新疆维吾尔族农村妇女HPV初筛确诊为不同感染状态者生命质量及心理研究
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摘要
目的研究新疆维吾尔族农村妇女HPV初筛为高危、低危和阴性者的生命质量和心理状况,为改善其生命质量及心理提供指导。方法采用欧洲五维健康量表(EQ-5D)、焦虑自评量表(SAS)和抑郁自评量表(SDS)于2017年2月调查新疆宫颈癌筛查项目某试点县HPV初筛为高危、低危和阴性者356人。分析高危、低危和阴性者的EQ-5D效用值和VAS得分、EQ-5D五维度报告健康问题的比例及SAS、SDS报告焦虑和抑郁的比例。结果高危、低危和阴性者的EQ-5D效用值中位数均为0. 78; VAS得分中位数分别为70. 00,80. 00和75. 00; EQ-5D焦虑/抑郁维度报告有问题的比例分别为54. 80%、51. 00%和50. 20%; SAS报告焦虑的比例分别为53. 60%、55. 10%和48. 90%; SDS报告抑郁的比例分别为39. 30%、30. 60%和20. 60%,差异有统计学意义(χ2=11. 448,P=0. 003),与阴性者相比,高危者报告抑郁的比例较大(20. 60%vs.30. 60%)。结论普适性量表EQ-5D显示高危、低危和阴性者生命质量相似,均存在焦虑和抑郁。而特异性量表SDS显示抑郁的测量能更好的反映不同HPV感染状态者的心理状况,应重点关注高危者的心理,为其心理提供指导。
Objective To study quality of life and psychology of high-risk,low-risk and negative HPV in rural Uygur women from Xinjiang. In order to provide guidance for improving their quality of life and psychology. Methods This study selected a pilot county of Xinjiang Cervical Cancer HPV Screening Project as the investigation site. EQ-5 D,SAS and SDS questionnaires were used to investigate high-risk,low-risk and negative HPV women. The survey was conducted in February 2017,a total of 356 women were investigated. Analyzed EQ-5 D utility value and VAS score,the proportion reported health problems of EQ-5 D five-dimensional and the proportion reported anxiety and depression of SAS and SDS of high-risk,low-risk and negative HPV women. Results The median EQ-5 D utility values of high-risk,low-risk and negative HPV women was 0. 78 respectively; The median VAS scores was 70. 00,80. 00 and 75. 00,respectively; The proportion of health problem reported in the anxiety/depression dimension was 54. 80%,51. 00% and 50. 20%,respectively; The proportion of SAS reported anxiety was 53. 60%,55. 10% and 48. 90%,respectively; The proportion of SDS reported depression was 39. 30%,30. 60% and 20. 60%,respectively,there was statistically significant difference( χ~2= 11. 448,P = 0. 003).Compared with the negative HPV women,the high-risk HPV women reported greater proportion of depression( 20. 60% vs.30. 60%).Conclusions EQ-5 D questionnaire showed the quality of life was similar to women with high-risk,low-risk and negative HPV. They all had anxiety and depression. SDS questionnaire showed the measurement of depression could better reflect the psychology of women with different HPV infection status. We supported to focus the psychology of high-risk women and to provide guidance for their psychology.
Objective To study quality of life and psychology of high-risk,low-risk and negative HPV in rural Uygur women from Xinjiang. In order to provide guidance for improving their quality of life and psychology. Methods This study selected a pilot county of Xinjiang Cervical Cancer HPV Screening Project as the investigation site. EQ-5 D,SAS and SDS questionnaires were used to investigate high-risk,low-risk and negative HPV women. The survey was conducted in February 2017,a total of 356 women were investigated. Analyzed EQ-5 D utility value and VAS score,the proportion reported health problems of EQ-5 D five-dimensional and the proportion reported anxiety and depression of SAS and SDS of high-risk,low-risk and negative HPV women. Results The median EQ-5 D utility values of high-risk,low-risk and negative HPV women was 0. 78 respectively; The median VAS scores was 70. 00,80. 00 and 75. 00,respectively; The proportion of health problem reported in the anxiety/depression dimension was 54. 80%,51. 00% and 50. 20%,respectively; The proportion of SAS reported anxiety was 53. 60%,55. 10% and 48. 90%,respectively; The proportion of SDS reported depression was 39. 30%,30. 60% and 20. 60%,respectively,there was statistically significant difference( χ~2= 11. 448,P = 0. 003).Compared with the negative HPV women,the high-risk HPV women reported greater proportion of depression( 20. 60% vs.30. 60%).Conclusions EQ-5 D questionnaire showed the quality of life was similar to women with high-risk,low-risk and negative HPV. They all had anxiety and depression. SDS questionnaire showed the measurement of depression could better reflect the psychology of women with different HPV infection status. We supported to focus the psychology of high-risk women and to provide guidance for their psychology.
引文
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[13]梁凌云,杜辉,Belinson Jerome L,等.基于人群的宫颈癌及癌前病变危险因素调查[J].中国妇产科临床杂志,2012,13(5):327-330.Liang L Y,Du H,Belinson J L,et al.A survey of relevant factors for cervical cancer and high grade cervical lesion based on population[J].Chinese Journal of Obstetrics and Gynecology,2012,13(5):327-330.
