原发性肺癌患者知晓病情前后的精神心理表现

Psychological representation before and after knowing the state of illness in patients with primary lung cancer

目的:评估原发性肺癌患者知晓病情前后的精神心理表现,寻找其规律性性,探讨进行康复干预的可能性。方法:2001-05/2003-10在解放军沈阳军区总医院门诊就诊和住院治疗的原发性肺癌患者163例。符合纳入标准的原发性肺癌患者89例,按随机数字法将其分为知情组(n=45)和对照组(n=44,暂不告之病情)。知情组在告之病情前、告之病情后1周内及告之病情15d后时接受症状自评量表调查,并于对照组比较。结果:两组症状自评量表评分比较中,知情组的躯体化(1.65±0.43)强迫(2.01±0.43)、人际关系(1.97±0.60)、抑郁(2.19±0.55)、焦虑(2.06±0.51)、敌对(1.70±0.42)、恐怖(1.87±0.43)和精神病性(1.63±0.43)等症状因子评分明显高于对照组(t=2.192～3.149,<0.05～0.01)。45例肺癌患者知情后7d内的强迫、人际关系、抑郁焦虑、敌对、恐怖和精神病性等症状因子评分明显高于知情前的测评结果(t=2.271～3.208,P<0.05～0.01),同时肺癌患者知情15d后的强迫、人际关系、抑郁、焦虑、敌对、恐怖和精神病性等症状因子评分明显低于知情后7d内的评估结果(t=2.082～3.136,P<0.05～0.01)。结论:肺癌患者知晓病情后经常出现各类精神心理问题。

AIM: To evaluate the mental and psychological representations of patients with primary lung cancer before and after they know the state of illness, so as to seek its regularity, and investigate the possibility of rehabilitative intervention.METHODS: Totally 167 patients with primary lung cancer treated or hospitalized in the Chinese PLA General Hospital of Shenyang Military Area Command between May 2001 and October 2003 were selected, and 89 of them, who were in accordance with the inclusion criteria, were divided into study group (n=45), who knew the state of illness, and control group (n=44), who did not know the state of illness. Patients in the study group were investigated with the clinical mental health symptom checklist 90 (SCL 90) before and 1 week and 15 days after they knew the status of illness, and the results were compared with those in the control group.RESULTS: In comparison of the SCL 90 scores, the scores of somatization (1.65±0.43), compulsion obsession(2.01±0.43), interpersonal sensitivity (1.97±0.60), depression(2.19±0.55), anxiety (2.06±0.51), hostility (1.70±0.42), phobic anxiety(1.87±0.43), and psychoticism (1.63±0.43) in the study group were obviously higher than those in the control group (t=2.192 to 3.149, P< 0.05 to 0.01).Within 7 days after the 45 cases in the study group knew their state of illness,the scores of compulsion obsession, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety and psychoticism were all markedly higher than those before they knew their state of illness (t=2.271 to 3.208, P< 0.05 to 0.01), while the above scores 15 days after they knew the state of illness were remarkably lower than those within 7 days (t=2.082 to 3.136, P< 0.05 to 0.01). CONCLUSION:Patients with lung cancer frequently encounter various mental and psychological problems after they know the state of illness.