乳腺癌化学治疗患者更年期症状相关生活质量及影响因素研究

Study on the predictors of the menopausal symptoms related quality of life in patients with breast cancer undergoing chemotherapy

目的·调查乳腺癌化学治疗(化疗)患者更年期症状相关生活质量,探讨其影响因素,为构建相应的干预措施提供理论依据。方法·2016年7月—2017年12月,采用方便抽样法,选取全国9所医院484名正在接受化疗的乳腺癌患者为调查对象进行问卷调查。对可能影响患者生活质量的因素进行单因素分析及Spearman相关分析,对有统计学意义的因素进行多元线性回归分析。结果·乳腺癌化疗患者更年期症状相关生活质量总分为(9.580±6.174)分,75.8%患者总分大于4分,提示生活质量较差。单因素分析发现,月经状态改变、婚姻状况及家庭月收入水平对患者的更年期症状相关生活质量的影响有统计学意义;相关性分析发现,化疗症状、焦虑抑郁与生活质量呈正相关,社会支持水平与生活质量呈负相关。进一步经多元逐步回归法分析,化疗症状、焦虑情绪、讯息与情绪支持3个变量进入回归方程,可共同解释总变异的43.0%(P<0.01)。结论·化疗症状及焦虑情绪的协同作用会影响乳腺癌化疗患者的更年期症状相关生活质量,应积极提供讯息与情绪支持,加强心理干预等多维度措施,改善患者生活质量。

Objective·To survey the menopausal symptoms related quality of life in patients with breast cancer undergoing chemotherapy and its determinants,which provides theoretical basis on intervention.Methods·In this cross-sectional study,a questionnaire survey was conducted on 484 breast cancer patients undergoing chemotherapy in 9 hospitals nationwide recruited by convenience sampling approach,from July 2016 to December 2017.Descriptive statistics,ANOVA,Spearman correlation and multiple linear regression analyses were preformed to explore the risk factors of the menopausal symptoms related quality of life.Results·The mean score of the Menopause Rating Scale(MRS)was 9.580±6.174 with 75.8%larger than 4,which indicated poor quality of life.One-Way ANOVA results showed the effect of marital status,monthly income,and the change of menstrual status on the MRS score were statistically significant.Spearman correlation results showed that the MRS score was positive correlated with anxiety and depression score and chemotherapy symptoms score,but negative correlated with social support score.Three of the nine variables,chemotherapy symptoms,anxiety,and information and emotional support,were selected by the multiple linear stepwise regression analysis,and could explain 43.0%of total variance(P<0.01).Conclusion·Most breast cancer patients undergoing chemotherapy have poor menopausal symptoms related quality of life.The main determinants were chemotherapy symptoms,anxiety,and information and emotional support.Informational and emotional support should be actively provided and mental health interventions should be strengthened,which could effectively improve their quality of life.