化疗对肺癌患者生活质量及焦虑情绪的影响及分析

Changes in Quality of Life and Anxiety of Lung Cancer Patients Underwent Chemotherapy

背景与目的通过观察肺癌患者化疗前后生活质量及焦虑情绪的改变,探讨化疗对肺癌患者生活质量及焦虑情绪的影响。方法随机抽取住院化疗的肺癌患者58例,分别于化疗前、化疗后2周期1星期内、化疗后4周期1星期内评估临床疗效,并进行肺癌患者生活质量量表(QLQ-C30)和ZUNG焦虑自评量表(SAS)评分。结果化疗前,生活质量功能领域、疲乏、呼吸困难条目得分较高,有焦虑情绪的占56%,SAS得分为49.54±5.64;焦虑症状与失眠轻度相关(P<0.05);化疗后2周期,呼吸困难得分下降,失眠、食欲丧失得分上升,较化疗前相比差异有统计学意义(P<0.05);有焦虑情绪的占80%,SAS得分为52.48±6.10,较化疗前相比差异有统计学意义(P<0.05);有基础病患者SAS得分高于无基础病患者,差异有统计学意义(P<0.05);焦虑症状与疲乏、呼吸困难轻度相关(P<0.05)。化疗后4周期,躯体、角色、情绪、社会功能得分下降明显,恶心呕心、食欲不振、便秘、经济困难条目得分上升,较化疗后2周期相比差异有统计学意义(P<0.05);有焦虑情绪的占72%,SAS得分为54.82±6.55,较化疗后2周期相比无统计学差异;SAS得分与KPS呈负相关(P<0.05);焦虑症状与疲乏、失眠相关(P<0.01),与便秘轻度相关(P<0.05)。结论化疗过程中,部分肺癌患者躯体症状得到缓解,焦虑情绪明显增加,生活质量有所下降,医务工作者应及时评价患者生活质量及情绪改变,提高患者生活质量,积极地对患者进行心理疏导治疗。

Background and objective This study aims to observe the changes in quality of life as well as the anxiety among lung cancer patients before and after chemotherapy. This work also aims to explore the effect of chemotherapy on quality of life and anxiety. Methods Fifty-eight lung cancer patients were evaluated based on clinical outcomes, EORTC QLQ-C30, and on SAS questionnaires before chemotherapy, one week after two courses of chemotherapy, and one week after four courses of chemotherapy. Results Before chemotherapy, functioning scale, fatigue, and dyspnoea scores were high, the rate of anxiety was 56% while the SAS score was 49.54±5.64. Anxiety was found to be positively correlated with insomnia （P〈0.05）. After two courses of chemotherapy, dyspnoea scores decreased, while insomnia and appetite loss scores increased. The difference was statistically significant （P〈0.05）. The rate of anxiety was 80% and the SAS score was 52.48±6.10. The difference was statistically significant compared with that before chemotherapy （P〈0.05）. The SAS scores of patients with disease history were higher than those of patients without disease history （P〈0.05）. SAS score was found to be positively correlated with fatigue and dyspnoea （P〈0.05）. After four courses of chemotherapy, the physical, role, emotional, and social function scores decreased, while the nausea and vomiting, appetite loss, constipation, and financial impact scores increased. The differ- ence was statistically significant （P〈0.05）. The anxiety rate was 72%, and the SAS score was 54.82±6.55. The difference was statistically significant （P〈0.05）. The SAS score was negatively correlated with KPS （P〈0.05）, significantly positively correlated with fatigue and insomnia （P〈0.01）, and positively correlated with constipation （P〈0.05）. Conclusion A number of patientshave experienced symptom relief, but during chemotherapy, the patients had significant anxiety. Thus, quality of life decreased. The quality of life and emotions of lung cancer patients should be evaluated, and positive psychological intervention should be given to improve quality of life.