围手术期和化疗期乳腺癌患者情绪和应对方式的调查

The Investigation of Emotion and Coping Styles of Patients with Breast Cancer during the Period of Operation and Chemotherapy

目的调查乳腺癌患者围手术期和化疗期的情绪、应对方式的特点及二者之间的关系。方法采用汉密尔顿焦虑量表、汉密尔顿抑郁量表和医学应对问卷对98例乳腺癌患者进行问卷调查。结果术前患者焦虑水平最高,术后抑郁水平最高;面对均数从术前到化疗末期逐渐增加,回避均数术前到化疗中期减小,化疗末期增加,屈服均数在化疗初期最高,随后又减小;乳腺癌患者术前焦虑与面对负相关(r=-0.209,P<0.05),与回避正相关(r=0.278,P<0.01);术前抑郁与面对负相关(r=-0.313,P<0.01),与回避正相关(r=0.398,P<0.001),与屈服正相关(r=0.304,P<0.01);术后抑郁与回避正相关(r=0.212,P<0.05)。结论乳腺癌患者围手术期的焦虑、抑郁水平高于化疗期;乳腺癌患者术前的医学应对方式以回避为主,化疗期以面对为主;面对是一种积极的应对方式,可以改善乳腺癌患者的情绪,回避应对较高的患者,潜在较高的负性情绪。

Objective To investigate the characteristics and correlation of emotion and coping styles of patients with breast cancer during the period of operation and chemotherapy. Methodss 98 patients with breast cancer were investigated with HAMA, HAMD and MCMQ. Results The preoperative anxiety level of patients was the highest and the postoperative depression level was the highest. The mean of facing coping style increased gradually. The mean of avoidance coping style decreased gradually and increased at the end stage of chemotherapy. The mean of obedience coping style increased gradually and then decreased in the intermediate stage of chemotherapy. There was a negative correlation between preoperative facing coping and anxiety（r =-0.209,P = 0.032）and depression（r =-0.313,P = 0.001 ）. There was a positive correlation between preoperative avoidance coping and depression（r =0.398, P 〈 0.001 ） and anxiety（ r =0.278, P = 0.004 ）. There was a positive correlation between preoperative depression and obedience coping（r =0.304, P 〈 0.01 ）, and a positive correlation between postopera- tive depression and avoidance coping（r =0.212, P 〈 0.05 ）. Conclusion Patients have higher anxiety and depression level during the period of operation. The preoperative medical coping style is avoidance coping, and facing coping style is the main coping style during the period of chemotherapy. Facing coping style is a positive coping style that can improve patients＇ emotion. The patients using higher avoidance coping style may have higher negative emotion.