COVID-19对消化道肿瘤患者调整化疗方案后心理状态的影响调查

Influence of COVID-19 on psychological status of patients with gastrointestinal cancer after adjusting chemotherapy regimen

目的 调查COVID-19对消化道肿瘤患者调整化疗方案后心理状态的影响。方法 选取2021年9月—2022年2月中国人民解放军陆军第七十三集团军医院收治的消化道肿瘤化疗患者378例,借助中文版COVID-19恐惧量表(FVC-19S-C)、中文版肿瘤患者疾病进展恐惧简化量表(FoP-Q-SF)、14项心理弹性量表问卷(RS-14)调查患者感染COVID-19恐惧、肿瘤复发恐惧和心理弹性状况,采用Pearson相关性分析对患者感染COVID-19恐惧、肿瘤复发恐惧和心理弹性之间进行相关分析。通过单因素和多因素Logistic回归分析影响患者肿瘤复发恐惧的独立危险因素。结果 378例患者中19.8%处于感染COVID-19恐惧高水平,40.2%处于肿瘤复发恐惧高水平,患者COVID-19恐惧、肿瘤复发恐惧均与心理弹性呈显著负相关(r=-0.218,P<0.001;r=-0.207,P<0.001),患者COVID-19恐惧与肿瘤复发恐惧之间存在显著正相关(r=0.237,P<0.001)。单因素分析提示,性别、年龄、文化程度、家庭年均收入、COVID-19传播期间化疗方案调整、COVID-19恐惧高水平和心理弹性评分与肿瘤复发恐惧具有显著关联性(P<0.05)。多因素分析发现,只有年龄<45岁、家庭经济状况差(年均收入<10万元)、COVID-19传播期间化疗方案调整和心理弹性差(评分<67.5分)是肿瘤复发恐惧高水平的独立风险因素。结论 COVID-19使消化道肿瘤化疗患者具有较高水平的肿瘤复发恐惧,特殊时期化疗方案调整在很大程度上增强了患者肿瘤复发恐惧,临床上应加强支持干预。

Objective To investigate the influence of COVID-19 gastrointestinal cancer patients'psychological state after adjusting chemotherapy regimen.Methods A total of 378 patients with gastrointestinal cancer treated with chemotherapy in the 73rd Group Military Hospital of the PLA Army from September 2021 to February 2022 were included as the research objects.FVC-19S-C,FoP-Q-SF and RS-14 were used to investigate patients′fear of infection with COVID-19 pneumonia,fear of tumor recurrence,and patients′resilience.Pearson correlation analysis was used to analyze the correlation between patients′fear of COVID-19 infection,fear of tumor recurrence and patients′resilience.Univariate and multivariate Logistic regression analysis were used to analyze the independent risk factors affecting the patients′fear of tumor recurrence.Results Among the 378 patients,19.8%were in the high level of fear of infection with COVID-19 and 40.2%were in the high level of fear of tumor recurrence.Patients′fear of COVID-19 and tumor recurrence were significantly negatively correlated with their resilience(r=-0.218,P<0.001;r=-0.207,P<0.001).There was a significant positive correlation between patients′fear of COVID-19 and their fear of tumor recurrence(r=0.237,P<0.001).Univariate analysis showed that gender,age,education level,average family income,adjustment of chemotherapy program during the epidemic,high level of fear of COVID-19 and resilience score were significantly associated with fear of tumor recurrence(P<0.05).Multivariate Logistic analysis found that only age<45 years old,poor family economic status(annual income<100000 yuan),adjustment of chemotherapy regimen during the epidemic,and poor psychological resilience(score<67.5 points)were independent risk factors for high levels of tumor recurrence fear.Conclusion Covid-19 makes patients with digestive tract tumors have a high level of fear of tumor recurrence.The adjustment of chemotherapy in special period has greatly enhanced the fear of cancer recurrence,and should strengthen the support of clinical intervention.