老年癌症患者手术应激后发生压疮与心理表现及应对方式的相关性

Relativity of psychological status and coping style with the occurrence of pressure sore in senile cancer patients after surgical stress

目的:研究老年癌症患者手术应激后压疮发生与心理表现、应对方式的相关性,寻求进行干预的可能方法。方法:1999-02/2004-02在肇庆市第一人民医院住院治疗的老年癌症患者 359例。277例经临床、影像学和病理确诊的老年癌症患者(≥60岁),术后半个月内体表出现压疮者 83例 (压疮组),患病率 29.9%,半个月内未出现压疮者 194例 无压疮组)。两组对象均接受临床精神卫 (生症状自评量表 (sym ptom checklist-90,SCL-90)和 Feifel编制的医学应对方式问卷中文版(M CM Q 问卷调查。 )结果:两组的 SCL-90评分比较中,压疮组的躯体化(1.64±0.51)、强迫(1.95±0.48)、人际关系 (1.89±0.53)、抑郁 (2.18±0.53)、焦虑(1.94±0.52)、恐怖 (1.86±0.49)、偏执 (1.93±0.55)和精神病性(1.79±0.54) 等症状因子评分明显高于无压疮患者(t=2.231～2.837,P 均 <0.01或 0.05)。两组的 M CM Q 评分比较中,压疮组中的屈从应对方式和回避应对方式得分明显高于无压疮组(P 均 <0.05)。按压疮面积分组比较中,大面积 ≥3.39cm 压疮组的强迫、抑郁、焦 ( 2 )虑、恐怖、偏执等症状因子评分明显高于小面积 <3.

AIM:To study the relativity of psychological status and coping style with the occurrence of pressure sore in senile cancer patients after surgical stress,and probe into the possible methods for psychological intervention. METHODS:Totally 359 senile cancer patients were hospitalized in The First People's Hospital of Zhaoqing City during February 1999 and February 2002.Of these senile patients,277(≥60 years old) were finally diagnosed with cancer after clinical,imaging and pathological examinations.Among the 277 senile cancer patients,pressure sore was in 83 cases(29.9%,pressure sore group) within half a month,and non-pressure sore in 194 cases(70.1%,control group).All patients received questionnaire survey by using symptom checklist-90(SCL-90) and medical coping modes questionnaire(MCMQ) edited by Feifel. RESULTS:In the comparison of SCL-90 scores,the scores of somatization(1.64±0.51),compulsion(1.95±0.48),interpersonal relation(1.89 ±0.53),depression(2.18±0.53),anxiety(1.94±0.52),phobic anxiety(1.86±0.49),paranoea(1.93±0.55) and psychosis(1.79±0.54) were significantly higher in the pressure sore group than in the control group(t =2.231-2.837,all P< 0.01 or 0.05).In the comparison of MCMQ scores,the scores of resignation and avoidance coping style in the pressure sore group were higher than those in the control group(all P< 0.05).The scores of compulsion,depression,anxiety,phobic anxiety and paranoea were significantly higher in the larger area pressure sore group(≥3.39 cm2) than in the small area pressure sore group(< 3.39 cm2)(t=2.257-2.328,all P< 0.05).The scores of avoidance coping style were significantly higher in the larger area pressure sore group than in the small area group(t=2.196,P< 0.05). CONCLUSION:The occurrence of pressure sore after operation in senile cancer patients is closely related to psychological factor and coping style,and the proper intervention may be effective to prevent the occurrence of pressure sore.