大肠癌患者生活质量与负性情绪的纵向研究

Negative emotions and quality of life in colorectal cancer patients: a longitudinal study

目的调查大肠癌患者生活质量与负性情绪状况,分析二者变化趋势及相互关系,为患者的心理护理提供科学的理论依据。方法采用便利抽样法,抽取在广州某三级甲等肿瘤专科医院住院行手术和化疗治疗的大肠癌患者98例,采用医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)及欧洲癌症症研究与治疗组织生活质量问卷(European Organization for Research and Treatment of Cancer,EORTC QLQ-C30),分别于诊断期、术后、化疗早期、化疗中期及化疗晚期5个阶段,对大肠癌患者不同治疗阶段的负性情绪和生活质量水平进行纵向调查分析。结果不同治疗阶段大肠癌患者的生活质量及焦虑抑郁得分比较,差异有统计学意义(P<0.001)。大肠癌患者的焦虑抑郁由重到轻排列依次为术后、诊断期、化疗早期、化疗中期及化疗晚期,焦虑发生率最高为术后36.73%,抑郁发生率最高为术后24.49%。整体生活质量得分为(48.29±19.44)分,随着化疗的进行,生活质量功能维度水平逐渐升高。不同治疗阶段大肠癌患者生活质量的功能型维度和整体型维度与焦虑抑郁存在负相关(P<0.001,P<0.01,P<0.05)。结论随着化疗的进行,大肠癌患者负性情绪逐渐缓解而生活质量逐渐提高。大肠癌患者在诊断期、术后及化疗早期的生活质量受损最严重,健康教育和护理干预应在此阶段有所侧重,要注重焦虑抑郁等负性情绪的评估和及时干预,以提高患者的生活质量。

Objective To investigate the dynamic changes in negative emotions and quality of life of colorectal cancer patients all through their therapy courses.Methods A total of 98 participants were engaged by convenient sampling method.HADS and EORTC QLQ-C30 scales were used to measure the anxiety and depression and QOL of the participants at diagnosis period,postoperative period,early stage chemotherapy,middle stage chemotherapy and late stage chemotherapy.The time effect of QOL and negative emotions was discussed by repeated measurement and analyses of variance,and Pearson correlation analysis was conducted on two variables.Results The differences of QOL and HADS scales at different periods were statistically significant(P<0.001).According to the degrees of anxiety and depression,the time points during the treatment course ranked in the following order:postoperative period,diagnosis period,early stage chemotherapy,middle stage chemotherapy and late stage chemotherapy.The incidence rate of anxiety and depression was 36.73%and24.49%,respectively.The mean score of whole QOL was 48.29±19.44.The overall trend of anxiety depres sion and quality of life was gradually improved with the treatment,and there was a correlation between the two variables.Conclusions As chemotherapy goes on the anxiety and depression of negative colorectal cancer patients reduced and their life quality becomes better gradually.The anxiety and depression and quality of life of colorectal cancer patients are affected to the most severe extent at the time points of postoperative period,diagnosis period,early stage chemotherapy.So during these periods,we should enhance health education and nursing interventions to them so as to enhance their quality of life.