肺癌和食管癌术后存活1年和5年者身心个性性格及其行为特征对比分析

Comparison of the characteristics of the physical and mental personality and the behaviors in the postoperative patients with lung cancer and esophageal cancer survived for 1 and 5 years

目的:了解肺和食管癌术后存活5年患者的精神状况、应对方式、个性特征,并与肺和食管癌术后存活1年患者进行比较。方法:①选择1995-05/2000-05在中国医科大学第四附属医院胸外科和解放军沈阳军区总医院胸外科住院经手术治疗的肺和食管癌患者36例,男25例,女11例;术后存活时间5～9年。选择2004-01/2005-01在本院做相同手术后仍存活的肺和食管癌患者(术后存活时间1年左右)为对照组,男26例,女15例;年龄45～69岁。均自愿接受各种个性和行为量表调查测试。②两组对象精神状况评估采用症状自评量表(由90个陈述句构成,根据自己最近1周的实际情况分4级回答,记14分,1为无,2为轻度,3为较重,4为严重。量表还包括9个因子:躯体化、强迫、人际关系、抑郁、焦虑、敌对、恐怖、偏执、精神病)。③两组对象应对方式评估采用医学应对方式问卷中文版犤共20条目,分为面对、回避和屈服3种应对方式,各条目4级记分,有不采用、偶尔采用、有时采用和经常采用4种选择(相应的评分为0,1,2,3)犦。④两组对象个性特征评估采用艾森克个性问卷犤由4个维度构成,即内外向性、神经质、精神病性、人格稳定性,相对于对照组得分越高分别表示精神病性、神经质、外向和情绪不稳定性越明显犦。⑤组间计量资料差异性测定采用t检验。结果:长期存活组患者36例,对照组41例均进入结果分析,并完成量表和问卷调查。①症状自评量表评分结果:长期存活组的躯体化、强迫、人际关系、抑郁、焦虑、恐怖、偏执和精神病性等症状因子评分和总分均明显低于对照组(t=2.058～3.152,P<0.05～0.01)。②医学应对方式问卷中文版评分结果:长期存活组中的面对应对方式得分明显低于对照组(t=2.299,P<0.05),而屈从应对方式和回避应对方式评分相近(P均>0.05)。③艾森克个性问卷评估结果:长期存活组的精神病性、神经质和人格稳定性得分明显低于对照组(t=2.190,2.241,2.136,P<0.05),而内外向性得分则显著高于对照组(t=2.178,P<0.05)。结论:肺癌和食管癌长期存活者均有较好的精神状况、对负性事件应对少,个性和行为都具有明显的非神经质倾向,多为外向性格,对外界刺激有较平和的情绪反应。

AIM： To investigate the mental status, coping style, personality characteristics of postoperative patients with lung cancer and esophageal cancer survived for 5 years, and compare with those survived for 1 year. METHODS： Thirty-six inpatients （25 males and 11 females） with lung cancer and esophageal cancer, who undergone surgical operation from May 1995 to May 2000 in the Fourth Affiliated Hospital of China Medical Uni- versity and Department of Chest Surgery, Chinese PLA General Hospital of Shenyang Military Area Command, were involved in the study, and they all survived for 5 to 9 years.Another 41 survived postoperative patients （26 males and 15 females） aged 45 to 69 years, who undergone the same operation in the same hospital （postoperative survived time was about 1 year） between January 2004 and January 2005, were taken as controls （control group）.All the subjects were tested with various personality and behavior scales voluntarily. ① Their mental status was assessed with symptom checklist-90 （consisted of 90 statements, answered according to the actual status in the latest 1 week by 4 grades and marked as 1 to 4 points： 1 as none, 2 as mild, 3 as a little severe, 4 as severe; the scale included 9 factors of somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism）. ② Their coping style was evaluated with the Chinese version of Medical Coping Modes Questionnaire （consisted of 20 items, including 3 coping styles of facing, avoidance and withdrawal, each item was scored by 4 grades, there were 4 choices for the item： not use, occasionally use, sometimes use and often use, the scores were 0, 1, 2 and 3 respectively）. ③ Their personality characteristics were evaluated with Eysenck personality questionnaire （consisted of 4 dimensions： introversion-extraversion, neuroticism, psychoticism, personality stability; The higher the score than the control group, the more obvious the psychoticism, neuroticism, extraversion and emotional instability）.④ The intragroup difference of measurement data was detected with the t test. RESULTS： All the 36 patients in the long survival group and 41 cases in the control group wre involved in the analysis of results, and they all finished the investigation of scale and questionnaire. ① Scores of symptom checklist-90： The scores of somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, phobic anxiety, paranoid ideation and psychoticism and the total score were all obviously lower in the long survival group than in the control group （t=2.058 to 3.152, P 〈 0.05 to 0.01）. ② Scores of the Chinese version of Medical Coping Modes Questionnaire： The score of the facing coping style was obviously lower in the long survival group than in the control group （t=2.299, P 〈 0.05）, but the scores of withdrawal and avoidance coping styles were close between the two groups （P 〉 0.05）. ③ The scores of Eysenck personality questionnaire： The scores of neuroticism, psychoticism and personality stability in the long survival group were obviously lower than those in the control group （t=2.190, 2.241, 2.136, P 〈 0.05）, but the score of introversion-extraversion was significantly higher than that in the control group （t=2.178, P 〈 0.05）. CONCLUSION： The postoperative patients with lung cancer and esophageal cancer, who have survived for a long time have better mental status, fewer negative events, and obvious non-neuroticism of both personality and behavior, most of them are extraversion, and they also have milder emotional reaction to outside stimulation.