辅助化疗期乳腺癌患者生命质量现状及影响因素分析

Study of quality of life and its influence factors among post-surgery breast cancer patients undergoing chemotherapy

目的了解辅助化疗期乳腺癌患者的生命质量状况,分析焦虑、抑郁、疲乏、自我形象等对生命质量的影响,探究生命质量的影响因素。方法采用自行编制的一般资料调查表、焦虑自评量表、抑郁自评量表、癌症疲乏量表、乳腺癌自我形象量表、乳腺癌患者生命质量量表对乳腺癌术后化疗患者进行问卷调查,统计分析采用描述性统计、方差分析、相关及回归分析等。结果162例乳腺癌患者辅助化疗期间生命质量总分(91.99±19.90)分,功能状况维度得分最低;自我形象总分(129.49±21.71)分,疲乏总分(24.42±9.91)分,12.34%(20/162)存在不同程度焦虑,36.42%(59/162)存在不同程度抑郁。辅助化疗期乳腺癌患者生命质量(FACT-B)得分在宗教信仰、未成年子女、家庭人均月收入及医疗付费方式等方面差异有统计学意义(t=4.882、6.660,F=3.796、4.771,P<0.05),生命质量水平与焦虑、抑郁、疲乏、自我形象均呈负相关(r=-0.648^-0.179,P<0.05);逐步回归分析结果显示,有无未成年子女、抑郁、疲乏、自我形象对生命质量具有显著影响(F=35.641,P<0.01,R=0.786,决定系数R^2=0.618,调整R2=0.601)。结论有无未成年子女,以及抑郁、疲乏和自我形象是生命质量的影响因素,应综合考虑以上因素,为辅助化疗期乳腺癌患者提供针对性护理,缓解症状困扰,关注其心理状态,可通过健康教育、形象指导、支持性心理疗法、正念减压、运动指导等综合心理社会支持方法,帮助患者减轻焦虑、抑郁,改善疲乏,提升自我形象,提高患者整体生命质量。

Objective To investigate the status of anxiety,depression,fatigue,Body Image and quality of life among post-surgery breast cancer patients undergoing chemotherapy,and explore the relationship between these variables and quality of life.Methods Participants meeting the inclusion and exclusion criteria were investigated by the self-designed general information questionnaire,Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),Cancer Fatigue Scale(CFS),Body Image After Breast Cancer Questionnaire (BIBCQ),Functional Assessment of Cancer Therapy-Breast(FACT-B). Statistical analysis included descriptive analysis,variance analysis,correlation and regression analysis.Results Totally 162 participants were investigated. Total score of FACT-B was (91.99±19.90) points,function dimension scored lowest;total score of BIBCQ was (129.49±21.71) points;total score of CFS was (24.42±9.91) points;the percent of anxiety was 12.34% (20/162);the percent of depression was 36.42% (59/162). Score of FACT-B showed differences on religious belief,whether have minor children,family per capita monthly income,ways of medical payment (t=4.882,6.660,F=3.796,4.771,P<0.05);anxiety,depression,fatigue and body image were all negatively correlated (r=-0.648- -0.179,P<0.05);Stepwise regression analysis showed that the effect of whether have minor children,depression,fatigue and body image on sexual function were significant (F=35.641,P<0.01,adjusted R^2=0.601).Conclusions All variables significant should be taken into consideration while caring for post-surgery breast cancer patients undergoing chemotherapy,by providing targeted care to relieve symptom burden,paying attention to psychological health. Nursing interventions including health education,image guidance,supportive psychotherapy,mindfulness reduction,exercise guidance and so on could be concerned,to help patients relieve anxiety and depression,improve fatigue,and self image,and improve their overall quality of life.