癌症患者及家属癌症告知心理反应影响因素

Psychological reactions and its influencing factors of cancer patients and their families to informing of cancer diagnosis

目的了解癌症患者及家属获知癌症诊断后的心理反应及其影响因素,为科学干预提供理论依据。方法采用自行设计的调查表对302例癌症患者和305名癌症患者家属进行问卷调查。结果初获知癌症诊断时,63.3%的患者和82.0%的家属存在不良情绪,家属的不良情绪发生率高于患者本人[OR（95%CI）=3.922（2.717～5.382）,P＜0.00];经过一段时间的心理适应期,患者和家属更倾向于平静地接受患癌现实（P＜0.00）;Logistic回归分析显示,性别、家庭人均月收入和丧礼经历是患者告知时不良情绪的影响因素（P＜0.05）;年龄、性别和丧礼经历是家属告知时不良情绪的影响因素（P＜0.05或P＜0.01）。结论告知癌症真实病情是可行的;告知真实病情后,医护人员应该及时疏导患者的不良情绪,重视家属的人文关怀。

Objective To explore psychological reactions and its influencing factors in the patients with cancer and their family memhers to the disclosure of cancer for providing theoretical basis to scientific intervention. Methods Totally 302 patients with cancer and 305 family members were investigated with a self-designed questionnaire. Results After the disclosure of cancer diagnosis, 63.6% of patients and 82.0% of their families showed a negative sentiment, and the incidence of adverse mood of the families was higher than that of the patients themselves （ OR = 3. 922,95% C1 = 2.717 - 5. 682;P 〈0.00）. After a period of psychological adjustment,most patients and their families could calmly accept the reality of cancer diagnosis （ P 〈 0.00）. The results of logistic analysis suggested that the age, gender, funeral experiences were the influencing factors of the adverse mood （ P 〈 0.05 ）. Conclusion It is feasible to inform cancer diagnosis to patients and their family members. The medical staff should timely comfort the negative sentiment of the patient and family members and implement psychological intervention according to different people.