乳腺癌化疗患者配偶认知行为调查及其与患者生命质量的相关性研究

Investigation on cognitive behavior of spouses of breast cancer patients undergoing chemotherapy and the correlation with life quality of patients

目的分析乳腺癌化疗患者配偶对疾病相关认知行为与患者生命质量的相关性,探讨提升乳腺癌化疗患者生命质量的对策.方法选择2017年6月-2019年6月宁波大学医学院附属医院收治的200例乳腺癌化疗患者及其配偶作为研究对象,所有患者均于完成一个化疗疗程后采用研究者组织制定的乳腺癌化疗患者配偶认知行为调查量表及乳腺癌患者生命质量调查量表(FACT-B)对患者配偶及患者进行调查.按照FACT-B评分总分最高分144分的60%为界限,根据患者FACT-B评分≥86分者设为观察组(81例),得分<86分者设为对照组(119例),分组统计两组患者配偶的一般情况及认知行为调查结果并行组间比较,分析患者配偶对乳腺癌化疗的认知行为与患者FACT-B的相关性.结果观察组患者配偶年龄、文化程度、职业、居住地、婚姻状况、宗教信仰、家庭人均月收入及医疗付费方式与对照组比较,差异均无统计学意义(χ^(2)=0.357,P=0.705;χ^(2)=0.317,P=0.736;χ^(2)=1.247,P=0.010;χ^(2)=1.037,P=0.082;χ^(2)=1.218,P=0.076;χ^(2)=0.641,P=0.418;χ^(2)=0.271,P=0.000;χ^(2)=1.726,P=0.054).观察组患者配偶对乳腺疾病及化疗相关知识的认知得分、陪伴时间及夫妻间沟通得分分别为(29.34±4.16)分、(2.74±0.36)分及(2.46±0.34)分,均高于对照组患者配偶的(21.61±3.57)分、(2.28±0.31)分及(3.04±0.29)分,观察组患者配偶焦虑评分为(2.07±0.37)分,低于对照组患者配偶的(2.41±0.31)分,差异均有统计学意义(t=5.574,P=0.000;t=3.617,P=0.023;t=3.926,P=0.016;t=3.735,P=0.020).经相关性分析显示,乳腺癌化疗患者配偶对乳腺癌疾病认知水平、化疗认知水平、陪伴时间及夫妻间沟通得分与乳腺癌患者FACT-B得分呈正相关(r=0.641,P=0.000;r=0.702,P=0.000;r=0.773,P=0.000),与其配合焦虑评分呈负相关(r=-0.591,P=0.007).结论乳腺癌化疗患者配偶对疾病认知水平及行为与乳腺癌化疗患者生存质量直接相关,临床应重视对乳腺癌化疗患者配偶进行必要的干预,提升其认知水平,形成更利于患者疾病治疗的行为习惯,以期提高乳腺癌患者生存质量.

Objective To analyze cognitive behavior of spouses of breast cancer patients undergoing chemotherapy and the correlation with life quality of patients,explore the countermeasures to improve life quality of breast cancer patients undergoing chemotherapy.Methods From June 2017 to June 2019,200 breast cancer patients undergoing chemotherapy and their spouses were selected from Affiliated Hospital of Medical College of Ningbo University.After one course of chemotherapy,all the patients and their spouses were investigated by cognitive behavior questionnaire of spouses of breast cancer patients and life quality questionnaire of breast cancer patients(FACT-B),the patients with FACT-B score≥86 were set as observation group(81 cases),and the patients with FACT-B score<86 were set as control group(119 cases).The general situation and cognitive behavior of the spouses in the two groups were analyzed and compared,the correlation between cognitive behavior of the spouses of patients with breast cancer undergoing chemotherapy and FACT-B score was analyzed.Results There was no statistically significant difference in age,educational level,occupation,residence,marital status,religious belief,family per capita monthly income,and medical payment mode between the two groups(χ^(2)=0.357,P=0.705;χ^(2)=0.317,P=0.736;χ^(2)=1.247,P=0.010;χ^(2)=1.037,P=0.082;χ^(2)=1.218,P=0.076;χ^(2)=0.641,P=0.418;χ^(2)=0.271,P=0.000;χ^(2)=1.726,P=0.054);the cognitive score of the spouses to breast diseases and chemotherapy-related knowledge,accompany time,and communication score of the spouses in observation group were(29.34±4.16),(2.74±0.36),and(2.46±0.34),respectively,which were statistically significantly higher than those in control group[(21.61±3.57),(2.28±0.31),and(3.04±0.29),respectively];the score of anxiety in observation group was(2.07±0.37),which was statistically significantly lower than that in control group(2.41±0.31)(t=5.574,P=0.000;t=3.617,P=0.023;t=3.926,,P=0.016;t=3.735,P=0.020).Correlation analysis showed that the cognitive score of the spouses to breast diseases and chemotherapy-related knowledge,accompany time,and communication score of the spouses were positively correlated with FACT-B score(r=0.641,P=0.000;r=0.702,P=0.000;r=0.773,P=0.000)and negatively correlated with anxiety score(r=-0.591,P=0.007).Conclusion The cognition level and behavior of the spouses of breast cancer patients undergoing chemotherapy are directly related to life quality of breast cancer patients.In order to improve life quality of breast cancer patients,more attention should be paid to the necessary intervention of the spouses of breast cancer patients undergoing chemotherapy,their cognition level should be improved,and the behavior habits that are more conducive to treatment of breast cancer patients should be formed.