首次膀胱灌注的中老年膀胱癌患者恐惧情绪现状及影响因素分析

Current situation and influencing factors of fear in middle-aged and elderly bladder cancer patients with first bladder irrigation

目的调查首次膀胱灌注的中老年膀胱癌患者的恐惧疾病进展水平,并分析其影响因素。方法选取2018年8月—2019年12月在上海市第十人民医院泌尿外科行经尿道膀胱癌电切除术后膀胱灌注化疗的145例非肌层浸润性膀胱癌患者作为研究对象,采用一般情况调查表、恐惧疾病进展简化量表和简易疾病感知问卷对其进行问卷调查,分析中老年膀胱癌患者的恐惧情绪及影响因素。结果145例中老年膀胱灌注患者的恐惧疾病进展总分为(28.32±7.34)分,生理健康维度得分为(18.24±4.32)分,社会家庭维度得分为(10.11±5.46)分;疾病感知总分为(44.12±10.65)分。患者恐惧疾病进展总分与疾病感知总分呈正相关(r=0.61,P<0.01)。单因素分析显示,年龄、个人月收入、宗教信仰、肿瘤病灶、肿瘤组织分级、肿瘤疾病进展或复发情况不同的中老年膀胱灌注患者恐惧疾病进展得分差异有统计学意义(P<0.05)。线性回归分析显示,宗教信仰、肿瘤组织分级、肿瘤疾病进展或复发、疾病感知是中老年膀胱灌注患者恐惧疾病进展的独立影响因素(P<0.01)。结论临床医护人员应关注中老年膀胱灌注患者恐惧疾病的进展过程,尤其是肿瘤组织分级高、处于肿瘤进展期、没有很好心理暗示的患者,同时可以通过改善疾病感知降低患者的恐惧疾病进展水平。

Objective To investigate the fear of disease progression in middle-aged and elderly patients with bladder cancer after bladder irrigation for the first time, and analyze its influencing factors.Methods From August 2018 to December 2019, 145 non-muscular invasive bladder cancer patients with bladder infusion chemotherapy who underwent transurethral resection of bladder cancer in the Department of Urology, Shanghai Tenth People's Hospital, were selected as the research object. The General Information Questionnaire, Fear of Progression Questionnaire-Short Form (FoP-Q-SF) and the Brief Illness Perception Questionnaire (BIPQ) were used to conduct a questionnaire survey to analyze the fear of middle-aged and elderly patients with bladder cancer and its influencing factors.Results Among 145 middle-aged and elderly patients with bladder irrigation, the total score of fear of disease progression was (28.32±7.34) , the scores of physiological health dimension and social family dimension were (18.24±4.32) and (10.11±5.46) respectively, and the total score of ill perception was (44.12±10.65) . The total score of the fear of disease progression of patients was positively correlated with the total score of ill perception (r=0.61, P<0.01) . Univariate analysis showed that there were statistical differences in the scores of fear of disease progression among middle-aged and elderly bladder irrigation patients with different ages, personal monthly incomes, religious beliefs, tumor lesions, tumor tissue grade, tumor disease progression or recurrence (P<0.05) . Regression analysis showed that the independent influencing factors of the fear of disease progression in middle-aged and elderly patients with bladder irrigation included the religious belief, tumor tissue grade, tumor disease progression or recurrence with a statistical difference (P<0.01) .Conclusions Clinical medical and nursing staff should pay attention to the fear of disease progression in middle-aged and elderly patients with bladder perfusion, especially those with high grade tumor tissues, who are in the advanced stage of tumor, and have no good psychological suggestion. At the same time, we can reduce their fear of disease progression by improving disease perception.