结直肠癌肠造口患者自我表露、心理困扰与适应水平的关系

Relationship between self-disclosure,psychological distress and adaptation level in patients with colorectal cancer undergoing enterostomy

目的:探究结直肠癌肠造口患者自我表露、心理困扰与适应水平的关系。方法:选择2019年1-12月于某院接受肠造口术的98例结直肠癌患者,采用痛苦表露指数量表(DDI)、心理困扰温度计(DT)及造口者社会心理适应量表(OAI-20)对患者进行问卷调查,评价患者自我表露、心理困扰与适应水平并分析三者间的关系。结果:结直肠癌造口患者自我表露、心理困扰、社会适应性评分分别为(30.32±7.73)分、(5.31±1.33)分和(42.92±11.38)分,自我表露处于低水平,心理困扰处于高水平,适应性处于低水平;结直肠癌肠造口患者自我表露与心理困扰负相关(r=-0.407,P<0.05),与适应水平正相关(r=0.377,P<0.05),心理困扰与适应水平负相关(r=-0.482,P<0.05);中介模型检验显示,结直肠癌肠造口患者自我表露对适应水平具有显著正向预测作用,且心理困扰在自我表露和社会适应之间起部分中介作用,中介效应占比为45.52%。结论:结直肠癌造口患者自我表露、社会适应均处于偏低水平而心理困扰处于高水平,自我表露直接影响患者适应水平,还可通过心理困扰的中介作用影响患者适应水平,医疗人员应重视解决结直肠癌造口患者的心理困扰,提高其适应水平。

Objective:To explore the relationship between self-disclosure, psychological distress and adaptation level in patients with colorectal cancer undergoing enterostomy.Methods:A total of 98 patients with colorectal cancer who underwent enterostomy in our hospital were enrolled between January 2019 and December 2019.Distress Disclosure Index(DDI),Psychological Distress Thermometer(DT)and Ostomy Adjustment Inventory-20(OAI-20)were used to conduct questionnaire surveys on patients, and the self-disclosure, psychological distress and adaptation level were evaluated among the patients and the relationship among the three was analyzed.Results:The scores of self-disclosure, psychological distress and social adaptability of patients with colorectal cancer undergoing enterostomy were(30.32±7.73)points,(5.31±1.33)points and(42.92±11.38)points respectively.Self-disclosure was at a low level, psychological distress was at a high level, and adaptation level was at a low level.Self-disclosure of patients with colorectal cancer undergoing enterostomy was negatively correlated with psychological distress(r=-0.407,P<0.05),and was positively correlated with adaptation level(r=0.377,P<0.05),and psychological distress was negatively correlated with adaptation level(r=-0.482,P<0.05).Intermediary model test showed that self-disclosure of patients with colorectal cancer undergoing enterostomy had a significant positive predictive effect on adaptation level, and psychological distress played a partially mediating role between self-disclosure and social adaptation, and the mediating effect accounted for 42.52%.Conclusion:The self-disclosure and social adaptation of patients with colorectal cancer undergoing enterostomy are at low levels while the psychological distress is at a high level.Self-disclosure directly affects the adaptation level of patients, and can also affect the adaptation level of patients through the mediating effect of psychological distress.It is necessary for medical personnel to pay attention to solving the psychological distress and improve the adaptation level of patients with colorectal cancer undergoing enterostomy.