中国癌症患者病情知情程度与生活质量焦虑抑郁情绪及尊严感的相关性研究

The Relationship between the Awareness of Disease Status and Quality of Life Anxiety Depression Dignity in Chinese Cancer Patients

目的:评估我国癌症患者的病情知情程度,分析病情知情程度与患者生活质量、焦虑抑郁情绪及尊严感的相关性。方法:采用横断面调查,选取就诊于河北医科大学第四医院的癌症患者作为研究对象。根据与患者访谈评估其病情知情程度。应用焦虑、抑郁量自评量表(SAS,SDS),尊严量表(PDI)以及生活质量调查表(QLQ-C30)进行调查,分析病情知情程度与患者生活质量、焦虑抑郁情绪及尊严感的相关性。结果:研究共纳入457例癌症患者,其中308例(67.40%)处于癌症晚期。其中完全不知情患者73例(15.97%),部分知情患者145例(31.73%),完全知情患者239例(52.30%)。85名患者(18.60%)存在焦虑情绪,333名患者(72.87%)存在抑郁情绪,69名患者(15.10%)同时存在焦虑抑郁情绪,423名患者(92.56%)存在不同程度的尊严受损。偏相关性分析显示患者疾病知情程度与生活质量中多个维度(情绪功能、认知功能、社会功能、疲乏、食欲降低症状及经济困难)(P<0.05)、焦虑(rs=-0.132,P=0.005)和尊严受损(rs=-0.096,P=0.041)存在明显相关性。结论:近50%癌症患者对自己的病情不知情或不完全知情,患者对自己的病情知情程度越低,生活质量越差,尊严越容易受损,越容易出现负面情绪,尤其是焦虑情绪。在临床工作中应尽量采取恰当的方法让患者了解自己的病情,这有利于提高患者生活质量,改善其负面情绪,以更好地实施全程全人的肿瘤诊疗策略。

Objective: To assess the levels of Chinese cancer patients’ awareness of disease status, and analyze the correlation between the awareness of disease status and quality of life, anxiety, depression, dignity. Methods: By cross-sectional investigation, cancer patients who were hospitalized in the fourth hospital of Hebei Medical University were selected as the research objects. According to the interview with patients, the degree of knowledge about the disease was evaluated. The self-assessment scale of anxiety and depression(SAS, SDS), dignity scale(PDI) and quality of life questionnaire(QLQ-C30) were used to investigate the relationship between the state of being informed and the patients’ quality of life, anxiety, depression and dignity. Results: A total of 457 cancer patients were included in the study, 308 of whom(67.40%) were in advanced stage of cancer. Among them, 73 patients(15.97%) were completely unknown, 145(31.73%) were partially informed, and 239(52.30%) were fully informed. 85 patients(18.60%) had anxiety, 333 patients(72.87%) had depression, 69 patients(15.10%) had anxiety and depression at the same time, 423 patients(92.56%) had different degrees of dignity damage. Partial correlation analysis showed that there was a significant correlation between the degree of informed disease and multiple dimensions of quality of life(emotional function, cognitive function, social function, fatigue, appetite reduction symptoms and economic difficulties)(P<0.05), anxiety(rs =-0.132, P = 0.005) and dignity impairment(rs =-0.096, P = 0.041). Conclusion: Nearly 50% of cancer patients have no or incomplete knowledge of their condition. The lower the level of patients’ knowledge of their condition, the worse the quality of life, the more easily their dignity is damaged, and the more likely they are to have negative emotions, especially anxiety. In clinical work, we should try our best to take appropriate methods to let patients know their own conditions, which is conducive to improving the quality of life of patients, improving their negative emotions, so as to better implement the whole process of cancer diagnosis and treatment strategy.