[14]郑杰,李小菊,张眉,等.新疆维吾尔族妇女宫颈癌筛查HPV感染确诊后不同时间生命质量研究[J].石河子大学学报(自然科学版),2016,34(5):589-593.Zheng J,Li X J,Zhang M,et al.The quality of life research on cervical cancer screening HPV infection of Uyghur women over the diagnosis time based on southern Xinjiang[J].Journal of Shihezi University(Natural Science),2016,34(5):589-593.
[15]Esther M,Marteau T M,Matthew H,et al.Psychological impact of human papillomavirus testing in women with borderline or mildly dyskaryotic cervical smear test results:cross sectional questionnaire study[J].Bmj,2004,328(7451):1293-1296.
[16]Rask M,Swahnberg K,Oscarsson M.Swedish women's awareness of human papillomavirus,and health-related quality of life,anxiety,and depression after a notification of an abnormal Pap smear result:a cross-sectional study[J].European Journal of Cancer Prevention the Official Journal of the European Cancer Prevention Organisation,2019,28:96-101.
[17]Rajmil L.Health measurement scales,a practical guide to their development and use,3rd[J].Journal of Epidemiology&Community Health,2015,47(5):481-484.
[2]Hsu Y Y,Wang W M,Fetzer S J,et al.Longitudinal psychosocial adjustment of women to human papillomavirus infection[J].Journal of Advanced Nursing,2018,74:2523-2532.
[3]O'Connor M,Costello L,Murphy J,et al.‘I don't care whether it’s HPV or ABC,I just want to know if I have cancer.‘Factors influencing women’s emotional responses to undergoing human papillomavirus testing in routine management in cervical screening:a qualitative study[J].Bjog,2015,121(11):1421-1430.
[4]冀淑英.妇科门诊人乳头瘤病毒阳性患者的心理健康状况调查分析[J].河南医学研究,2016,25(6):1129-1130.Ji S Y.Investigation and analysis of mental health status of human papillomavirus positive patients in gynecological clinic[J].Henan Medical Research,2016,25(6):1129-1130.
[5]Sun S,Chen J,Johannesson M,et al.Population health status in China:EQ-5D results,by age,sex and socio-economic status,from the national health services survey2008[J].Quality of Life Research,2011,20(3):309-320.
[6]Zung W W K.A Rating Instrument For Anxiety Disorders[J].Psychosom,1971,12(6):371-379.
[7]Zang W K.A self-rating depression scale[J].Arch Gen Psychiatry,1965,12(6):63-70.
[8]Guglielmo R,Joakim D,Kmiriam E M,et al.Efficacy of HPV-based screening for prevention of invasive cervical cancer:follow-up of four European randomised controlled trials[J].Lancet,2014,383(9916):524-532.
[9]EQC G.Euro qola new facility for the measurement of health-related quality of life[J].Health Policy,1990,16(3):199-208.
[10]周忠良,周志英,厉旦,等.陕西省城乡居民健康相关生命质量研究:基于EQ-5D量表效用值的测算[J].中国卫生经济,2015,34(2):13-16.Zhou Z L,Zhou Z Y,Li D,et al.Analyzing the healthrelated quality of life of urban and rural residents in Shanxi:estimation based on the EQ-5D value sets[J].Chinese Health Economics,2015,34(2):13-16.
[11]Liu R,Tang A,Wang X,et al.Assessment of quality of life in chinese patients with inflammatory bowel disease and their caregivers[J].Inflammatory Bowel Diseases,2018,24(9):2039-2047.
[12]张晓玲,黄欧平,朱清仙.心理干预对宫颈人乳头瘤病毒感染患者治疗后生活质量的影响[J].中国妇幼保健,2010,25(22):3091-3092.Zhang X L,Huang O P,Zhu Q X.Effect of psychological intervention on the life quality of patients with cervical human papillomavirus infection after treatment[J].Chinese Journal of Maternal and Child Health,2010,25(22):3091-3092.
[13]梁凌云,杜辉,Belinson Jerome L,等.基于人群的宫颈癌及癌前病变危险因素调查[J].中国妇产科临床杂志,2012,13(5):327-330.Liang L Y,Du H,Belinson J L,et al.A survey of relevant factors for cervical cancer and high grade cervical lesion based on population[J].Chinese Journal of Obstetrics and Gynecology,2012,13(5):327-330.
[14]郑杰,李小菊,张眉,等.新疆维吾尔族妇女宫颈癌筛查HPV感染确诊后不同时间生命质量研究[J].石河子大学学报(自然科学版),2016,34(5):589-593.Zheng J,Li X J,Zhang M,et al.The quality of life research on cervical cancer screening HPV infection of Uyghur women over the diagnosis time based on southern Xinjiang[J].Journal of Shihezi University(Natural Science),2016,34(5):589-593.
[15]Esther M,Marteau T M,Matthew H,et al.Psychological impact of human papillomavirus testing in women with borderline or mildly dyskaryotic cervical smear test results:cross sectional questionnaire study[J].Bmj,2004,328(7451):1293-1296.
[16]Rask M,Swahnberg K,Oscarsson M.Swedish women's awareness of human papillomavirus,and health-related quality of life,anxiety,and depression after a notification of an abnormal Pap smear result:a cross-sectional study[J].European Journal of Cancer Prevention the Official Journal of the European Cancer Prevention Organisation,2019,28:96-101.
[17]Rajmil L.Health measurement scales,a practical guide to their development and use,3rd[J].Journal of Epidemiology&Community Health,2015,47(5):481-484.