早期知情干预对Ⅲ期非小细胞肺癌患者抑郁的影响

Effect of informing the diagnosis on depressive state in patients with non-small cell lung cancer of stage Ⅲ

背景与目的作为一种不可治愈的恶性肿瘤,无法手术切除的肺癌常常给患者带来心理上的巨大摧残,由此将产生包括抑郁在内的一系列负性情绪,是否告知或者以何种方式告知患者病情一直是医疗界关注的话题之一。本研究旨在探讨早期知情干预对Ⅲ期非小细胞肺癌患者抑郁情绪的影响。方法以43例Ⅲ期非小细胞肺癌为观察对象;在明确诊断后的早期阶段,根据患者家属的要求并结合患者本人的具体情况分别给予完全隐瞒、部分知情和完全知情干预;以汉密尔顿抑郁量表为抑郁症状的评估工具,调查干预前后患者抑郁状况的变化。结果完全隐瞒组干预后疑病评分增加,完全知情组自杀、绝望等项目评分增加;部分知情组干预后在迟缓、认知障碍、绝望及总分方面均较干预前明显改善,完全知情组在知情干预后睡眠方面的评分较干预前明显变差。结论初诊的Ⅲ期非小细胞肺癌中抑郁情绪比较普遍;短期的完全隐瞒或完全知情干预无助于抑郁的缓解,适度知情干预有利于抑郁状态的改善。

Background and objective As other tumors,unresectabe lung cancer can cause many psychological problems to the patients,such as depression and anxiety.The present paper aims to evaluate the status of depression before and after knowing the state of illness in patients with non-small cell lung cancer of stage Ⅲ.Methods 43 cases of newly diagnosed non-small cell lung cancer(NSCLC) with stage Ⅲ were enrolled in the study.All the patients were distributed into three groups and given different intervention,that w...