结直肠癌化疗患者癌症复发恐惧影响因素的纵向研究

Factors Influencing Fear of Recurrence among Colorectal Cancer Patients Undergoing Chemotherapy:A Longitudinal Study

目的 探讨结直肠癌患者在化疗不同阶段癌症复发恐惧(fear of cancer recurrence,FCR)水平的动态变化并分析其影响因素。方法 采用便利抽样法,选取2021年7月至2022年1月在江西省某三级甲等医院接受化疗的结直肠癌患者为研究对象,采用一般资料调查表、恐惧疾病进展简化量表(fear of progression questionnaire-short form,FoP-Q-SF)、社会支持评定量表(social support rating scale,SSRS)、医学应对方式问卷(medical coping modes questionnaire,MCMQ)于化疗前、第1次化疗后、第2次化疗后、第3次化疗后对其进行调查。结果 共161例患者完成4次测评,在4个测评时间点,FCR得分分别为(38.02±5.78)、(36.68±5.04)、(34.86±4.46)、(33.89±4.27)分,随着化疗的进行,患者FCR和社会支持水平下降,倾向于采用面对的应对方式(均P<0.05)。广义估计方程(generalized estimating equations,GEE)结果显示,年龄、性别、居住地、有无合并症、婚姻状况、肿瘤分期、社会支持及应对方式是结直肠癌化疗患者FCR的影响因素(均P<0.05)。结论 结直肠癌化疗患者FCR水平较高且随着化疗的进行呈动态变化,护理人员应从不同年龄、有无合并症、肿瘤分期等综合因素制定干预措施,实现精准、个体化的动态管理。

Objective To explore the dynamic changes of FCR level in different phases of chemotherapy among colorectal cancer patients,and analyze the influencing factors.Methods Convenient sampling was used to select colorectal cancer patients who underwent chemotherapy in a tertiary hospital in Jiangxi Province from July,2021 to January,2022.The general information questionnaire,FoP-Q-SF,SSRS,and MCMQ were used for investigation before chemotherapy,and after the first,second and third chemotherapy.Results A total of 161 patients completed four investigations.The FCR scores at four time points were(38.02±5.78),(36.68±5.04),(34.86±4.46),and(33.89±4.27).With the progress of chemotherapy,the FCR and social support levels decreased and patients tended to adopt the coping mode of confronce(all P0.05).The GEE found that age,gender,residence,comorbidity,marital status,tumor stage,social support and coping mode were the influencing factors of FCR among colorectal cancer patients undergoing chemotherapy(all P0.05).Conclusions The FCR level of colorectal cancer patients undergoing chemotherapy is high and dynamically changes with the progress of chemotherapy.Nursing staff should develop interventions considering the factors of ages,comorbidity,tumor stage,etc.,so as to achieve accurate and individualized dynamic management.