晚期肺癌患者生存痛苦现状及影响因素分析

Status and influencing factors of existential distress in patients with advanced lung cancer

目的了解晚期肺癌患者生存痛苦现状并分析其影响因素,为制订针对性干预方案提供参考。方法采用便利抽样法,选取2022年2月—2023年8月潍坊市2所三甲医院肿瘤内科的320例晚期肺癌患者为研究对象。采用一般资料调查表、中文版生存痛苦量表(EDS)、社会支持评定量表(SSRS)、中文版癌症自我管理效能感量表(SUPPH)、患者健康问卷-9(PHQ-9)对患者进行调查。采用Spearman相关分析对晚期肺癌患者SSRS总分、SUPPH总分及PHQ-9总分与EDS总分的相关性进行分析,采用多重线性回归分析晚期肺癌患者生存痛苦的影响因素。本研究共发放问卷320份,回收有效问卷318份,问卷有效回收率为99.38%(318/320)。结果318例晚期肺癌患者EDS总分为3.00(2.00,4.00)分。EDS总分与PHQ-9总分呈正相关,与SSRS总分、SUPPH总分均呈负相关(P<0.01)。多重线性回归分析显示,婚姻状况、社会支持、自我管理效能感、抑郁是晚期肺癌患者生存痛苦的影响因素(P<0.05)。结论晚期肺癌患者存在轻度的生存痛苦,医护人员应注意评估患者生存痛苦水平,多关注离异或丧偶、社会支持及自我管理效能感水平较低、存在抑郁状态的患者,尽早制订干预策略以缓解其负面情绪,帮助患者重建他们存在的意义,从而改善患者的心理状况,降低生存痛苦水平。

Objective To understand the current status of existential distress in patients with advanced lung cancer and analyze its influencing factors,so as to provide a reference for developing targeted intervention programs.MethodsA total of 320 patients with advanced lung cancer were selected using convenience sampling from two ClassⅢGrade A hospitals in Weifang between February 2022 and August 2023.The data were collected using a General Information Questionnaire,the Chinese Version of the Existential Distress Scale(EDS),the Social Support Revalued Scale(SSRS),the Chinese Version of the Strategies Used by People to Promote Health(SUPPH),and Patient Health Questionnaire-9(PHQ-9).Spearman correlation analysis was conducted to analyze the relationships between EDS,SSRS,SUPPH,and PHQ-9 scores,and multiple linear regression analysis was used to identify the influencing factors of existential distress in patients with advanced lung cancer.A total of 320 questionnaires were distributed,with 318 valid responses,yielding a valid response rate of 99.38%(318/320).Results The total EDS score for the 318 patients was 3.00(2.00,4.00).EDS scores were positively correlated with PHQ-9 scores and negatively correlated with SSRS and SUPPH scores(P<0.01).Multiple linear regression analysis showed that marital status,social support,self-management efficacy,and depression were influencing factors of existential distress in patients with advanced lung cancer(P<0.05).Conclusions Patients with advanced lung cancer experience mild existential distress.Medical staff should assess existential distress levels,paying close attention to patients who are divorced or widowed,have low levels of social support and self-management efficacy,or are experiencing depression.Early interventions should be developed to alleviate negative emotions and help patients rebuild their sense of meaning,thereby improving psychological well-being and reducing survival distress.