妇科癌症患者心理健康和应对方式的相关研究

Correlation between mental health and coping style in gynecological cancer patients

目的调查妇科癌症患者创伤后应激障碍发生率、心理健康水平与心理弹性的关系。方法采用创伤后应激障碍症状清单-平民版(PTSD checklist-civilian version,PCL-C)、心理弹性量表(connor-davidson resilience scale,CD-RISC)、症状自评量表(symptom checklist 90,SCL-90)、艾森克人格问卷(Eysenck personality questionnaire,EPQ)、应对方式问卷对181例三甲医院的妇科癌症患者进行问卷调查。结果①妇科癌症患者的PTSD总分为(30.75±11.28)分,PTSD总分≥38分者41例(22.65%),总分≥45分者20例(11.05%),总分≥50分者11例(6.08%)。②PTSD阳性组在心理弹性的总分上显著低于PTSD阴性组(P<0.05)。③妇科癌症患者SCL-90阳性组在心理弹性总分上显著低于SCL-90阴性组(P<0.01)。在人格(EPQ)的神经质得分显著高于阴性组(P<0.01),在应对方式的自责、退避、合理化因子得分上显著高于阴性组(P<0.05)。④PTSD总分与SCL-90总分、自责、退避应对方式3个因素成正相关,与心理弹性(CD)总分、解决问题、求助、合理化应对方式4个因素成负相关。SCL-90总分与PTSD总分、自责、幻想、退避应对方式4个因素成正相关,与CD总分、外向性、合理化应对方式3个因素成负相关。结论妇科癌症患者创伤后应激障碍发生率较高,低心理弹性、低心理健康水平、消极的应对方式是创伤后应激障碍的重要预测因素。

Objective To investigate the correlation of post traumatic stress disorder（PTSD） with mental health and resilience in gynecological cancer patients.Methods PTSD,mental health and resilience in 181 gynecological cancer patients were investigated with PTSD checklist-civilian version（PCL-C）,Connor-Davidson resilience scale（CD-RISC）,self-report symptom checklist-90（SCL-90）,Eysenck personality questionnaire（EPQ） and coping style questionnaire（CSQ）.Results The total PTSD score was 30.75±11.28 for the 181 gynecological cancer patients.Of these patients,41（22.65%） had a total PTSD score ≥38,20（11.05%） had a total PTSD score ≥45,and 11（6.08%） had a total PTSD score ≥50.The total mental resilience score was significantly lower for the patients with positive PTSD and SCL-90 than for those with negative PTSD and SCL-90（P〈0.05）.The nervousness score was significantly lower while the self-blame,avoidance and rationalization scores were significantly higher for the patients with positive EPQ than those with negative EPQ（P〈0.05）.The total PTSD score was positively correlated with the total scores of SCL-90,self-blame and avoidance,and negatively correlated with the total scores of CD-RISC,problem solving,help seeking and rationalization.The total SCL-90 score was positively correlated with the total scores of PTSD,self-blame,delusion and avoidance,and negatively correlated with the total scores of CD-RISC,positive coping and rationalization.Conclusion The prevalence of PTSD is rather high in gynecological cancer patients.Low mental resilience and heath and passive coping style are the main predictors for PTSD.