心理痛苦温度计在消化道肿瘤及功能性胃肠病患者中的应用

Application of distress thermometer in patients with gastrointestinal cancer and functional gastrointestinal disorders

目的评估心理痛苦温度计在消化道肿瘤及功能性胃肠病患者中的应用,了解中国消化道肿瘤及功能性胃肠病患者心理痛苦现状及影响因素。方法选取消化道肿瘤患者157例和功能性胃肠病患者238例作为研究对象,使用心理痛苦温度计及其相关问题列表进行问卷筛查,通过统计学描述分析显著心理痛苦的检出率,卡方检验及Logistic回归分析探讨显著心理痛苦的影响因素,Pearson相关分析探讨心理痛苦与相关问题的相关性。结果消化道肿瘤患者的心理痛苦评分为4.84±2.77,以中度痛苦为主,占到43.9%,有显著心理痛苦(即得分≥4分)的占68.5%。功能性胃肠病患者的心理痛苦评分为3.60±2.72,以轻度痛苦为主,占到47.9%,有显著心理痛苦的占43.7%。不同性别、年龄、文化程度及收入情况影响消化道肿瘤患者的心理痛苦评分(P<0.05)。而功能性胃肠病患者仅在年龄及文化程度上差异有显著性(P<0.05)。消化道肿瘤及功能性胃肠病患者心理痛苦相关问题得分最高的两项为身体问题及情绪问题。消化道肿瘤及功能性胃肠病患者心理痛苦得分与相关问题总分及其身体问题、情绪问题、实际问题及交往问题呈正相关。结论心理痛苦温度计不仅可反映肿瘤患者的心理痛苦,同样适用于功能性胃肠病患者,能及时发现患者心理痛苦的程度及原因,可为临床医护人员进行个体化的心理干预提供理论依据。

Objective To investigate the application of distress thermometer （ DT） on psychological pain in Chinese patients with gastrointestinal cancer and functional gastrointestinal of disorders （ FGID ）;and to better understand the present status and related factors of psychological pain in these patients .Methods Questionnaire survey of DT and related problem lists were carried out in 157 patients with cancer and 238 patients with FGID .The statistical description was used to analyze positive psychological pain .Square test and Logistic regression were used to analyze influence factors of significant psychological distress .Pearson correlation analysis was used to assess the correlation between psychological distress and related problems .Results Psychological pain score of cancer patients and FGID patients were 4.84 ±2.77 and 3.60 ±2.72 ,respectively .Moderate to severe degree of pain accounted for 68.5% in cancer patients, compared to 43.7% in FGID patients.In cancer patients, sex, age, educational backgrounds and income were associated with the pain score , whereas in FGID patients , only age and educational background showed significant association .Physical and emotional problems were the top two items having the highest score.Psychological distress score was positively correlated with physical problems , emotional problems , practical problems and communication problems in both cancer and FGID patients .Conclusion The Distress Thermometer can be used to assess the severity and explore the causes of psychological distress in Chinese gastrointestinal cancer patients and FGID patients .Our study provides evidence for the possibility of future personalized intervention to treat medical mental problems .