教育程度与婚姻对乳腺癌妇女精神障碍影响的多元Logistic分析

Education and the Duration of Marriage Contributing on Psychiatric Disorder of MMPI-Rated among Breast Cancer Women.

目的 阐述乳腺癌的诊断和治疗所造成的心理应激反应与创伤 ,依年龄、受教育程度、婚姻状况及人格特征和实际生活经历、社会与家庭关系和患者的心理及精神历史的不同而各不相同。方法 乳腺癌妇女精神状态与人格的评定采用临床晤谈、MMPI和生活事件量表以及基本情况问卷的方法 ,以 SPSS1 0 .0软件为工具进行统计学处理。结果 2 0 8例年龄为2 4～ 83岁乳腺癌妇女 ,平均 47岁。平均结婚时间 2 3± 1 1年。受教育程度文盲或小学文化 61人 ,占 2 9.3 % ;初中 5 3人 ,占2 5 .5 % ;高中和大专 5 0人 ,占 2 4.0 % ;大学以上 44人 ,占 2 1 .2 %。患病时间从术后 1个月～ 2 0 4个月 ( 1 7年 )不等。 40 .9%的患者 Hs高于 70分 ,72 .6%的患者 D分高于 70分 ,3 8.5 %的妇女 Hy分高于 70分 ,而 Pd高于 70分 ,占 1 7.8% ,Mf高于60分 ,占 5 0 .0 % ,但都低于 70分 ;Pa有 42 .8%的人高于 70分 ,Pt有 5 4.8%的人高于 70分 ,Sc有 76.9%的人高于 70分 ,Ma则有 1 7.8%的患者高于 70分 ;2 0 8例患者有 2 0 1例 Si分低于 70分 ,有 5 8.6%高于 60分。多因素 Logistic分析结果 ,受教育程度越高、结婚时间越长者 Hy、Pt和 Sc量表值减低 ,与文盲和小学文化相比 ,初中以上各水平 OR分别对 Hy为 0 .72 ,0 .5 1 ,0 .3 7( P=0 .0

Objective Psychological distress response dependents on different age,education and marriage status and personality,life experience,social support and her mental health state after initial treatment.Methods Education,age and duration of marriage,family support and coping strategies as risk factors for MMPI Rated psychological outcome were assessed among 208 consecutive patients with breast cancer who admitted to the oncology departments received further adjuvant treatment after surgery.Results (1)Among 208 breast cancer women,age is from 24 to 83(Mean=47±10.5).And 89% of them are married and mean marrage time is 23 years.And 61 women is illiteracy or primary education and other ratio of the education levels is equal.40.9% of the sample for Hs,72.6% for D and 38.5% for Hy score exceeded 70 score and 17.8% of the patients for Pd and Pa and no Mf surpass 70.54.8% for Pt and 76.9% of the sample for Sc exceeded 70 score.only 3.3% for Si over 70.(2)Multiple Logistic regression results:High education level(for Hy,Pt and Sc)and long marriage tiemt(for Pt and Sc),age at diagnosis(for Dand Pa),good family support(D,Pa and Pt),had more association with lower levels of MMPI(OR<1,P< 0.05 ).But long marriage time is risk factor for Hy at same time(OR>1,P<0.05).Conclusion High education level and long marriage time had more association with lower levels of Hy,Pt and Sc.But ong marriage time is risk factor for Hy.Good family support had very strong association with lower levels of MMPI for Dand Pa and Pt.However,family income,chemical therapy,marriage status and region of breast cancer,chemotherapy factors had little or no association with all level of MMPI.