癌症患者疾病感知的特点及其相关因素

Characteristics and related factors of illness perception in Chinese cancer patients

目的与糖尿病为代表的慢性疾病对比，了解癌症患者对疾病感知的认知特点，促进癌症患者的康复。方法使用中文修订版疾病感知问卷（CIPQ—R）对210例癌症患者与71例糖尿病患者进行问卷调查。结果癌症与糖尿病患者的疾病感知存在差异[Wilks’Lambda：0．69，F（8，268）=15．08，P〈0．001，η^2=0．31]，癌症患者的疾病后果与情绪表达因子得分显著高于糖尿病患者[疾病后果F（1，275）=23．32，P〈0．001，η^2=-0．08；情绪表达F（1，275）：25．95，P〈0．001，η^2=0．09]，而癌症患者各控制因子的得分均显著低于糖尿病患者[P〈0．001]。相关分析表明，癌症患者的个人控制和治疗控制因子与症状和情绪反应负相关，而与疾病的认识和理解正相关。性别是影响癌症患者的疾病感知重要因素，与糖尿病患者显著不同，男性癌症患者在疾病的一致性、时间持续性（周期性）、情绪表达3个因子得分高于女性[一致性F（1，275）=5．57，P〈0．05，η^2=0．02；时间持续性（周期性）F（1，275）=12．40，P〈0．01，η^2=0．04；情绪表达F（1，275）=13．06，P〈0．001，η^2=0．05]。结论提高对疾病认识和理解可促进癌症患者正性、更积极的生活态度改变。本研究为通过对慢性病患者疾病认知的调整，以促进他们更好地康复提供了依据。

Objective To investigate the illness perception of cancer patients as well as the difference of illness perception between cancer patients and diabetics so as to help them to derive meaning from illness experiences and facilitate posttraumatic growth. Methods A sample of 210 Chinese cancer patients and 71 diabetics was recruited from the same hospital and CIPQ-R completed. Results Cancer patients had higher consequences IF（1, 275） = 23.32, P 〈 0 .001, η^2 = 0.08 ] and emotional representation [ F（ 1, 275 ） = 25.95, P 〈 0. 001,η^2 = 0. 09 ] ; as well as less perceived controls over illness as compared with diabetics. Among the cancer patients, those with a better understanding about the meaning of illness tended to report more positive changes. Conclusion Illness perception is one of the important cognitive components affecting posttraumatic growth of cancer patients. Helping patients to derive meaning from their illness experiences facilitates the posttraumatic growth after cancer diagnosis.