癌症长期幸存者创伤后成长的心理调查

Psychological Investigation of Post-traumatic Growth in Long-term Cancer Survivors

目的了解癌症长期幸存者创伤后成长状况。方法调查655例癌症长期幸存者(乳腺癌、前列腺癌、肠癌、胃癌或肺癌)(>5年)创伤后成长及影响因素,并对结果进行统计学分析。结果癌症后更加坚强的长期幸存者年龄更年轻,女性比例高于男性,癌症分期以Ⅰ/Ⅱ期比例更大,差异有统计学意义(P<0.05);癌症后更好应对的女性比例高于男性,年收入高于6万比例高于年收入低于6万者,未行化疗、放疗的患者比例更高,差异有统计学意义(P<0.05);有积极变化的患者年收入高于6万的比例更高;癌症后更健康习惯的长期幸存者年龄更年轻,在婚比例更高;经过多因素logistic回归分析发现,长期幸存者中,女性、处于癌症Ⅰ/Ⅱ期更可能报告更加坚强;女性、年收入超过6万和未化疗更可能报告更好应对;年收入超过6万更有可能报告有积极变化;在婚更可能报告有更健康习惯。结论癌症长期幸存者存在创伤后成长,且与年龄、性别、年收入、癌症分期、婚姻状况有关,临床应积极对癌症幸存者进行创伤后成长的评估,并根据患者不同状况进行心理干预或指导,提高癌症幸存者生活质量。

Objective To investigate the post-traumatic growth of long-term cancer survivors.Methods 655 long-term cancer survivors(their cancer including breast cancer,prostate cancer,colorectal cancer,gastric cancer and lung cancer,their survival time more than 5 years)were investigated for their post-traumatic growth and its influence factors,the results being analyzed.Results Those long-term cancer survivors who had stronger personality tended to be younger,had a higher proportion of women than men and were more likely to be stagedⅠorⅡ,the differences being statistically significant(P<0.05).Among those who had better responses after cancer diagnosis,the proportion of women was higher than men,the proportion of patients with an annual income more than 60,000 yuan was higher than patients with an annual income less than 60,000 yuan and the proportion of patients who had not received chemotherapy or radiotherapy was higher,the differences being statistically significant(P<0.05).Among those who had positive changes,the proportion of patients with an annual income more than 60,000 yuan was higher.The long-term survivors who had healthier habits after cancer diagnosis,tended to be younger and married.Multivariate logistic regression analysis showed that among the long-term survivors,women stagedⅠorⅡwere more likely to have a stronger personality,women with an annual income more than 60,000 who had not received chemotherapy were more likely to report better responses,patients with an annual income more than 60,000 were more likely to report positive changes and married patients were more likely to report having healthier habits.Conclusion Long-term cancer survivors present post-traumatic growth,which is related to age,gender,annual income,cancer stage and marital status.Clinicians should actively evaluate post-traumatic growth of long-term cancer survivors and conduct psychological intervention or guidance according to their conditions,to promote their life quality.