646例放疗患者及家属焦虑评估及相关因素分析

Assessment of anxiety and analysis risk factors in 646 patients receiving radiotherapy and their relatives

目的 通过对放疗患者及家属进行焦虑评估,分析焦虑发生的相关因素,为改善放疗患者及家属的生活质量提供依据.方法 放疗开始前使用焦虑自评表SAS对患者及家属进行焦虑评分,并分析不同影响因素下的焦虑检出率.结果 共646例受试者,包括463例患者和183例家属.受试者总体、患者人群及家属人群的平均分数分别为41.52±10.08、41.02±9.37及42.79±11.56,均高于我国正常人群常模37.23±12.58（P=0.000、0.000、0.000）.年龄11～30、31～50、51～90岁的焦虑检出率分别为27％（7/26）、11.0％（20/182）、19.1％（47/246）（P=0.026）.是、否复发的焦虑检出率分别为27％（13/48）、15.4％（64/415）（P=0.040）.是、否转移的焦虑检出率分别为27％（17/63）、15.2％（60/396）（P=0.020）.≥3种慢性病或重大疾病者与其他患者的焦虑检出率分别为26％（19/74）与15.0％（58/387）（P=0.024）.多因素二元Logistics回归分析显示≥3种慢性病或重大疾病为发生焦虑的高风险因素（OR=1.92,95％CI=1.03～3.567）.结论 放疗患者及家属易发生焦虑.年轻、复发或转移、≥3种慢性病或重大疾病患者焦虑检出率高.在放疗前对患者及家属进行焦虑评估,并开展心理疏导是十分有必要的.

Objective To evaluate the anxiety and explore relevant risk factors in patients receiving radiotherapy and their relatives,aiming to provide evidence for improving the quality of life. Methods Before radiotherapy,the self-rating anxiety scale （SAS） was utilized to evaluate the anxiety of patients and their relatives. The incidence rate of anxiety was analyzed under the influence from different risk factors. Results A total of 646 participants （463 patients and 183 relatives） were included in this study. The average SAS scores of all participants,patients and family relatives were 41.52±10. 08,41.02±19. 37 and 42.79±11. 56, significantly higher than 37.23±12. 58 for the healthy population in China （P= 0. 000. 0.000,0. 000）.For patients aged 11-30,31-50 and 51-90 years,the incidence rate of anxiety was 26%（7/ 26）,11. 0%（20/ 182） and 19. 1%（47/ 246）,respectively （P= 0. 026）.The incidence rate of anxiety for patients with and without tumor recurrence was 27% （13/ 48） and 15. 4% （64/ 415） （P= 0. 040）.Seventeen of 63 patients （27%） with metastases experienced anxiety,whereas 60 of 396 patients （15. 2%） without metastases suffered from anxiety （P= 0. 020）.The incidence rate of anxiety in patients with three or more chronic diseases was 26%（19/ 74）,significantly higher compared with 15. 0%（58/ 387） in those with less comorbidities （P= 0. 024）. Multivariate binary logistic regression analysis demonstrated that three or more chronic diseases or serious diseases were high risk factors of anxiety （OR= 1. 92,95%CI：1. 03-3. 567）. Conclusions Patients who receive radiotherapy and their relatives are prone to anxiety. Young age,tumor recurrence or metastasis and≥ three comorbidities or severe diseases are the high risk factors of anxiety. It is necessary to evaluate the anxiety of patients and their family relatives before radiotherapy and deliver psychological counseling.