乳腺癌患者心理韧性相关影响因素分析及心理韧性与焦虑的关系
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摘要
目的:分析乳腺癌患者心理韧性的影响因素,并分析心理韧性与焦虑的关系。方法:于2017年2月～2018年4月期间,选择蚌埠医学院第二附属医院收治的乳腺癌患者287例为研究对象,分别采用心理韧性量表(RS)、焦虑自评量表(SAS)评估研究对象的心理韧性及焦虑状态,并采用多因素Logistic回归分析法分析乳腺癌患者心理韧性相关的影响因素,应用多元逐步线性回归分析法分析乳腺癌患者心理韧性与焦虑的关系。结果:乳腺癌患者RS得分为(76.72±9.82)分。单因素分析显示,不同年龄、居住地、家庭月收入及费用支出形式患者的RS得分比较差异有统计学意义(P<0.05);不同文化程度、婚姻状况、手术类型及肿瘤分期患者的RS得分比较差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,年龄为20～40岁、居住地为农村、家庭月收入<3000元、费用支出形式为自费是乳腺癌患者心理韧性的影响因素(P<0.05)。乳腺癌患者SAS得分为(5.02±1.42)分,以心理韧性为自变量,焦虑为因变量进行多元逐步线性回归分析,结果显示,乳腺癌患者心理韧性为焦虑的预测因子,其心理韧性水平越高,焦虑程度越低(P<0.05)。结论:乳腺癌患者心理韧性水平偏低,且其对患者焦虑状态具有预测作用,年龄为20～40岁、居住地为农村、家庭月收入<3000元、费用支出形式为自费是乳腺癌患者心理韧性的影响因素,临床治疗中应该根据以上影响因素进行相关干预。
Objective: To analyze the influencing factors of psychological resilience of breast cancer patients. To analyze the relationship between psychological resilience and anxiety. Methods: A total of 287 breast cancer patients, who were treated in Second Affiliated Hospital of Bengbu Medical College from February 2017 to April 2018, were chosen as study subjects. The psychological resilience and anxiety level of the subjects were evaluated by Psychological Resilience Scale(RS) and self-rating Anxiety Scale(SAS).The influencing factors of psychological resilience in breast cancer patients were analyzed by multivariate logistic regression analysis.The relationship between psychological resilience and anxiety in breast cancer patients was analyzed by stepwise regression analysis.Results: RS score of breast cancer patients was(76.72±9.82). Univariate analysis showed that there were significant differences in RS scores among patients of different ages, residence, family monthly income and expenditure patterns(P<0.05). There were no significant differences in the scores of RS among patients with different educational background, marital status, type of operation and stage of cancer(P >0.05). Multivariate logistic regression analysis showed that age from 20 to 40 years old, residence in rural areas, family monthly income<3000 yuan and patients at their own expense were the influencing factors of psychological resilience of breast cancer patients(P<0.05). The SAS score of breast cancer patients was(5.02 ±1.42). Taking mental resilience as independent variable and anxiety as dependent variable, multiple stepwise linear regression analysis was carried out. The results showed that psychological resilience was a predictor of anxiety in breast cancer patients. The higher the level of psychological resilience, the lower the degree of anxiety(P<0.05).Conclusion: The psychological resilience level of breast cancer patients is low, which can predict the anxiety state of patients. The age of20 to 40 years old, living in rural areas, family monthly income less than 3000 yuan, the expenditure form of self-expense are the influence factors of breast cancer patients' psychological resilience. According to the above influence factors, relevant interventions should be carried out in clinical treatment.
Objective: To analyze the influencing factors of psychological resilience of breast cancer patients. To analyze the relationship between psychological resilience and anxiety. Methods: A total of 287 breast cancer patients, who were treated in Second Affiliated Hospital of Bengbu Medical College from February 2017 to April 2018, were chosen as study subjects. The psychological resilience and anxiety level of the subjects were evaluated by Psychological Resilience Scale(RS) and self-rating Anxiety Scale(SAS).The influencing factors of psychological resilience in breast cancer patients were analyzed by multivariate logistic regression analysis.The relationship between psychological resilience and anxiety in breast cancer patients was analyzed by stepwise regression analysis.Results: RS score of breast cancer patients was(76.72±9.82). Univariate analysis showed that there were significant differences in RS scores among patients of different ages, residence, family monthly income and expenditure patterns(P<0.05). There were no significant differences in the scores of RS among patients with different educational background, marital status, type of operation and stage of cancer(P >0.05). Multivariate logistic regression analysis showed that age from 20 to 40 years old, residence in rural areas, family monthly income<3000 yuan and patients at their own expense were the influencing factors of psychological resilience of breast cancer patients(P<0.05). The SAS score of breast cancer patients was(5.02 ±1.42). Taking mental resilience as independent variable and anxiety as dependent variable, multiple stepwise linear regression analysis was carried out. The results showed that psychological resilience was a predictor of anxiety in breast cancer patients. The higher the level of psychological resilience, the lower the degree of anxiety(P<0.05).Conclusion: The psychological resilience level of breast cancer patients is low, which can predict the anxiety state of patients. The age of20 to 40 years old, living in rural areas, family monthly income less than 3000 yuan, the expenditure form of self-expense are the influence factors of breast cancer patients' psychological resilience. According to the above influence factors, relevant interventions should be carried out in clinical treatment.
