疾病应对方式对转移性去势抵抗性前列腺癌化疗患者生存质量的影响

Effect of Disease Coping Style on Quality of Life in Patients with Metastatic Castration Resistant Prostate Cancer Undergoing Chemotherapy

目的调查转移性去势抵抗性前列腺癌(metastatic castration resistant prostate cancer,mCRPC)化疗患者疾病应对方式特点和生存质量现状,探讨二者关系,为临床实践中改善mCRPC化疗患者疾病应对方式和生存质量提供依据。方法2019-01/2020-06月,采用便利抽样法选取兰州市3家三级甲等医院泌尿外科或肿瘤科接受化疗的391例mCRPC患者作为研究对象。利用患者一般人口学及疾病相关信息问卷、晚期患者生存质量量表(quality of life concerns in the end of life questionnaire,QOLC-E)及医学应对方式问卷进行调查。分析患者疾病应对方式、生存质量现状,同时分析应对方式与生存质量间的关系。结果mCRPC化疗患者生存质量总分为(2.92±0.38)分,mCRPC化疗患者生存质量与屈服、回避策略呈负相关(P<0.05),与面对应对策略呈正相关(P<0.01)。结论医护人员应指导患者建立积极的疾病应对态度,重视疾病应对方式对患者生存质量的影响,通过引导患者重塑积极的疾病应对方式来改善其生存质量。

Objective To investigate the characteristics of disease coping style and quality of life in metastatic castration resistant prostate cancer(mCRPC)patients undergoing chemotherapy and discuss the relationship between these two,further to improve the treatment and the quality of the disease in the clinical practice of mCRPC.Methods A total of 391 mCRPC patients who received chemotherapy from urology or oncology department of 3 third-level grade A hospitals in Lanzhou from January 2019 to June 2020 were collected by convenience sampling method.Patients′general demographic and disease-related information questionnaire,quality of life concerns in the end of life questionnaire(QOLC-E)and medical coping style questionnaire were used to investigate.The status of disease coping style and quality of life of patients,as well as the relationship between coping style and quality of life were analyzed.Results The total score for all mCRPC patients undergoing chemotherapy was(2.92±0.38)points.The quality of life in mCRPC patients undergoing chemotherapy was negatively correlated with surrender and avoidance strategies(P<0.05),while positively correlated with coping strategies(P<0.01).Conclusion Medical staff should guide all patients to establish a positive attitude towards coping with disease,pay attention to the impact of coping style on patients′quality of life,and improve the quality of life by guiding patients to reshape the positive coping style of the disease.