社区初诊癌症患者心理痛苦状况及影响因素

The state of psychological distress and influencing factors in newly diagnosed cancer patients in the community

目的 :了解社区初诊癌症患者心理痛苦现状及影响因素,为制定针对性干预措施提供依据。方法 :采用包含心理痛苦温度计(DT)和心理痛苦相关问题列表(PL)两个部分的心理痛苦管理筛查工具(DMSM)对社区85例初诊癌症患者进行心理痛苦状况调查。其中男性患者34例,女性患者51例,平均年龄(50.25±11.40)岁。初次诊断结果分别为肺癌37例,乳腺癌有30例,肠癌11例,胃癌7例。结果 :患者DT平均得分为(4.65±2.45)分;DT≥4分的有54例,占63.52%。不同部位癌症患者DT得分差异有统计学意义(P <0.05);心理痛苦相关因素排序前3位的是身体问题中的癌因性疲乏、情绪问题中的担忧、和实际问题中的经济问题,所占比例分别为87.05%、78.82%、74.11%。结论 :社区初诊癌症患者心理痛苦处于较高水平;影响因素较多,并相互交织。提示护理人员需了解不同患者的心理痛苦因素,在社区肿瘤随访过程中应制定个性化干预计划与措施,减轻患者心理痛苦程度,提高生命质量。

Objective： To understand the current situation and infuencing factors of psychological distress in patients with newly diagnosed cancer in the community to provide evidence for the development of targeted interventions. Methods： Psychological distress management screening measure（DMSM） consisting of distress thermometer（DT） and psychological distress related problem list（PL） was used to investigate the psychological distress status of 85 community cancer patients. Among them, 34 were male and 51 were female, with an average age of 50.25 ± 11.40 years old. The initial diagnosis results were 37 cases of lung cancer, 30 cases of breast cancer, 11 cases of intestinal cancer and 7 cases of gastric cancer. Results： The average score of patients with DT was （4.65±2.45） points; there were 54 cases with DT≥4 points, accounting for 63.52%. The diference in DT scores of patients with diferent diseases was statistically signifcant（P〈0.05）. The top three psychological distress related factors were cancer-related fatigue, anxiety in emotional problems and economic problems in practical problems, accounting for 87.05%, 78.82% and 74.11%, respectively. Conclusion： The psychological distress of patients with newly diagnosed cancer in the community is at a high level; there are many infuencing factors and they are intertwined. It is suggested that nursing staf need to understand the psychological distress factors of diferent patients, in the community tumor follow-up process, individualized intervention plans and measures should be developed to reduce the psychological distress of patients and improve the quality of life.