乳腺癌辅助化疗患者400例心理痛苦评估研究

Evaluation of psychological distress in 400 cases of breast cancer after receiving adjuvant chemotherapy

目的采用心理痛苦温度计量表评估乳腺癌辅助化疗患者心理痛苦发生情况,并分析心理痛苦的相关影响因素。方法收集2013年12月至2015年11月期间在西安交通大学第一附属医院乳腺肿瘤外科术后接受辅助化疗的女性乳腺癌患者作为研究对象。采用心理痛苦温度计量表,对440名乳腺癌辅助化疗患者进行心理痛苦筛查,并分析心理痛苦的影响因素。结果在调查对象中:1心理痛苦得分平均为4.46±2.07,心理痛苦≥4分发生率为71.50%(286/400);2单因素分析显示:心理痛苦程度与年龄、文化程度、医疗费用支付方式、家庭关系、家庭人均月收入、手术方式6个因素有关(χ2值分别为0.042、0.020、<0.001、<0.001、<0.001、0.001,均P<0.05),与有无配偶、职业分类、化疗后月经情况无关(均P>0.05);3多因素Logistic回归分析显示:文化程度高、医疗支付自费额度大是患者出现心理痛苦的危险因素(OR值分别为1.463、2.107,均P<0.05),年龄增大和家庭关系和谐是患者出现心理痛苦的保护因素(OR值分别为0.731、0.349,均P<0.05)。结论 1乳腺癌化疗患者的心理痛苦发生率较高;2年龄越小、文化程度越高、医疗支付自费额度越大患者的心理痛苦程度越严重。为乳腺癌辅助化疗患者提供个体化的心理疏导可能会减轻患者的心理痛苦。

Objective To evaluate the occurrence of psychological distress by using distress thermometer （DT） in breast cancer patients after receiving adjuvant chemotherapy and to analyze related influencing factors of psychological distress. Methods A total of 440 cases of breast cancer patients were selected as research objects. All those patients received post-operative adjuvant chemotherapy at the department of breast surgical oncology in the First Affiliated Hospital of Xi＇ an Jiaotong University from December 2013 to November 2015. DT was used to screen psychological distress so as to analyze its influencing factors. Results The average score of psychological distress of the cases was 4.46 ＋ 2.07. The incidence rate of psychological distress t〉4 points reached 71.50% （286/400）. Besides, univariate analysis showed that six factors, namely age, educational level, payment mode of medical bills, family relationships, household monthly income, and surgical procedures could affect the test results of psychological distress （X2 value was 0. 042, 0. 020, 〈 0.001, 〈 0.001, 〈 0. 001 and O. 001, respectively, all P 〈 0.05 ）. Factors like spouse, occupation, and menstruation condition after chemotherapy were irrelevant to the test results （ all P 〉 0.05 ）. In addition, multivariate Logistic regression analysis showed that high educational level and high amount of self-paying medical bills were the risk factors for psychological distress in patients （OR value was 1. 463 and 2. 107, respectively, both P 〈 0. 05 ）. Growing age and harmonious family relationships were protective factors for psychological distress （ OR value was 0.731 and 0. 349, respectively, both P 〈 0.05 ）. Conclusion The incidence rate of psychological distress is relatively high in breast cancer patients undergoing chemotherapy. The younger the patient is, the higher his or her educational level is and the higher the amount of self-paying medical bills is, the severer the psychological distress is. Providing personalized psychological counseling for breast cancer patients after receiving adjuvant chemotherapy may ease their psychological distress.