老年非M3急性髓系白血病化疗患者心理弹性水平及影响因素分析

Analysis of psychological resilience and its influencing factors in elderly patients with non⁃M3 acute myeloid leukemia undergo⁃ing chemotherapy

目的分析老年非M3急性髓系白血病化疗患者心理弹性水平及影响因素,为其防治提供依据。方法回顾性分析2019年6月—2022年6月四川大学华西医院收治的112例老年非M3急性髓系白血病的临床资料。评估老年非M3急性髓系白血病化疗患者心理弹性水平,同时分析影响老年非M3急性髓系白血病化疗患者心理弹性水平的因素。结果心理弹性水平:坚韧(28.59±2.34)分、自强(20.48±2.48)分、乐观(9.34±1.35)分,总分(58.41±4.85)分。文化程度、性格、家庭人均月收入、对疾病的了解程度、化疗次数、FAB分型、治疗方案、治疗强度皆为影响老年急性髓系白血病化疗患者心理弹性水平的单因素(P<0.05);多因素Logistic回归分析表明,文化程度(初中及以下)、性格(内向型)、家庭人均月收入(≤2000元)、对疾病的了解程度(不了解)、化疗次数(4~6次)、FAB分型(M_(4)~M_(6))、治疗方案(传统化疗)、治疗强度(高强度)均为影响老年急性髓系白血病化疗患者心理弹性水平的独立危险因素(P<0.05)。年龄、性别、付费方式等皆为非影响老年急性髓系白血病化疗患者心理弹性水平的单因素(P>0.05)。结论老年非M3急性髓系白血病化疗患者心理弹性处于较弱水平,文化程度、性格、家庭人均月收入、对疾病的了解程度、化疗次数、FAB分型、治疗方案、治疗强度可能是其重要影响因素,临床可据此进行针对性干预,以提高患者心理弹性水平。

Objective To analyze the level of psychological resilience and its influencing factors in elderly patients with non⁃M3 acute myeloid leukemia(AML)undergoing chemotherapy,and provide evidence for its prevention and treatment.Methods The clinical data of 112 elderly patients with non⁃M3 AML admitted to West China Hospital from June 2019 to June 2022 were retrospectively analyzed.The level of psychological resilience of elderly patients with non⁃M3 AML treated with chemotherapy was analyzed,and the factors affecting the psychological resilience of these patients were analyzed.Results The level of psychological resilience:tenacity(28.59±2.34)points,self⁃improvement(20.48±2.48)points,op⁃timism(9.34±1.35)points,total scores(58.41±4.85)points.Educational level,personality,per capita monthly family income,understanding of the disease,chemotherapy frequency,FAB classification,treatment plan and treatment intensity were the single factors affecting the level of psychological resilience of elderly patients with AML treated with chemotherapy(P<0.05).Multivariate Logistic regression analysis showed that education level(junior high school or below),personality(intro⁃verted type),per capita monthly income of the family(≤2000 yuan),understanding of the disease(unknown),chemother⁃apy frequency(4⁃6 times),FAB classification(M4⁃M6),treatment plan(traditional chemotherapy)and treatment intensity(high intensity)were all independent risk factors affecting the level of psychological resilience of these patients(P<0.05).Age,gender,payment method and other factors were not the single factors affecting the level of psychological resilience of these patients(P>0.05).Conclusion The psychological resilience of elderly patients with non⁃M3 AML undergoing chemo⁃therapy is at a relatively weak level.Education level,personality,per capita monthly family income,understanding of the dis⁃ease,chemotherapy frequency,FAB classification,treatment plan and treatment intensity may be important influencing factors.Clinical intervention can be carried out according to these factors to improve the level of psychological resilience of patients.