乳腺癌治疗期患者自我表露现状与影响因素调查研究

Self-disclosure and its influencing factors in patients with breast cancer during treatment

目的了解乳腺癌治疗期患者自我表露现状,并探讨其影响因素,为医护人员有针对性地制定临床决策提供参考依据。方法研究者采用自制的乳腺癌治疗期患者一般资料调查问卷、中文版痛苦自我表露指数量表(distress disclosure Index,DDI)、应用夫妻支持应对量表(dyadic coping Inventory,DCI)与医院焦虑抑郁量表(hospital anxiety and depression scale,HADS),于2019年1~8月对衡阳市5所三级甲等医院乳腺外科193名乳腺癌治疗期患者进行调查。结果乳腺癌治疗期患者DDI量表得分为(38.83±5.15)分,DCI量表得分为(46.47±6.41)分,HADS中焦虑分量表得分为(8.43±3.60)分,抑郁分量表得分为(8.50±3.57)分。相关分析结果显示,乳腺癌治疗期患者消极夫妻支持应对、焦虑、抑郁与自我表露呈负相关(P<0.05),积极夫妻支持应对与自我表露呈正相关(P<0.05)。Logistic回归分析显示,患者手术方式、年龄、夫妻支持应对、焦虑及抑郁是影响乳腺癌治疗期患者自我表露水平的主要因素。结论乳腺癌治疗期患者自我表露水平偏低,医护人员应根据影响乳腺癌治疗期患者自我表露水平的因素制定有效的针对措施,加强与患者与配偶沟通,亲密夫妻关系,积极夫妻支持应对,为患者提供支持性的表露方式与环境,心理咨询师循循诱导缓解患者负性情绪,提高患者自我表露水平。

Objective To understand the status of self-disclosure of patients with breast cancer during treatment,and to discuss its influencing factors.Methods A survey was conducted among 193 patients with breast cancer during treatment in 5 Grade III level A hospitals in Hengyang between January and August 2019 using A self-designed questionnaire.Chinese version of distress disclosure index(DDI)scale,husband and wife support coping scale(Dyadic Coping Inventory,DCI)and hospital anxiety and depression scale(HADS)were used to assess the overall self-disclosure status.Results The scores of DDI,DCI,anxiety and depression in patients with breast cancer during treatment were 38.83±5.15,46.47±6.41,8.43±3.60 and 8.50±3.57,respectively.The correlation analysis showed that negative husband-wife support coping,anxiety,depression were negatively correlated with self-disclosure(P<0.05),while positive husband-wife support coping is positively correlated with self-disclosure(P<0.05).Logistic regression analysis showed that surgical method,age,husband-wife support coping,anxiety and depression were the major factors for self-disclosure of patients with breast cancer.Conclusions The level of self-disclosure of patients with breast cancer during treatment is low,therefore,health care workers should formulate effective measures based on the factors that affect the level of self-disclosure of patients with breast cancer,communicate more with patients and their spouses,intimate husband-wife relationship and support their relationship in order to provide patients with supportive disclosure style and environment.Psychological counselors should help patients to relieve negative emotions and improve the level of self-disclosure.