肺癌患者心理弹性及影响因素的研究

Psychological resilience and its influencing factors of patients with lung cancer

目的：探讨肺癌患者心理弹性水平及其影响因素。方法采用方便抽样法,应用一般资料问卷、Conner-Davidson心理弹性量表（ CD-RISC）、医学应对问卷（ MCMQ）和医院焦虑抑郁量表对182例肺癌患者进行问卷调查。结果182例肺癌患者心理弹性得分（65.2±15.0）分。82例术前组肺癌患者心理弹性评分为（68.9±15.4）分,术后组为（63.5±13.6）分,化疗组为（60.3±14.3）分,心理弹性水平呈下降趋势,差异有统计学意义（F=5.530,P〈0.05）。不同教育程度、婚姻状况、医保类型、治疗阶段、是否转移的肺癌患者心理弹性得分,差异有统计学意义（P〈0.05）。本组182例肺癌患者焦虑平均得分（5.72±4.52）分,抑郁平均得分（4.74±4.39）分。相关分析显示,肺癌患者心理弹性与焦虑、抑郁、屈服呈负相关,与面对呈正相关（P〈0.05）；与回避无相关性（P〉0.05）。多元线性回归分析显示,治疗阶段、应对方式、抑郁是肺癌患者的心理弹性重要的影响因素（P〈0.05）,共同解释总变异的45.8%。结论肺癌患者心理弹性水平较低,且受到多种因素的影响。护理工作者应关注患者心理变化,采取有效措施降低其心理压力,提高心理弹性水平,进而提高其生存质量。

Objective To investigate the psychological resilience status and its influencing factors of lung cancer patients. Methods A total of 182 patients with lung cancer were selected by convenient sampling method and were investigated the psychological resilience with Chinese Version Connor and Davidson′s resilience scale （ CD-RISC ） , the Chinese version of medical coping modes questionnaire （ MCMQ ） , and the hospital anxiety and depression Scale （ HAD） . Results The total score of resilience in 182 lung cancer patients acquired （65. 2 ± 15. 0）. The total score of resilience in 82 preoperative patients was （68. 9 ± 15. 4）, postoperative patients （63.5 ±13.6）, chemotherapy patients （60.3 ±14.3）; resilience status showed down trend （F=5.530,P〈0. 05）. Different educational background, marriage status, medical insurance type, treatment stage and cancer metastasis had difference of psychological resilience （P〈0. 05）. The average anxiety score of 182 cancer patients was （5. 72 ± 4. 52） and depression score obtained （4. 74 ± 4. 39）. The correlation analysis presented that lung cancer patients′psychological resilience had negative correlation with anxiety, depression and surrender while it had positive correlation with confrontation （P 〈0. 05）, but had no correlation with avoidance （P〉0.05）. Multiple regression analysis revealed treatment stages, copying strategies and depression were the main influencing factors which all explained 45. 8% of total variation. Conclusions Resilience of patients with lung cancer are at a lower level, which effected by many factors. Nursing staffs should pay attention to patients psychological status, take effective measures to help them to get higher level of psychological resilience, so as to improve quality of life.