口腔颌面部肿瘤患者术前焦虑状况及影响因素分析

Preoperative anxiety and influencing factors in patients with mouth and maxillofacial neoplasms

目的:调查口腔颌面部肿瘤患者术前焦虑情绪水平,并对其影响因素进行分析。方法:采用便利抽样法,选取2018年6月—2019年1月在天津市某三级甲等口腔专科医院拟行手术治疗的385例口腔颌面部肿瘤患者作为研究对象,采用患者一般资料调查表、SAS、社会支持量表(SSRS)、特质应对方式问卷(TCSQ)分别对患者的一般资料、焦虑状态、社会支持、应对方式进行调查。结果:共发放问卷385份,回收有效问卷361份。本研究125例(34.63%)患者存在焦虑症状,其中轻度焦虑者105例(29.09%)、中度焦虑者18例(4.99%)、重度焦虑者2例(0.55%)。多重逐步回归结果显示,积极应对方式、诊断、社会支持、职业、住院费用支付方式、性别是口腔颌面部肿瘤患者术前焦虑的主要影响因素,共同解释了变异量的43.26%(P<0.05)。结论:口腔颌面部肿瘤患者术前焦虑的发生率较高,特别是对于社会支持少、应对方式相对消极、诊断为恶性肿瘤的女性患者,医护人员应及时给予个性化的心理干预和健康教育,以协助患者顺利渡过围手术期。

Objective:To investigate the preoperative anxiety level of patients with mouth and maxillofacial neoplasms and analyze the influencing factors.Methods:Using the convenient sampling method,a total of 385 patients with mouth and maxillofacial neoplasms who planned to receive surgery in a Class Ⅲ Grade A stomatological hospital in Tianjin from June 2018 to January 2019 were selected as the research objects.General information questionnaire for patients,Self-Rating Anxiety Scale(SAS),Social Support Rating Scale(SSRS)and Trait Coping Style Questionnaire(TCSQ)were used to investigate patients'general information,anxiety state,social support and coping style.Results:Totally 385 questionnaires were distributed,361 questionnaires were recovered.In this study,125 patients(34.63%)had anxiety symptoms,including 105 patients with mild anxiety(29.09%),18 patients with moderate anxiety(4.99%),and 2 patients with severe anxiety(0.55%).The results of multiple stepwise regression showed that active coping style,diagnosis,social support,occupation,payment method of hospitalization expenses and gender were the main influencing factors of preoperative anxiety in patients with mouth and maxillofacial tumors,which jointly explained 43.26% of the variation(P<0.05).Conclusions:The incidence of preoperative anxiety in patients with mouth and maxillofacial neoplasms is relatively high,especially for female patients with less social support,relatively negative coping style and diagnosis with malignant tumor.Medical staff should give personalized psychological intervention and health education in time to help patients successfully pass the perioperative period.