乳腺癌患者围手术期的应对方式及其对生活质量的影响

Ways of coping and quality of life of breast cancer patients between perioperation

目的探讨乳腺癌患者围手术期应对方式对生活质量的影响。方法选取2013年3月至2014年9月间手术治疗的乳腺癌患者80例,应用医学应对问卷(MCMQ)及生活质量量表(FACT-B)对患者术前、术后进行调查,探讨手术前后患者应对方式对生活质量的影响。结果 (1)3种应对方式中,面对和回避维度从术前至出院前是递增的,与出院前差异有统计学意义(P<0.05);而屈服维度呈递减趋势,与出院前差异有统计学意义(P<0.05)。生活质量方面,患者术前生存质量明显低于出院前,差异有统计学意义(P<0.05),其中5个相关维度中,社会家庭状况术前明显低于出院前,差异有统计学意义(P<0.05),其他4个维度差异无统计学意义(P>0.05)。(2)总体生活质量与面对维度和回避维度呈正相关(P<0.05),与屈服维度呈负相关(P<0.05);面对维度与社会/家庭状况、功能状况均呈正相关(P<0.05);回避维度与社会/家庭状况,功能状况呈正相关(P<0.05)。屈服维度与生理状况、情感状况、功能状况、附加关注呈负相关(P<0.05)。结论乳腺癌患者围手术期应对方式与生活质量相关,患者在不同时期可能表现出不同的应对方式。

Objective To investigate the influence of Medical Coping Mode Questionnaire （ MC- MQ） on quality of ire for breast cancer patients between perioperation. Methods 80 breast cancer patients were chosen as a research object, and were tested before and after operation for using MCMQ and Measure- ment Scale of Quality of Life for Patients with Breast Cancer （ FACT-B）, in order to investigate the influ- ence of MCMQ on quality of ife for breast cancer patients. Results （ 1 ） Face and avoidance dimension were increasing fronl preoperative to before discharge and the difference was statistically significant compared with before leaving hospital （P 〈 0. 05 ）. Yield dimension showed a trend of decline and the difference was statistically significant compared with before leaving hospital （ P 〈 0. 05 ）. The preoperative quality of life was significantly lower than before discharge, and the difference was statistically significant （ P 〈 0. 05 ）. Social family situation before operation was lower significantly than before discharge, and the difference was statistically significant （ P 〈 0. 05）. （2） The overall quality of life positively correlated with face and avoid- ance dimension （ P 〈 0. 05 ）, while negatively correlated with yield dimension （ P 〈 0. 05 ） ; Face dimension positively correlated with social/famiy condition and functional status （ P 〈 0. 05 ） ; Avoidance dimension positively correlated with social/famiy condition and functional status （ P 〈 0. 05 ）. Yield dimension nega- tively correlated with physical activity, emotional state, functional status and additional attention （P 〈 0. 05）. Conclusion Coping style of breast cancer patients between perioperation is closely related to the quality of life. Patients may show different responses in different periods.