引文
[1]张军,张永庆,王昌亮,等.35岁以下年轻乳腺癌患者的临床特征及预后因素分析[J].现代生物医学进展,2016,16(12):2346-2350
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[14]Ye ZJ,Liang MZ,Qiu HZ,et al.Effect of a multidiscipline mentorbased program,Be Resilient to Breast Cancer(BRBC),on female breast cancer survivors in mainland China-A randomized,controlled,theoretically-derived intervention trial[J].Breast Cancer Res Treat,2016,158(3):509-522
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[16]Tadayon M,Dabirizadeh S,Zarea K,et al.Investigating the relationship between psychological hardiness and resilience with depression in women with breast cancer[J].Gulf J Oncolog,2018,1(28):23-30
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[21]Markovitz SE,Schrooten W,Arntz A,et al.Resilience as a predictor for emotional response to the diagnosis and surgery in breast cancerpatients[J].Psychooncology,2015,24(12):1639-1645
[22]Lim JW,Shon EJ,Paek M,et al.The dyadic effects of coping and resilience on psychological distress for cancer survivor couples[J].Support Care Cancer,2014,22(12):3209-3217
[23]Fradelos EC,Latsou D,Mitsi D,et al.Assessment of the relation between religiosity,mental health,and psychological resilience in breast cancer patients[J].Contemp Oncol(Pozn),2018,22(3):172-177
[24]DuguéM,Garncarzyk C,Dosseville F.Psychological characteristics of stress in nursing student[J].Rev Epidemiol Sante Publique,2018,66(6):347-354
[25]Murali K,Makker V,Lynch J,et al.From Burnout to Resilience:An Update for Oncologists[J].Am Soc Clin Oncol Educ Book,2018,23;(38):862-872
[26]马文燕,陆超祥,余洋,等.农村留守中学生心理韧性在一般疏离感与主观幸福感间的作用[J].中国学校卫生,2018,39(04):619-622
[27]王月琴,张宇,王青.离异单亲大学生父母依恋同伴依恋与心理韧性的关系[J].中国学校卫生,2017,38(2):219-223
[28]郭谊楠,许乐,谢娜娜,等.低年资护士心理韧性和社会支持的现状及其相关性[J].解放军护理杂志,2017,34(13):26-29
[29]吴子敬,刘叶,李小寒.乳腺癌患者心理韧性现状及其与焦虑抑郁之间的关系[J].中国医科大学学报,2018,47(1):78-81
[30]Axelsson U,Rydén L,Johnsson P,et al.A multicenter study investigating the molecular fingerprint of psychological resilience in breast cancer patients:study protocol of the SCAN-B resilience study[J].BMC Cancer,2018,18(1):789
[2]Lee JH,Kim HY.Symptom Distress and Coping in Young Korean Breast Cancer Survivors:The Mediating Effects of Social Support and Resilience[J].J Korean Acad Nurs,2018,48(2):241-253
[3]Wu PH,Chen SW,Huang WT,et al.Effects of a Psychoeducational Intervention in Patients With Breast Cancer Undergoing Chemotherapy[J].J Nurs Res,2018,26(4):266-279
[4]Ye ZJ,Qiu HZ,Liang MZ,et al.Effect of a mentor-based,supportiveexpressive program,Be Resilient to Breast Cancer,on survival in metastatic breast cancer:a randomised,controlled intervention trial[J].Br J Cancer,2017,117(10):1486-1494
[5]Tahghighi M,Rees CS,Brown JA,et al.What is the impact of shift work on the psychological functioning and resilience of nurses An integrative review[J].J Adv Nurs,2017,73(9):2065-2083
[6]LalibertéDurish C,Yeates KO,Brooks BL.Psychological Resilience as a Predictor of Persistent Post-Concussive Symptoms in Children With Single and Multiple Concussion[J].J Int Neuropsychol Soc,2018,24(8):759-768
[7]杨梦,刘佳鸿,白银玉,等.哮喘儿童心理韧性现状及其影响因素的研究[J].中国儿童保健杂志,2016,24(12):1332-1334
[8]Rosenberg AR,Bradford MC,Mc Cauley E,et al.Promoting resilience in adolescents and young adults with cancer:Results from the PRISMrandomized controlled trial[J].Cancer,2018,124(19):3909-3917
