中晚期癌症患者首次住院期间心理状况变化及影响因素研究

Investigation of the Change of Psychological Health Situation and Its Influence Factors on Patients with Middle-Advanced Cancer during First Hospitalization

目的:探讨中晚期癌症患者首次住院期间心理健康状况及其影响因素。方法:对120名中晚期首次住院进行放化疗的癌症患者,在治疗前、中、后三个时期采用SCL-90量表进行自评式心理健康状况调查研究。结果:SCL- 90量表调查显示中晚期癌症患者治疗前心理健康状况明显差于治疗后状况,与SCL-90常模比较表现为异常的心理状态。单因素方差分析得出血红蛋白水平、疼痛状况、家庭及社会支持、自我评价状况、营养状态、行为状态、年龄、医疗报销、性别及知情状况等十一个因素对患者心理健康影响较大,多元逐步回归分析提示在不同治疗时期影响心理健康状况的主要因素又不尽相同。结论:在癌症治疗过程中缺乏家庭及社会支持、疼痛、贫血、营养状态差及较差的经济状况等因素对中晚期癌症患者心理健康可造成较大的负面影响。

Objective： To investigate psychological health situation and its related influence factors on patients with middleadvanced cancer during their first hospitalization. Methods ： In the three periods of （ before, in the middle and after） treatment, using self-rating scale to investigate the mental status of 120 patients with middle-advanced cancer during their first radiotherapy and chemo- therapy in hospital. Results： In all 120 patients, the factor score of SCL-90 showed that the mental health status of these patients before treatment was significantly worse than the status after cure. Compared with SCL-90 norm, they were in abnormal psychological status during their first hospitalization. One-way ANOVA analysis concluded that there were eleven factors which had great influence upon the psychological health of these patients such as hemoglobin level, pain status, family and social supports, self-rate health status, nutrition status, KPS score, age, the ways of medical expenses, gender and informed status of cancer diagnosis. Multiple stepwise regression analysis indicated that the main factors which affected mental health situation were different at stages of treatment. Conclusion： Shortage of family and social supports, pain, anemia, poor nutrition status and poor economic conditions in the course of treatment can result in great negative influence upon mental health status of patients with middle-advanced cancer.