食管癌患者术后早期心理痛苦评估及其影响因素分析

Evaluation of early postoperative psychological pain in patients with esophageal cancer and analysis on its influential factors

目的调查食管癌患者术后早期心理痛苦情况,探讨其相关的影响因素,为制定食管癌围手术期精准化的心理管理方案提供依据。方法选取赤峰市医院2019年1月至2021年1月确诊的食管癌且行根治性手术的患者106例为研究对象,对患者人口学资料、疾病资料使用自行设计的一般资料调查问卷和心理痛苦筛查管理工具(DMSM)对其进行横断面研究。结果 106例食管癌患者术后早期的心理痛苦温度计(DT)评分为(4.5±0.8)分,DT评分 < 4分40例(37.7%),DT评分≥ 4分66例(62.3%)。单因素分析显示,一般资料调查表中,文化程度、住院费用、吸烟史、手术方式是食管癌患者术后早期心理痛苦的影响因素(χ^(2)=7.87、9.56、12.65、7.03,均P < 0.05);心理痛苦相关问题列表(PL)中,疲乏、抑郁、疼痛、睡眠、呼吸、进食、照顾孩子是食管癌患者术后早期心理痛苦的影响因素(χ^(2)=48.18、64.19、42.17、27.14、36.13、35.01、8.01,均P < 0.05)。多因素回归分析发现,一般资料调查表中,文化程度、住院费用、吸烟史、手术方式是食管癌患者术后早期心理痛苦的影响因素(χ^(2)=14.71、8.31、13.56、6.47,均P < 0.05);心理痛苦相关PL中,疲乏、抑郁、疼痛、呼吸、进食是食管癌患者术后早期心理痛苦的影响因素(χ^(2)=5.45、3.91、4.89、3.96、4.00,均P < 0.05)。结论食管癌患者术后早期心理痛苦发生率高,造成患者心理痛苦的主要影响因素是身体问题,而情绪问题、文化程度、住院费用、吸烟史、手术方式等相关影响因素不容忽视。

Objective To investigate early postoperative psychological pain in patients with esophageal cancer and analyze its influential factors,providing evidence for developing accurate psychological management plan during the perioperative period of esophageal cancer.Methods A cross-sectional study was conducted on the demographic data,disease data,and psychological pain screening management tool(Distress Management Screening Measurement of patients with esophageal cancer who received treatment in Chifeng Municipal Hospital between January 2019 and January 2021 with a self-designed general data questionnaire.Results The average score of the distress thermometer was 4.5±0.8 points among the 106 patients with esophageal cancer in the early postoperative stage.DT score was<4 points in 40 patients(37.7%)and it was≥4 points in 66 patients(62.3%).Univariate analysis revealed that in the general data questionnaire,education level,hospital expense,smoking history,and operation methods were the influential factors of early postoperative esophageal cancer(χ^(2)=7.87,9.56,12.65,7.03,all P<0.05).In the list of psychological pain-related problems,fatigue,depression,pain,sleep,breathing,eating,and child care were the influential factors of early postoperative physiological pain in patients with esophageal cancer(χ^(2)=48.18,64.19,42.17,27.14,36.13,35.01,8.01,all P<0.05).Multivariate regression analysis showed that in the general data questionnaire,education level,hospital expense,smoking history,and operation methods were the influential factors of early postoperative esophageal cancer(χ^(2)=14.71,8.31,13.56,6.47,all P<0.05).In the list of psychological pain-related problems,fatigue,depression,pain,breathing,and eating were the influential factors of early postoperative physiological pain in patients with esophageal cancer(χ^(2)=5.45,3.91,4.89,3.96,4.00,all P<0.05).Conclusion The incidence of early postoperative psychological pain is high in patients with esophageal cancer.The main influential factor of psychological factors are physical problems,while the influential factors emotional problems,education level,hospital expense,smoking history,and operation methods cannot be ignored.