本文選題：乳腺癌 + 心理特征��； 參考：《濟(jì)南大學(xué)》2017年碩士論文

【摘要】：目的評價及分析晚期化療乳腺癌患者心理特征和生活質(zhì)量狀況;評估心理干預(yù)對晚期化療乳腺癌患者心理狀態(tài)及生活質(zhì)量的影響。方法本研究收集了山東省腫瘤醫(yī)院2016年2月-2017年2月收治的晚期化療乳腺癌患者89例,分為干預(yù)組(45例)和對照組(44例)。干預(yù)組予常規(guī)化學(xué)治療和心理干預(yù)治療,對照組僅行常規(guī)化學(xué)治療。評價兩組患者心理干預(yù)前、干預(yù)后(即初次測評和再次測評)的心理狀態(tài)和生活質(zhì)量,比較心理干預(yù)后(即再次測評)干預(yù)組和對照組心理狀態(tài)及生活質(zhì)量的差異,分析心理干預(yù)的效果。心理干預(yù)方法包括心理教育干預(yù)、團(tuán)體心理干預(yù)和個體心理干預(yù)。使用的調(diào)查工具有:生活質(zhì)量調(diào)查問卷(European Organization for Research and Treatment Quality of Life Questionnare-Core30,EORTC QLQ-C30)、抑郁自評量表(Self-rating depression scale,SDS)、焦慮自評量表(Self-Rating Anxiety Scale,SAS)和創(chuàng)傷后成長評定量表(Posttraumatic Growth Inventory,PTGI)。結(jié)果1.干預(yù)組和對照組在年齡、婚姻狀況、職業(yè)、醫(yī)療付費(fèi)方式、文化程度、KPS評分方面沒有統(tǒng)計學(xué)差異(P0.05),具有可比性。2.收錄入組的乳腺癌患者初次測評時,總體健康狀況得分對照組為7.26±1.33,干預(yù)組為7.89±1.73;功能領(lǐng)域中,角色功能、認(rèn)知功能、社會功能,對照組和干預(yù)組得分分別為[1.50±1.49;1.67±1.30]、[3.34±1.02;3.56±1.10]、[4.55±1.56;4.76±1.61];軀體功能、情緒功能得分對照組和干預(yù)組分別為[8.23±2.89;8.97±3.01]、[7.41±2.15;7.76±2.23]。氣促、便秘、腹瀉維度的得分相對較少,表明這方面問題相對較少。3.初次測評時,干預(yù)組和對照組所有患者,抑郁總體占44.9%,其中輕度抑郁為28.1%,中度抑郁為16.8%。干預(yù)組和對照組晚期化療乳腺癌患者總體焦慮比率為40.4%,其中,輕度焦慮為22.5%,中度焦慮為17.9%。4.干預(yù)組患者PTGI結(jié)果顯示,創(chuàng)傷后成長總分為66.28±14.084,最大值為93分,最小值為32分。其中,“與他人關(guān)系”得分為23.31±5.107,“新的可能性”得分為15.73±4.245,“個體的力量”得分為12.20±4.230,“精神信仰上的變化”得分為6.87±1.853,“對生活的欣賞”得分為8.64±2.630。5.QLQ-C30再次測評和初次測評相比,在角色功能、認(rèn)知功能、情緒功能、總體健康狀況、疲倦、失眠方面的差異有統(tǒng)計學(xué)意義(P0.05),在軀體功能、社會功能、惡心嘔吐、疼痛、氣促、食欲喪失、便秘、腹瀉、經(jīng)濟(jì)困難方面差異無統(tǒng)計學(xué)意義。6.干預(yù)組患者,初次測評時抑郁總體占44.4%,再次測評時占24.4%,干預(yù)后患者抑郁的比率明顯下降,差異有統(tǒng)計學(xué)意義(P0.05)。對照組抑郁患者,初次測評時占45.5%,再次測評時占50%,再次測評和初次測評相比,患者抑郁所占的比率反而上升。干預(yù)組患者,初次測評時焦慮總體占42.2%,再次測評時占24.4%,再次測評和初次測評相比,焦慮比率下降,但差異沒有統(tǒng)計學(xué)意義(P0.05)。對照組焦慮患者,初次測評時總體占38.6%,再次測評占36.4%,前后兩次測評焦慮患者所占比率變化不大,差異沒有統(tǒng)計學(xué)意義。結(jié)論1.晚期化療乳腺癌患者總體健康狀況處于中等水平,功能領(lǐng)域得分整體處于中低水平,功能狀況較差;癥狀領(lǐng)域中除氣促、便秘、腹瀉得分較低(問題較少)外,其余領(lǐng)域問題較多,生活質(zhì)量較差。2.晚期化療乳腺癌患者存在抑郁、焦慮的心理障礙,且主要是輕中度。3.心理干預(yù)后對干預(yù)組患者進(jìn)行創(chuàng)傷后成長評定量表測評,患者存在一定成長。4.心理干預(yù)后,患者在角色功能、認(rèn)知功能、情緒功能、總體健康狀況、疲倦、失眠方面,較初次測評時(即干預(yù)前)有明顯改善,有顯著性差異。表明心理干預(yù)在一定程度上改善了患者的生活質(zhì)量。5.心理干預(yù)可以改善患者的抑郁狀態(tài),干預(yù)組患者心理干預(yù)后,抑郁者所占比率較前下降,且差異有統(tǒng)計學(xué)意義。
[Abstract]:Objective to evaluate and analyze the psychological characteristics and quality of life of patients with advanced chemotherapy of breast cancer, and to evaluate the psychological status and quality of life of breast cancer patients with advanced chemotherapy. Methods 89 cases of advanced treatment of breast cancer treated in February -2017 February 2016 in Shandong cancer hospital were collected and divided into intervention group (45 cases). And the control group (44 cases). The intervention group was treated with routine chemical therapy and psychological intervention, and the control group was only treated with routine chemical therapy. The psychological state and quality of life were evaluated before the intervention of the two groups. The psychological state and quality of life in the intervention group and the control group were compared with the psychological intervention group and the control group. The results of psychological intervention included psychological education intervention, group psychological intervention and individual psychological intervention. The survey tools used were the quality of life questionnaire (European Organization for Research and Treatment Quality of Life Questionnare-Core30, EORTC QLQ-C30), and the self rating Depression Scale Ng depression scale, SDS), the self rating Anxiety Scale (Self-Rating Anxiety Scale, SAS) and the post traumatic growth assessment scale (Posttraumatic Growth Inventory, PTGI). Results there was no statistical difference between the 1. intervention group and the control group in age, marital status, occupation, medical pay, cultural range, and score. In the first evaluation of the breast cancer patients, the total health status score was 7.26 + 1.33 in the