[9]Kamen C,Jabson JM,Mustian KM,et al.Minority stress,psychosocial resources,and psychological distress among sexual minority breastcancer survivors[J].Health Psychol,2017,36(6):529-537
[10]胡淑贤,石搏,黄可欣,等.不同类型音乐对缓解乳腺癌患者化疗焦虑、抑郁的效果研究[J].中国妇幼保健,2013,28(2):359-361
[11]Henry BJ.Quality of Life and Resilience:Exploring a Fly Fishing Intervention for Breast Cancer Survivors[J].Clin J Oncol Nurs,2017,21(1):E9-E14
[12]Wu Z,Liu Y,Li X,et al.Resilience and Associated Factors among Mainland Chinese Women Newly Diagnosed with Breast Cancer[J].PLoS One,2016,11(12):e0167976
[13]Yang JH,Kim OS.The Structural Equation Model on Resilience of Breast Cancer Patients Receiving Chemotherapy[J].J Korean Acad Nurs,2016,46(3):327-337
[14]Ye ZJ,Liang MZ,Qiu HZ,et al.Effect of a multidiscipline mentorbased program,Be Resilient to Breast Cancer(BRBC),on female breast cancer survivors in mainland China-A randomized,controlled,theoretically-derived intervention trial[J].Breast Cancer Res Treat,2016,158(3):509-522
[15]Lam WW,Yoon SW,Sze WK,et al.Comparing the meanings of living with advanced breast cancer between women resilient to distress and women with persistent distress:a qualitative study[J].Psychooncology,2017,26(2):255-261
[16]Tadayon M,Dabirizadeh S,Zarea K,et al.Investigating the relationship between psychological hardiness and resilience with depression in women with breast cancer[J].Gulf J Oncolog,2018,1(28):23-30
[17]Bennett JM,Rohleder N,Sturmberg JP.Biopsychosocial approach to understanding resilience:Stress habituation and where to intervene[J].J Eval Clin Pract,2018,24(6):1339-1346
[18]Dooley LN,Slavich GM,Moreno PI,et al.Strength through adversity:Moderate lifetime stress exposure is associated with psychological resilience in breast cancer survivors[J].Stress Health,2017,33(5):549-557
[19]Astin JA,Shapiro J,Shapiro D.Psychological control and morbidity/mortality in breast cancer patients:a 20-year follow-up study[J].Behav Med,2015,39(1):7-10
[20]何明珠,姜玲,王静,等.肿瘤化疗患者心理韧性及其影响因素的研究[J].护理学杂志,2015,30(1):60-62
[21]Markovitz SE,Schrooten W,Arntz A,et al.Resilience as a predictor for emotional response to the diagnosis and surgery in breast cancerpatients[J].Psychooncology,2015,24(12):1639-1645
[22]Lim JW,Shon EJ,Paek M,et al.The dyadic effects of coping and resilience on psychological distress for cancer survivor couples[J].Support Care Cancer,2014,22(12):3209-3217
[23]Fradelos EC,Latsou D,Mitsi D,et al.Assessment of the relation between religiosity,mental health,and psychological resilience in breast cancer patients[J].Contemp Oncol(Pozn),2018,22(3):172-177
[24]DuguéM,Garncarzyk C,Dosseville F.Psychological characteristics of stress in nursing student[J].Rev Epidemiol Sante Publique,2018,66(6):347-354
[25]Murali K,Makker V,Lynch J,et al.From Burnout to Resilience:An Update for Oncologists[J].Am Soc Clin Oncol Educ Book,2018,23;(38):862-872
[26]马文燕,陆超祥,余洋,等.农村留守中学生心理韧性在一般疏离感与主观幸福感间的作用[J].中国学校卫生,2018,39(04):619-622
[27]王月琴,张宇,王青.离异单亲大学生父母依恋同伴依恋与心理韧性的关系[J].中国学校卫生,2017,38(2):219-223
[28]郭谊楠,许乐,谢娜娜,等.低年资护士心理韧性和社会支持的现状及其相关性[J].解放军护理杂志,2017,34(13):26-29
[29]吴子敬,刘叶,李小寒.乳腺癌患者心理韧性现状及其与焦虑抑郁之间的关系[J].中国医科大学学报,2018,47(1):78-81
[30]Axelsson U,Rydén L,Johnsson P,et al.A multicenter study investigating the molecular fingerprint of psychological resilience in breast cancer patients:study protocol of the SCAN-B resilience study[J].BMC Cancer,2018,18(1):789