肺癌患者化疗期间的生活质量与情绪的关系

Quality of Life and Affect of Lung Cancer Patients Receiving Chemotherapy

目的:探讨肺癌患者在化疗期间的生活质量与述情障碍和负性情绪的关系。方法:采用中国癌症患者化学生物治疗生活质量问卷(QLQ-CCC),多伦多述情障碍量表(TAS-26)和症状自评量表(SCL-90)对51 名正在进行化学治疗的肺癌患者进行测评。结果:(1)疗后的QLQ 量表总分及躯体、心理、社会和总体感觉分量表得分比疗中有显著提高(总分提高11%,P<0.05)。(2)疗后述情障碍者QLQ 的总分及躯体、心理分量表得分比无述情障碍者显著较低(总分低8%,P<0.05),而疗中两组则无明显差异。(3)相关分析显示疗后QLQ 的躯体分与TAS-DIF 因子、肺癌临床分期、躯体化和抑郁显著相关(r=-0.37～0.61,P<0.05):QLQ 心理分与TAS-DDF 因子、肺癌临床分期、SCL-躯体化、SCL-抑郁和SCL-焦虑显著相关(r=-0.43～0.51,P<0.05)。(4)多元逐步回归分析显示TAS-DIF 因子、肺癌临床分期是疗后QLQ 躯体分的独立预测变量(t 分别为-3.13,-3.81,P<0.05):肺癌临床分期、SCL-抑郁是疗后QLQ 心理分的独立预测变量(t 分别为-2.42,-2.84 P<0.05)。结论:述情障碍和负性情绪对肺癌患者疗后的躯体和心理功能状态的恢复造成负面影响。其中,不会识别情感、不会区分情感与躯体感受会加重疗后躯体症状,而疗前抑郁则会增加疗后的心理困扰。

Objective:The aim of the present study was to examine the relationships between alexithymia, negative affect,and quality of life(QOL)of lung cancer patients receiving chemotherapy.Methods:51lung cancer patients receiving chemotherapy completed questionnaires of quality of life questionnaire for Chinese cancer patients receiving chemobiotherapy(QLQ-CCC),26-item Toronto alexithymia scale(TAS-26)and symptom checklist (SCL-90).Results:1)The patients had better score in QLQ(increased by 11%,P<0.05)and in each aspect of it after chemotherapy than during chemotherapy.2) Alexithymic patients had significantly poorer score in QLQ(was lower by 11%,P<0.05)and in physical and psychological aspect of it than non-alexithymic patients after chemotherapy. There was no difference between the two groups during chemotherapy.3) Pearson's correlation showed that physical aspect of QLQ was significantly correlated with TAS-DIF,phase of lung cancer,SCL-somatization and SCL-depression after chemotherapy(r=-0.37～0.61,P<0.05),and psychological aspect of QOL was significantly correlated with TAS-DDF,phase of lung cancer,SCL-somatization,SCL-depression and SCL-anxiety after chemotherapy(r=-0.43～0.51,P<0.05).4)Stepwise linear regression showed that TAS-DIF and phase of lung cancer were independent predictive variables of physical aspect of QLQ after chemotherapy (t=3.13 and-3.81,P<0.05), and phase of lung cancer and SCL-depression were independent predictive variables of psychological aspect of QLQ after chemotherapy(t=-2.42 and-2.84,P<0.05).Conclusion:These results suggest that alexithymia,combined with negative affect and other factors,may have a negative effect on the recovery of physical and psychological aspect of quality of life of lung cancer patients receiving chemotherapy.