新疆某医院乳腺癌患者术后生存质量影响因素的调查
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摘要
目的:描述乳腺癌患者术后的生存质量、抑郁、应对方式及社会支持状况;探讨乳腺癌患者术后影响生存质量的因素。研究对象和方法:采用描述性研究设计,整群抽样纵向调查方法,调查了在新疆某肿瘤专科医院的150名乳腺癌患者。在患者手术后2周、术后3个月对患者重复进行问卷调查,问卷由自行设计的一般情况调查表、乳腺癌生存质量测定量表、抑郁自评量表、社会支持评定量表、医学应对问卷五部分组成。采用SPSS16.0统计软件进行数据的统计分析。结果:1)乳腺癌患者术后2周与术后3个月整体生存质量均不高。乳腺癌患者术后2周与术后3个月生存质量除情感维度比较有差异外,总分和余四个维度比较均无明显差异,且术后3个月生存质量情感维度得分较前明显下降;乳腺癌患者术后2周抑郁发生率为54.67%,术后3个月抑郁发生率增至62.00%,且各阶段抑郁总分显著高于常模(P<0.01),负性情绪表现明显,但术后2周和术后3个月乳腺癌患者的抑郁水平比较无明显差异(P>0.05);乳腺癌患者术后2周应激期和术后3个月化疗期应对方式各因子得分与常模比较,面对应对的得分均与常模相似;而回避、屈服两种应对方式的得分均高于常模(P<0.01);乳腺癌患者术后各阶段的社会支持处于中等水平,其中,主观支持均高于常模(P<0.01),而客观支持与支持利用度均低于常模(P<0.01)。2)乳腺癌术后各阶段生存质量与社会支持呈正相关,与抑郁情绪负相关,即社会支持越高,抑郁负性情绪越少,生存质量越好。3)对生存质量及其多个维度均有显著影响作用的因素包括文化程度、婚姻情况、医疗保障方式、抑郁情绪、社会支持、病理分期、应对方式。结论:乳腺癌患者术后各阶段整体生存质量不高。术后抑郁的发生率较高,且常采用回避、屈服两种应对方式;社会支持处于中等水平;影响生存质量及其多个维度的主要因素是文化程度、婚姻情况、医疗保障方式、抑郁情绪、社会支持、病理分期、应对方式。
Objective: To describe breast cancer patients quality of life, depression, coping style and social support; to explore the impact factors of quality of life of breast cancer patients. Subjects and methods::A descriptive design was used. By cluster sampling method and longitudinal investigation, 150 breast cancer patients were recruited from the affliated Toumour Hospital Xinjiang Medical University. After two weeks of the operation and three months of the operation, Patients were investigated with repeated questionnaires. The general demographic questionnaire, functional assessment of cancer therapy-breast, self-rating depression scale and medical coping modes questionnaire, social support rating scale were used to collect data. The data were analyzed with software SPSS version 16.0. Results: 1) The quality of life of breast cancer patients with after two weeks and after 3 months the overall are not high. After 2 weeks and after 3 months, the quality of life of the breast cancer patients ,except for emotional dimension, the total score and other four dimensions there was no significant difference in comparison, and 3 months postoperatively emotional dimension of quality of life scores marked decline over the previous; the incidence rate depression of breast cancer patients after 2 weeks were 54.67%, after 3 months the incidence of depression increased to 62.00%, and the various stages of depression scores were significantly higher than norm (P <0.01), negative emotion was obvious, but after two weeks and after 3 months of depression breast cancer patients showed no significant difference in the level (P> 0.05); breast cancer patients after 2 weeks of stress period and after 3 month chemotherapy response the factor scores compared with the norm, the facing coping style scores were similar to the norm; but avoidance and obedience coping styles scores were higher than the norm (P <0.01); breast cancer patients with various stages of social support at the middle level, subjective support is higher than the norm (P <0.01), and objective support and support utilization were lower than the norm (P <0.01). 2) The quality of life of breast cancer patients at various stages of postoperative and social support were positively correlated negatively correlated with depression, that is, the higher the social support, the fewer depression, the better quality of life. 3) The quality of life and its various dimensions have a significant impact including: education level, marital status, medical protection, depressed mood, social support, pathological stage, coping style. Conclusion: The overall quality of life of the breast cancer patients in various stages is not high. There are a higher incidence of depression, and often the use of avoidance and obedience two coping styles; social support at the middle level; the main affection factors of quality of life of breast cancer patients and its multiple dimensions are educational level, marital status, medical protection, depression, social support, pathological stage, coping style.
Objective: To describe breast cancer patients quality of life, depression, coping style and social support; to explore the impact factors of quality of life of breast cancer patients. Subjects and methods::A descriptive design was used. By cluster sampling method and longitudinal investigation, 150 breast cancer patients were recruited from the affliated Toumour Hospital Xinjiang Medical University. After two weeks of the operation and three months of the operation, Patients were investigated with repeated questionnaires. The general demographic questionnaire, functional assessment of cancer therapy-breast, self-rating depression scale and medical coping modes questionnaire, social support rating scale were used to collect data. The data were analyzed with software SPSS version 16.0. Results: 1) The quality of life of breast cancer patients with after two weeks and after 3 months the overall are not high. After 2 weeks and after 3 months, the quality of life of the breast cancer patients ,except for emotional dimension, the total score and other four dimensions there was no significant difference in comparison, and 3 months postoperatively emotional dimension of quality of life scores marked decline over the previous; the incidence rate depression of breast cancer patients after 2 weeks were 54.67%, after 3 months the incidence of depression increased to 62.00%, and the various stages of depression scores were significantly higher than norm (P <0.01), negative emotion was obvious, but after two weeks and after 3 months of depression breast cancer patients showed no significant difference in the level (P> 0.05); breast cancer patients after 2 weeks of stress period and after 3 month chemotherapy response the factor scores compared with the norm, the facing coping style scores were similar to the norm; but avoidance and obedience coping styles scores were higher than the norm (P <0.01); breast cancer patients with various stages of social support at the middle level, subjective support is higher than the norm (P <0.01), and objective support and support utilization were lower than the norm (P <0.01). 2) The quality of life of breast cancer patients at various stages of postoperative and social support were positively correlated negatively correlated with depression, that is, the higher the social support, the fewer depression, the better quality of life. 3) The quality of life and its various dimensions have a significant impact including: education level, marital status, medical protection, depressed mood, social support, pathological stage, coping style. Conclusion: The overall quality of life of the breast cancer patients in various stages is not high. There are a higher incidence of depression, and often the use of avoidance and obedience two coping styles; social support at the middle level; the main affection factors of quality of life of breast cancer patients and its multiple dimensions are educational level, marital status, medical protection, depression, social support, pathological stage, coping style.
引文
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