恶性肿瘤病人与亲属心理健康和生存质量调查及心理干预对病人的影响

Investigation on psychological health and quality of life of malignant tumor patients and their relatives and the influence of psychological intervention on patients

[目的]调查恶性肿瘤病人和亲属心理健康和生存质量水平,探讨心理干预的临床效果。[方法]将119例恶性肿瘤病人随机分为对照组(40例)、单纯干预组(40例)、共同干预组(39例),入院1周内3组病人和共同干预组亲属均填写症状自评量表(SCL-90)及简明健康状况调查表(SF-36),分别测评其心理健康和生存质量水平;对照组给予常规治疗,单纯干预组在常规治疗的基础上配合心理干预治疗,共同干预组在常规治疗的基础上配合针对病人和亲属的心理干预治疗。治疗6周后,对3组病人心理健康及生存质量水平进行再次评价,了解心理干预对病人心理健康及生存质量的影响。[结果]①心理干预治疗前,3组病人SCL-90总分、阳性项目数、躯体化、强迫症状、人际关系敏感、抑郁、焦虑及恐怖方面因子分高于常模,亲属在总分、阳性项目数、抑郁、焦虑及恐怖方面因子分高于常模(P<0.01或P<0.05);②心理干预治疗前,3组病人SF-36生存质量各维度得分均低于常模,亲属在生理职能、总体健康、活力、情感职能、精神健康维度得分低于常模(P<0.01或P<0.05);③心理干预治疗后,单纯干预组、共同干预组SCL-90因子分降低,SF-36相关维度得分升高,均优于对照组,而共同干预组效果优于单纯干预组(P<0.01或P<0.05)。[结论]恶性肿瘤病人和亲属均存在不同程度的心理健康及生存质量水平下降;针对恶性肿瘤病人和亲属共同心理干预治疗,有利于改善恶性肿瘤病人的心理健康水平,提高其生存质量。

Objective：To investigate the level of psychological health and quality of life of malignant tumor patients and their relatives,and to probe into the clinical effects of psychological intervention on patients.Methods：A total of 119 malignant tumor patients were randomly divided into control group（n=40）,simple intervention group（n=40） and combined intervention group（n=39）.Then levels of mental health and quality of life of all patients and their relatives were evaluated by filling out SCL-90 and SF-36.Patients in control group were given conventional treatment.Patients in simple intervention group were given psychological intervention treatment based on the conventional treatment.Patients in combined intervention group were given psychological intervention treatment to aim directly at patients and their relatives besides the conventional treatment.Then mental health and quality of life of all three groups patients were reevaluated after 6 weeks of treatment so as to know about the influence of psychological intervention on patients＇ mental health and quality of life.Results：①Before psychological intervention treatment,the total score,the number of positive items,scores of somatization,coercion,interpersonal relations,depression,anxiety and terror of SCL-90 of 3 group patients were higher than that of the norms.The total score,the number of positive items,and scores of depression,anxiety and terror of relatives of patients were higher than that of the norms（P0.01 or P0.05）.②Before psychological intervention treatment,scores of each dimension of quality of life in SF-36 of all 3 group patients were lower than that of the norms.Scores of physiological function,general health,vitality,emotional functioning and mental health dimensions of their relatives were lower than that of the norms（P0.01 or P0.05）.③After psychological intervention treatment,scores of SCL-90 related factors in simple intervention group and combined intervention group patients were lower,and scores of SF-36 related dimensions of the two groups cases were higher than that of control group cases.However,the effect of combined intervention group patients was superior to that of simple intervention group cases（P0.01 or P0.05）.Conclusion：Psychological health and quality of life of malignant tumor patients and their relatives declined at different levels and in different dimensions.Psychological intervention to aim directly at malignant tumor patients and their relatives can help to improve patients＇ psychological health level and to enhance their quality of life.