豫北地区食管癌患者及其配偶的心理健康状况调查及干预

Investigation and intervention of psychological health status of patients with esophageal cancer and their spouses in Northern Henan

目的了解豫北地区食管癌患者及其配偶的心理健康状况及影响因素，并探讨临床心理干预对其心理健康水平的影响效果，为提高食管癌特殊群体的生活质量提供指导。方法采用症状自评量表（SCL-90）及社会人口学资料调查表，调查120例食管癌患者及配偶的心理健康状况，并分析其影响因素。将研究对象随机分为干预组与对照组各60例，对照组给予常规治疗，干预组在常规治疗的基础上接受心理干预，4周后，比较2组干预效果。结果豫北地区食管癌患者及其配偶的SCL-90评分均高于常模，其中食管癌患者的总分（154．97±22．53）、躯体化（1．89±0．32）、焦虑（1．85±0．37）、抑郁（1．75±0．44）等多个因子得分及其配偶的总分（149．16±20．25）、焦虑（1．96±0．46）、抑郁（1．89±0．43）因子得分显著增高（P〈0．01）。心理健康水平在不同社会人151学特征上有显著差异，男性、50～59岁、文化程度低、经济状况差的患者及女性、文化程度低的配偶的心理健康水平显著低于其他亚群（P〈0．01）；心理干预后，干预组患者及其配偶的心理健康水平较对照组显著改善（P〈0．05）。结论豫北地区食管癌患者及其配偶的心理健康状况较差，心理健康水平与多种因素相关，心理干预有利于改善患者及其配偶的心理健康状况。

Objective To explore the psychological health status and its influential factors of patients with esophageal cancer and their spouses in northern Henan and investigate the clinical efficacy of psychological intervention. Methods A to- tal of 120 patients with esophageal cancer couples were randomly divided into intervention group （n = 60 ）and control group （n = 60） ,their mental health status were investigated by symptom checklist -90 （SCL-90） and the influential factors of psycho- logical health were studied with socio-demographic questionnaire. The control group were given routine treatment and the inter- vention group were given psychological intervention based on routine treatment. Four weeks later, the mental health standard of the two groups were revaluated and compared. Results Both patients and their spouses reported significantly higher scores on SCI-90 subscales, in which patients＇ total score （ 154.97 ± 22.53 ）, somatization （ 1.89± 0.32 ）, depression （ 1.75 ± 0.44 ）, anxiety （ 1.85 ± 0.37 ） , and the spouses＇ total score （ 149.16±20.25 ）, depression （ 1.89 ± 0.43 ） and anxiety （ 1. 96 ± 0.46 ） were all higher significantly than those of normal model（ P 〈 0.01 ）. The psychological health level of patients and their spouses were significantly variance on different sociodemographic features. Patients who were male, 50 - 59 years old, lower degree of education, poor incomes and spouses who were female, lower degree of education were worse significantly in psychological health level than other subgroup （ P 〈 0.01 ）. After psychological intervention, the psychological health level of intervention group was improved significantly compared with control group （ P 〈 0.05 ）. Conclusion The psychological health status of pa- tients with esophageal cancer and their spouses in Northern Henan was far worse, which is caused by various factors. Psycholog- ical intervention is beneficial to improve their mental health status.