心理痛苦温度计对胸部恶性肿瘤患者放疗前心理痛苦的诊断价值

The diagnostic value of psychological distress thermometer in patients with chest malignant tumors before radiotherapy

目的 探讨心理痛苦温度计在胸部恶性肿瘤患者放疗前心理痛苦的临床诊断价值.方法 对145例胸部恶性肿瘤患者采用医院焦虑抑郁量表及心理痛苦温度计(中文版)进行心理痛苦诊断.以医院焦虑抑郁量表诊断结果为金标准,分析中文版心理痛苦温度计的诊断效能,并统计各种心理问题发生率.结果 心理痛苦温度计筛选心理痛苦患者的受试者工作特征曲线下面积为0.89,且心理痛苦温度计评分为4分时约登指数最高(0.800),此时灵敏度和特异度分别为87.0%、89.2%(P<0.01).以4分为临界值,应用心理痛苦温度计评估,心理痛苦检出率为42.0%;应用医院焦虑抑郁量表评估,焦虑抑郁检出率为46.5%;二者检出率比较差异无统计学意义(P>0.05).入组患者心理痛苦问题排名前10位的依次为担心复发(82.8%)、疲乏(65.6%)、疼痛(57.7%)、睡眠(54.4%)、恐惧(45.5%)、经济问题(37.7%)、进食(31.8%)、无时间精力做家务(26.2%)、无时间精力照顾老人和小孩(21.2%)、身体活动受限(11.3%).结论 心理痛苦温度计对胸部恶性肿瘤患者放疗前心理痛苦具有较好的诊断效能,可作为临床心理痛苦的诊断指标.

Objective To explore the clinical diagnostic value of psychological distress thermometer in pa-tients with chest malignant tumors before radiotherapy.Methods 145 patients with thoracic malignant tumors were diagnosed with HADS and DT for psychological distress.Using HADS diagnostic results as the gold standard,analyze the diagnostic efficacy of DT and count the incidence of various psychological problems.Results The area under the ROC of the patients with psychological distress selected by DT was 0.89,and the Youden index was the highest(0.800)when the DT score was 4 points.At this time,the sensitivity and specificity were 87.0%and 89.2%respectively(P<0.01).With a cut-off value of 4,the detection rate of psychological distress was 42.0%when evaluated by DT.Using HADS assessment,the detection rate of anxiety and depression was 46.5%;there was no significant difference in the detection rate between the two(P>0.05).The list of psychological distress problems showed that the top 10 relat-ed factors were fear of relapse(82.8%),fatigue(65.6%),pain(57.7%),sleep(54.4%),fear(45.5%),economic problems(37.7%),eating(31.8%),lack of time and energy to do housework(26.2%),lack of time and energy to care for the elderly and children(21.2%),and limited physical activity (11. 3%). Conclusions Psychological distress thermometer has a good diagnostic effect on psychological pain of patients with chest malignant tumors, and can be used as a diagnostic indicator of clinical psychological pain.