无业和性格消极与乳腺癌术后放疗患者焦虑情绪的关系

The correlations between unemployment, pessimistic personality, and anxiety in postoperative radiotherapy patients with breast cancer

目的研究乳腺癌术后放疗患者焦虑情绪的相关影响因素,并探索其与患者术后放疗期间生活质量的关系。方法前瞻性研究行术后放疗的180例乳腺癌患者,采集患者基本信息及乳腺癌诊治情况,采用广泛性焦虑量表(General Anxiety Disorder Questionnaire,GAD-7评分)评估其焦虑程度,采用匹兹堡睡眠质量指数量表(Pittsburgh Sleep Quality Index,PSQI)评估其睡眠质量和采用乳腺癌生存质量量表(Quality of Life Questionnaire-Breast Cancer Module,EORTC QLQ-BR23评分)评估其生存质量。采用多因素logistic回归、Spearman相关性分析探究乳腺癌术后放疗患者焦虑的相关影响因素。并基于结构方程模型(SEM)探索焦虑影响因素、焦虑和生活质量的关系。结果在这个单中心数据中,乳腺癌术后放疗患者焦虑情绪发生率为30%(n=54),与生活质量的功能维度成负相关(r=-0.451,P<0.001),与生活质量的症状维度成正相关(r=0.343,P<0.001)。就业状况(OR=2.57,P=0.033)、性格倾向(OR=4.24,P<0.001)是乳腺癌术后放疗患者出现焦虑情绪的独立影响因素。性格倾向通过焦虑情绪间接影响生活质量的功能维度和症状维度。结论无业、性格倾向偏消极的乳腺癌术后放疗患者更易出现焦虑倾向,且焦虑情绪与其生活质量密切相关。

Objective To investigate the influencing factors related to anxiety in postoperative radiotherapy patients with breast cancer and explore its relationship with the quality of life during the postoperative radiotherapy period.Methods A prospective study was conducted on 180 breast cancer patients undergoing postoperative radiotherapy.Patient demographics and breast cancer diagnosis and treatment information were collected.Anxiety levels were assessed using the Generalized Anxiety Disorder-7(GAD-7)scale,the Pittsburgh Sleep Quality Index(PSQI)was used to evaluate the sleep quality,and the Quality of Life Questionnaire-Breast Cancer Module(EORTC QLQ-BR23)were used to evaluate quality of life.Multiple logistic regression and Spearman correlation analysis were employed to explore the influencing factors of anxiety in postoperative radiotherapy patients with breast cancer.The relationship between anxiety,influencing factors,and quality of life was explored using structural equation modeling(SEM).Results In this single-center data,the incidence of anxiety in postoperative radiotherapy patients with breast cancer was 30%(n=54).Anxiety was negatively correlated with the functional dimension of quality of life(r=-0.451,P<0.001)and positively correlated with the symptom dimension of quality of life(r=0.343,P<0.001).Employment status(OR=2.57,P=0.033)and personality traits(OR=4.24,P<0.001)were identified as independent influencing factors for anxiety in postoperative radiotherapy patients with breast cancer.Personality traits indirectly affected the functional and symptomatic dimensions of quality of life through anxiety.Conclusion Unemployment and a tendency towards negative personality traits make postoperative radiotherapy patients with breast cancer more susceptible to anxiety,and anxiety is closely related to their quality of life.