社区低剂量螺旋CT肺癌筛查患者心理状况与影响因素分析

Analysis and countermeasures of psychological status of patients with low-dose spiral CT lung cancer screening in community

目的分析低剂量螺旋CT(low-dose computer tomography,LDCT)社区肺癌筛查人群的焦虑及抑郁状态相关影响因素。方法选择社区LDCT肺癌筛查结果为阳性患者464例,分析其一般资料、焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS),P<0.05被认为有统计学差异。评估与焦虑、抑郁发生相关的危险因素。结果单因素分析结果显示:性别、肿瘤家族史、吸烟史、家庭二手烟暴露史、担心给家庭增加负担、担心工作受到影响、初次检查与社区LDCT肺癌筛查患者焦虑及抑郁状态的发生均显著相关(P<0.05)。多元回归分析显示有吸烟史、家庭二手烟暴露史、担心给家庭增加负担、担心工作受到影响、初次检查是焦虑情绪的独立危险因素(P<0.05),女性、有吸烟史,肿瘤家族史,担心给家庭增加负担,担心工作受到影响,初次检查是抑郁情绪的独立危险因素(P<0.05)。结论有吸烟史、二手烟暴露史、肿瘤家族史、担心给家庭增加负担、担心工作受到影响、初次检查的患者焦虑及抑郁发生风险提高,此类患者心理健康状况更应得到医务人员关注。

Objective To explore influence factors of anxiety and depression by analyzing the status of the population who underwent low-dose spiral CT(low-dose computer tomography,LDCT)lung cancer screening in community,and then to provide a basis for developing the best psychological intervention program.Methods A total of 464 patients with LDCT screening in the community were enrolled in this study They were asked to finish the general questionnaire,self-rating anxiety scale(self-rating anxiety scale,SAS)and self-rating depression scale(self-rating depression scale,SDS)questionnaires.was used for statistical analysis.P<0.05 was defined as significant difference statistically.Results Univariate analysis showed that gender,history of lung cancer,family history of cancer,history of smoking,history of exposure to secondhand smoke in the family,fear of increasing burden on families,fear of work being affected,whether initial screening and community LDCT lung cancer screening for anxiety and depression is significantly related.Multiple regression analysis showed a history of lung cancer,smoking history,family exposure to secondhand smoke,fear of increasing burden on families,fear of work being affected,whether initial examination was an independent risk factor for anxiety(P<0.05)and gender,lung cancer,smoking history,Family history of cancer,worried about increasing burden on families,worried about work being affected,whether initial examination were independent risk factors for depression(P<0.05).Conclusion Anxiety and depression of patients who underwent LDCT lung cancer screening in the community are affected by many factors.Paying attention to the psychological state of patients,adopting the best intervention measures,and reducing the psychological pressure of patients would improve the patients’compliance of examinations and enhance their confidence in continuing treatment.