生活事件、应对方式和社会支持与胃癌发病的关系

Relationship of life events, coping styles and social support to the episode of gastric cancer

目的:探讨生活事件(lifeevents,LE)、应对方式和社会支持与胃癌发病的关系,寻求干预的可能性。方法:经临床、影像学和病理诊断确诊的胃癌患者(胃癌组),按相同年龄、性别、民族、职业、文化程度、婚姻状态和居住地区与正常对照组1:配对,并调查入选对象发病1年前遭遇的LV(杨德森,LV量表),评估应对方式(Feifel,医学应对方式问卷中文版)和社会支持(肖永源,社会支持评定量表)。结果:共配成65对,胃癌组发病前1年有61例遭遇不同LV,遭遇率94%,而对照组分别为28例和43%,前者明显高于后者(χ2=18.717,P<0.001)。胃癌组遭遇的LV频度(3.64±1.14)件/例、强度(20.40±7.66)/例,正性生活事件频度(0.80±0.19)件/例、强度(2.88±0.47)/例,负性生活事件频度(2.84±1.07)件/例、强度(17.52±8.2)/例均明显高于对照组(t=2.832～3.265,P均<0.01)。在应对方式评估中,胃癌组的面对应对方式评分明显高于对照组(5.23±1.62和4.09±0.87;t=2.234,P<0.05),而屈从和回避应对方式评分无明显区别(P均>0.05)。胃癌组的客观支持(9.83±2.65)、主观支持(21.52±4.71)、支持利用(6.54±2.80)和社会支持总分(40.26±11.75)均明显低于对照组(t=2.183～2.390;P均<0.05)。结论:LV、应对方式与社会支持与胃癌发病有密切联系。

AIM:To study the relationship between life events (LE) or coping style or social support and episode of gastric cancer and to discuss the possibility of psychological intervention.METHODS:All patients with gastric cancer (gastric cancer group, GCG), diagnosed by clinical imaging and pathological examine, were matched with normal subjects(control group, CG) by same age, sex, race, profession, education,marriage and residential region. Before treatment the subjects of both groups were inquired with questionnaires of LE scale, coping style scale and social support scale. RESULT:Sixty Five cases of gastric cancer had been mated with normal subjects one to one. The incidence rate of meeting LE was 94% in GCG and 43% in CG (χ 2=18.717,P< 0.001). The frequencies of meeting LE, averse LE and positive LE in GCG were (3.64± 1.14)/case, (0.80± 0.19)/case, (2.84± 1.07)/case, and the strengths in GCG were 20.40± 7.66, 2.88± 0.47 and 17.52± 8.2, both of which were significantly higher than those of CG(t=2.832- 3.265, P< 0.01).The coping style score of confrontation in GCG was 5.23± 1.62, significantly higher than that of CG (4.09± 0.87) (t=2.238,P< 0.05),but an insignificant difference was found in the coping style scores of resignation and avoidance between the two groups (P >0.05). Social support scale showed that the scores of objective support, subjective support, utilization rate and social support were 9.83± 2.65, 21.52± 4.71, 6.54± 2.80 and 40.26± 11.75, significantly lower than those of CG (t=2.183- 2.390, all P< 0.05).