of Affective Disorders,2016,189(2):118-126.
[15]ZHANG JK,LI YS,JIN JZ,et al.Type D personality is associated with longer symptom duration,poor mental health status,and poor quality of life among rectal cancer patients[J].Chinese Journal of Bases and Clinics in General Surgery,2017,32(3):297-306.[张家魁,李永双,金俊哲,等.D型人格与直肠癌患者就诊延迟、精神状态及生存质量的关系[J].中国普外基础与临床杂志,2017,32(3):297-306.]
[16]WANG HY,LIANG YD,WEI YC.A comparative study of type Dpersonality and anxiety and depression in patients with cerebral infarction before and after intervention[J].Chongqing Medical College,2016,45(27):3845-3847.[王华英,梁应丹,韦云彩.脑梗死患者D型人格与焦虑抑郁情绪干预前后的对比研究[J].重庆医学,2016,45(27):3845-3847.]
[17]Wang LL,Hao S,Zhang S,et al.PTEN/PI3K/AKT protein expression is related to clinicopathological features and prognosis in breast cancer with axillary lymph node metastases[J].Human Pathology,2017,48(5):61-69.
[18]Liu K,Song CF,Cheng SZ,et al.Correlations of nurse intention to continue work contracts,social support and type D personality[J].Modern Clinical Nursing,2016,15(9):6-11.
[19]MENG F,GUO HN,CUI YL,et al.Correlation between type Dpersonality and cognitive fusion in 388 employees of state-owned enterprises[J].Chinese Journal of Industrial Hygiene and Occupational Diseases,2016,34(2):95-98.[孟菲,郭慧娜,崔云龙,等.388名国有企业职工D型人格与认知融合的关系[J].中华劳动卫生职业病杂志,2016,34(2):95-98.]
[20]Tang Q,Zhou Z,Chen J,et al.Correlation of metastasis characteristics with prognosis in gastric mixed adenoneuroendocrine carcinoma:Two case reports[J].Medicine,2017,96(50):9189-9351.