青年癌症患者109例对死亡态度调查分析

Investigation and analysis of death attitude of 109 young cancer patients

目的了解青年癌症患者群体对待死亡态度的现状及其影响因素,为其健康教育工作提供参考。方法采用便利抽样,应用中文版死亡态度描绘(DAP-R)量表(修订版),对资料完整的109例青年癌症患者对死亡态度的问卷调查资料进行分析,采用两独立样本t检验分析量表各维度得分,采用单因素方差分析和多元线性回归探讨影响死亡态度的因素。结果青年癌症患者死亡态度自然接受维度得分最高,为(3.23±0.87)分,其次为死亡逃避维度,为(3.17±0.81)分,逃离接受维度得分最低,为(2.84±0.77)分。不同文化程度(F死亡逃避=2.792,P=0.044)、宗教信仰(t自然接受=2.497,P=0.014)、亲人死亡史(t自然接受=2.128,P=0.036)、家庭内谈论死亡(F死亡恐惧=5.127,P=0.008;F趋近接受=4.055,P=0.020;F逃离接受=3.900,P=0.023;F自然接受=5.290,P=0.006)、参加丧葬体验(F趋近接受=2.670,P=0.036)、治疗时间(F趋近接受=3.115,P=0.029)等特征的青年癌症患者死亡态度得分差异有统计学意义。多元线性回归分析结果显示,家里人谈论死亡(死亡恐惧:t经常谈论vs从未谈论=-2.417,P=0.017;逃离接受:t偶尔谈论vs从未谈论=2.282,P=0.025;自然接受:t偶尔谈论vs从未谈论=-3.105,P=0.002)、文化程度(死亡逃避:t专科vs初中及以下=-2.708,P=0.017)、治疗时间(逃离接受:t≥6个月vs刚入院=-2.174,P=0.032)和比较亲近的人死亡病史(自然接受:t=2.663,P=0.009)为独立影响因素。结论青年癌症患者群体的死亡态度较为矛盾,既对死亡持自然接受态度,又逃避和抵触死亡;家庭内部讨论死亡、亲人去世经历等是青年癌症患者对待死亡态度的影响因素,应制定个性化的干预策略,帮助他们认识与理解死亡,提升生活质量。

Objective To understand the current situation and influencing factors of death attitude of young cancer patients,so as to provide reference for death health education of young cancer patients.Methods Convenience sampling and the Chinese version of death attitude description scale(DAP-R)(revised version)was used to investigate 109 young cancer patients.Two independent sample t-tests were used to analyze the scores of each dimension of the scale,and one-way analysis of variance and multiple linear regression were used to explore the factors affecting death attitudes.Results The scores of natural acceptance dimension of young cancer patients’ attitudes to death was the highest(3.23±0.87),the following was death escape dimension(3.17±0.81),and the lowest was escape acceptance dimension(2.84±0.77).There were statistically significant differences in the death attitude scores of young cancer patients with different education levels(Fdeath avoidance=2.792,P=0.044),religious beliefs(tnatural acceptance=2.497,P=0.014),death history of relatives(tnatural acceptance=2.128,P=0.036),family talking about death(Ffear of death=5.127,P=0.008;Fapproaching acceptance=4.055,P=0.020;Fescape acceptance=3.900,P=0.023;Fnatural acceptance=5.290,P=0.006),participating in funeral experience(Fapproaching acceptance=2.670,P=0.036)and time of therapy(Fapproaching acceptance=3.115,P=0.029).The results of multiple linear regression analysis showed that family members talking about death(death fear:toften talk about vs never talk about=-2.417,P=0.017;escape acceptance:toccasionally talk about vs never talk about=2.282,P=0.025;natural acceptance:toccasionally talk about vs never talk about=-3.105,P=0.002),education level(death escape:tspecialist vs junior high school and below=-2.708,P=0.017),treatment time(escape acceptance:tmore than six months vs just admitted=-2.174,P=0.032)and death history of a close person(naturally accepted:t=2.663,P=0.009)were independent factors.Conclusions The death attitude of young cancer patients is relatively contradictory.They both naturally accept death and resist death.Discussing death and the death experience of relatives within the family are factors that affect young cancer patients’ attitudes towards death.Individualized interventions should be developed to help them recognize and understand death and improve their quality of life.