control group and 7.89 in the intervention group. In the functional field, the scores of role function, cognitive function and social function were [1.50 + 1.49, 1.67 1.30], [3.34 + 1.02, 3.56 + 1.10], [4.55 + 1.56 and 4.76 + 1.61], body function and emotional work. The score in the control group and the intervention group were [8.23 2.89, 8.97 + 3.01], [7.41 + 2.15, 7.76 + 2.23]. and constipation, and the scores of diarrhoea were relatively less. It showed that in the first evaluation of.3., all the patients in the intervention group and the control group accounted for 44.9% of the depression, of which the mild depression was 28.1%, and the moderate depression was the 16.8%. intervention group. The overall anxiety ratio of the patients with advanced chemotherapy in the control group was 40.4%, of which the mild anxiety was 22.5%, and the moderate anxiety in the 17.9%.4. intervention group showed that the total score was 66.28 + 14.084, the maximum was 93, and the minimum was 32. The score of "the relationship with him" was 23.31 + 5.107, and the "new possibility" was obtained. The score was 15.73 + 4.245. The score of "individual strength" was 12.20 + 4.230. The score of "spiritual belief change" was 6.87 + 1.853. The score of "appreciation of life" was 8.64 + 2.630.5.QLQ-C30. Compared with the first assessment, there were statistical differences in role function, cognitive function, emotional function, overall health condition, fatigue and insomnia. Learning significance (P0.05), in the body function, social function, nausea and vomiting, pain, breath, loss of appetite, constipation, diarrhea, and economic difficulties, there was no significant difference in the.6. intervention group. The total depression was 44.4% in the first assessment, 24.4% in the second evaluation, and the rate of depression after the intervention was significantly decreased (P0.05). In the group of depressed patients, the first evaluation was 45.5% and the second assessment was 50%. Compared with the first evaluation, the rate of depression was increased. The anxiety in the intervention group was 42.2% in the first assessment and 24.4% in the second evaluation. The anxiety rate was decreased compared with the first assessment, but the difference was not statistically significant. P0.05). In the control group, the primary assessment was 38.6% in the control group and 36.4% for the second assessment. The ratio of the two times before and after the assessment of anxiety patients was not significant, and the difference was not statistically significant. Conclusion the overall health status of the 1. advanced chemotherapy breast cancer patients was at the middle level, the score of the functional field was in the middle and low level, and the functional status was poor. In the field of symptoms, the scores of Qi, constipation and diarrhea were lower (less problems), and there were more problems in the rest of the field. The poor quality of life.2. advanced chemotherapy for breast cancer patients had depression, anxiety mental disorder, and the main reason was that after the mild and moderate.3. psychological intervention, the patients in the intervention group were evaluated by the post traumatic growth assessment scale, and the patients had a certain growth of.4. Psychological intervention, patients in role function, cognitive function, emotional function, overall health status, fatigue, insomnia, compared with the first assessment (before intervention), there are significant differences. It shows that psychological intervention improves the quality of life of the patients to some extent.5. psychological intervention can improve the patient's depression, intervention group After psychological intervention, the proportion of depressive patients was lower than before, and the difference was statistically significant.
【學(xué)位授予單位】：濟(jì)南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.73

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