胃癌患者化疗期间心理弹性与化疗耐受性、生存质量的关系

Relationship between psychological resilience and chemotherapy tolerance,quality of life in patients with gastric cancer during chemotherapy

目的:探索胃癌患者化疗期间心理弹性与化疗耐受性、生存质量的关系。方法:选择2014年6月到2015年6月在本院确诊并接受化疗的52例胃癌患者,经FOLFOx4方案进行常规的化疗。调查患者Conner-Davidson心理弹性量表(CD-RISC),采用中位数法将其分为高弹性组和低弹性组各26例,采用WHO不良反应分度标准评价两组患者其化疗耐受性,生存质量核心问卷(QLQ-C30)评价其生存质量。采用Pearson相关性分析心理弹性与化疗耐受性和生存质量之间的相关性。结果:化疗前胃癌患者坚韧维度、自强维度、乐观维度和总心理弹性分显著高于化疗期间(t=3.599,3.765,4.469,5.132;P<0.001);高心理弹性组食欲减退评分显著高于低心理弹性组(t=4.410,P=0.000),骨髓抑制评分显著高于低心理弹性组(t=3.719,P=0.001),生活质量评分显著高于低心理弹性组(t=5.715,P=0.000),躯体功能评分显著高于低心理弹性组(t=4.148,P=0.000),角色功能评分显著高于低心理弹性组(t=3.110,P=0.003),认知功能评分显著高于低心理弹性组(t=3.941,P=0.000),情绪功能评分显著高于低心理弹性组(t=8.563,P=0.000),社会功能评分显著高于低心理弹性组(t=8.563,P=0.000),症状维度疲乏评分显著低于低心理弹性组(t=-8.810,P=0.000),恶心呕吐评分显著低于低心理弹性组(t=-3.235,P=0.002),失眠评分显著低于低心理弹性组(t=-12.008,P=0.000),食欲丧失评分显著低于低心理弹性组(t=-11.023,P=0.000),经济困难评分显著低于低心理弹性组(t=-13.807,P=0.000);心理弹性与化疗耐受性(食欲减退)和生存质量(生活质量、躯体功能、情绪功能、社会功能)呈显著正相关关系(r=0.413,0.461,0.402,0.545;P<0.05),与生存质量(疲乏、失眠、食欲丧失、经济困难)呈显著负相关关系(r=-0.546,-0.684,-0.647,-0.695;P<0.01)。结论:胃癌患者化疗期间心理弹性与其化疗耐受性、生存质量显著相关。

Objective:To explore the relationship between psychological resilience and chemotherapy tolerance,quality of life in patients with gastric cancer during chemotherapy.Methods:A total of 52 patients with gastric cancer who were diagnosed and received chemotherapy in our hospital from June 2014 to June 2015 were selected,and they were given routine chemotherapy of FOLFOx4 regimen.The Conner-Davidson Psychological Resilience Scale(CD-RISC)was investigated,and the patients were divided into high resilience group and low resilience group according to the median method,with 26 cases in each group.The WHO adverse reactions indexing standard was used to evaluate the chemotherapy tolerance in the two groups.The quality of life questionnaire-Core(QLQ-C30)was used to evaluate the quality of life.Pearson correlation analysis was used to analyze the correlation between psychological resilience and chemotherapy tolerance and quality of life.Results:The toughness,self-improvement,optimism dimension and the overall psychological resilience in patients with gastric cancer before chemotherapy were significantly higher than those during chemotherapy was significantly higher than that during chemotherapy(t=3.599,3.765,4.469,5.132;P<0.001).The appetite reduction score and bone marrow suppression score in high psychological resilience group were significantly higher than those in low psychological resilience group(t=4.410,3.719;P<0.001),and their quality of life score,physical function score,role function score,cognitive function score,emotional function score and social function score were significantly higher than those in low psychological resilience group(t=5.715,4.148,3.110,3.941,8.563,5.768;P<0.01),and the symptom dimension fatigue score,nausea and vomiting score,insomnia score,appetite loss score and economic difficulty score were significantly lower than those in low psychological resilience group(t=-8.810,3.235,-12.008,-11.023,-13.807;P<0.05).Psychological resilience was significantly positively correlated with chemotherapy tolerance(appetite reduction)and quality of life(quality of life,physical function,emotional function,social function)(r=0.413,0.461,0.402,0.545;P<0.05),and was significantly negatively correlated with quality of life(fatigue,insomnia,appetite loss,economic difficulty)(r=-0.546,-0.684,-0.647,-0.695;P<0.01).Conclusion:Psychological resilience of patients with gastric cancer during chemotherapy is correlated with chemotherapy tolerance and quality of life.