口腔癌患者术后创伤后成长水平及其与心理弹性和应对方式的关系

Post-traumatic growth of oral cancer patients after surgery and its relationship with psychological resilience and coping styles

目的了解口腔癌患者术后创伤后成长状况及其影响因素,探讨其与心理弹性、应对方式的相关性,为临床构建积极心理干预方案提供依据。方法回顾性收集304例口腔癌手术患者的病历资料,采用创伤后成长量表(PTGI)、心理弹性量表(CD-RISC)、简易应对方式问卷(SCSQ)对患者进行调查,分析口腔癌患者术后创伤后成长的影响因素,及其与心理弹性、应对方式的相关性。结果完成调查的患者300例,PTGI总分为(60.40±14.33)分;其中PTGI得分≥57分(阳性组)共186例(62.0%),<57分(阴性组)共114例(38.0%)。阴性组未婚或离异、月收入≤4000元、手术结合放化疗的患者占比高于阳性组,CD-RISC评分、SCSQ积极应对得分低于阳性组,SCSQ消极应对得分高于阳性组,差异均有统计学意义(P<0.05)。Logistic回归分析结果显示,婚姻状况、月收入、治疗方式、CD-RISC评分、SCSQ评分均为口腔癌患者术后创伤后成长的影响因素(P<0.05)。Spearman相关性分析结果显示,PTGI总分及各维度得分与CD-RISC评分、SCSQ积极应对评分呈正相关,与SCSQ消极应对评分呈负相关(均P<0.05)。结论超过1/3的口腔癌患者术后创伤后成长水平低,建议重点关注未婚或离异、收入低、手术结合放化疗、心理弹性水平低及消极应对的患者群体,以改善预后。

Objective To understand the status and influencing factors of post-traumatic growth of oral cancer patients after surgery,and investigate its correlation with psychological resilience and coping styles so as to provide a basis for clinical development of positive psychological intervention program.Methods The medical records of 304 patients who underwent oral cancer surgery were collected retrospectively.The post-traumatic growth inventory(PTGI),Connor-Davidson resilience scale(CD-RISC),and the brief coping style questionnaire(SCSQ)were used for investigation.The factors influencing post-traumatic growth of oral cancer patients after surgery,and its correlation with psychological resilience and coping styles were analyzed.Results A total of 300 patients completed the survey,with a mean total score on the PTGI of(60.40±14.33)points;There were 186(62.0%)patients with PTGI score≥57(positive group)and 114(38.00%)patients with PTGI score<57(negative group).In the negative group,the proportions of unmarried or divorced patients,those with a monthly income≤4000 yuan,and those undergoing surgery combined with radiotherapy and chemotherapy was higher than those in the positive group.The CD-RISC scores and positive coping scores on the SCSQ were lower in the negative group,while negative coping scores were higher,with all differences being statistically significant(P<0.05).Logistic regression analysis indicated that marital status,monthly income,treatment modalities,CD-RISC score,and SCSQ score were influencing factors for post-traumatic growth of oral cancer patients(P<0.05).Spearman correlation analysis showed that total PTGI score and scores in each dimension were positively correlated with CD-RISC scores and SCSQ positive coping scores,and negatively correlated with SCSQ negative coping scores(P<0.05).Conclusions More than one-third of oral cancer patients exhibit low levels of post-traumatic growth after surgery.Special attention should be given to unmarried or divorced individuals,those with low income,patients undergoing surgery combined with radiotherapy and chemotherapy,individuals with low psychological resilience levels,and those employing negative coping strategies in order to improve prognosis.