乳腺癌患者心理痛苦及其相关因素的研究

Psychological distress and related factors in patients with breast cancer

目的探讨乳腺癌住院患者化疗期间的显著心理痛苦发生情况及其相关因素，为临床制定心理干预对策提供依据。方法对2013年5月—2014年11月临潼区妇幼保健医院接受化疗的乳腺癌患者按入院次序连续抽取100名作为研究对象，采用一般资料问卷和心理痛苦温度计（distressthermometer，DT）进行问卷调查，收集到的资料录入EpiData3．0数据库，采用SPSS18．0软件进行统计学分析，P〈0．05表示差异有统计学意义。结果心理痛苦检出率（DT≥4分）为71．0％，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、家庭人均月收入、化疗前是否绝经及所处的化疗周期有关（P〈0．05）。Logistic回归发现，年龄大（OR=0．731，95％CI：0．409-0．842）和医疗费用医保支付（OR=0．349，95％CI：0．144—0．846）是乳腺癌患者化疗后出现心理痛苦的保护因素（P〈0．05），文化程度高（OR=1．463，95％CI：1．033—2．071）是乳腺癌患者化疗后出现心理痛苦的危险因素（P〈0．05）。结论较多乳腺癌患者化疗后出现心理痛苦，年龄、医疗费用支付方式、文化程度是引起心理痛苦的主要因素，这些因素可能成为减轻乳腺癌患者的心理痛苦的干预点。

Objective To investigate the prevalence of psychological distress during chemotherapy among inpatients with breast cancer, and analyze its related factors for providing evidence of clinical psychological intervention strategies. Meth- ods Selected 100 subjects of female breast cancer who had been treated with chemotherapy admitted to Lintong maternal and child health hospital from May,2013 to November,2014. The questionnaires included the general information and psy- chological distress thermometer（ DT）, data were input to EpiData 3.0 database after investigation, and using SPSS 18.0 for statistical analysis,P 〈 0.05 indicates statistically significant differences. Results The frequency of psychological dis- tress（ DT I〉4）was 71.0%. Univariate analysis showed that：psychological distress degree is related to age, the degree of education, the way of payment for treatment cost, Family per capita income per month, whether menopause before chemotherapy and chemotherapy cycle （P 〈 0.05 ）. Logistic regression analysis showed that：older of patients （ OR = 0.731,95 % CI：0. 409-0. 842） and use health insurance to payment for treatment cost（ OR = 0. 349,95% CI：0. 144-0. 846） were protective factors of psychological distress in breast cancer patients after chemotherapy（ P 〈 0.05 ）. and the degree of education（ OR = 1. 463,95% CI： 1. 033-2.071 ）is the risk factor of psychological distress in breast cancer patients after chemotherapy（P 〈 0.05 ）. Condusion The Most patients of breast cancer had serious psychological distress, the main risk factors were higher education, age and higher ratio at one＇ s own expense in treatment. This article maybe provide the right way to relieve the patients＇ psychological distress.