【摘要】：目的調(diào)查消化道癌癥患者兩個化療階段心理彈性的水平及變化情況,探討其兩個化療階段心理彈性的影響因素,為描述消化道癌癥患者兩個化療階段的心理彈性及其變化情況,制定針對性的干預(yù)方案提供參考。方法選取2015年10月至2016年11月在某醫(yī)科大學(xué)第一、第二附屬醫(yī)院的214名化療期消化道癌癥患者進(jìn)行6個月隨訪,采用統(tǒng)一設(shè)計的調(diào)查表,調(diào)查患者一般社會人口學(xué)和疾病相關(guān)資料,采用心理彈性量表(Resilience Scale-14,RS-14)評估患者的心理彈性水平,測量患者心理彈性的影響因素由醫(yī)學(xué)應(yīng)對方式問卷(Medical Coping Modes Questionnaire,MCMQ)、社會支持評定量表(Social Support Rating Scale,SSRS)、家庭功能APGAR問卷、安德森癥狀評估量表(M.D.Anderson Symptom Inventory,MDASI)、中文版疾病不確定感量表(Mish-el’s Uncertainty In Illness Scale-Adult,MUIS-A)、Herth希望量表(Herth Hope Inder,HHI)組成。使用Epi Data3.1建立數(shù)據(jù)庫,SPSS17.0統(tǒng)計軟件進(jìn)行統(tǒng)計分析。對心理彈性及其各維度得分進(jìn)行描述性分析,并進(jìn)行單因素和相關(guān)分析,應(yīng)用多元線性回歸法分析患者兩個化療階段心理彈性的影響因素,運用配對檢驗比較患者兩個化療階段心理彈性水平的變化。結(jié)果1.首次化療后共發(fā)放問卷214份,首次化療六個月后隨訪有效問卷177份,消化道癌癥患者首次化療后和首次化療六個月后心理彈性得分分別為72.64±7.91、76.00±7.01,處于中等以上水平;2.消化道癌癥患者首次化療后心理彈性總分、個人能力、對自我和生活的接納得分分別是72.64±7.91、52.42±5.77、20.22±2.96;首次化療六個月后的得分分別為76.00±7.01、54.42±5.03、21.58±2.60。首次化療六個月后的心理彈性及各維度得分均高于首次化療后且差異具有統(tǒng)計學(xué)意義(P=0.000,P=0.000,P=0.000)。3.多元線性回歸分析顯示,性別、家庭所在地、疾病分期、屈服、社會支持、家庭功能、癥狀嚴(yán)重度和癥狀困擾、希望是化療期消化道癌癥患者心理彈性的影響因素。其中首次化療后患者心理彈性的影響因素為性別、家庭所在地、疾病分期、社會支持、家庭功能、癥狀嚴(yán)重度、希望。首次化療六個月后患者心理彈性的影響因素為性別、屈服、社會支持、家庭功能、癥狀困擾、希望,其中希望對患者心理彈性的影響作用最大。結(jié)論消化道癌癥患者在首次化療后和首次化療六個月后的心理彈性得分處于中等偏上水平;首次化療六個月后的心理彈性及各維度的得分均高于首次化療后,心理彈性呈現(xiàn)上升狀態(tài)。消化道癌癥患者兩個化療階段心理彈性的影響因素不同,其中要特別關(guān)注的是希望和保護(hù)性因素對心理彈性的重要影響。探討這些影響因素可為消化道癌癥患者構(gòu)建不同階段心理彈性的整體結(jié)構(gòu)及針對性的心理彈性干預(yù)提供科學(xué)依據(jù)。
[Abstract]:Objective to investigate the level and changes of psychological elasticity in two stages of chemotherapy in patients with cancer of digestive tract, and to explore the influencing factors of the two stages of chemotherapy, so as to describe the changes of psychological elasticity in two stages of chemotherapy in patients with cancer of digestive tract. To provide reference for the development of targeted intervention programs. Methods A total of 214 patients with digestive tract cancer in the first and second affiliated hospital of a medical university from October 2015 to November 2016 were followed up for 6 months. The general socio-demographic and disease-related data of the patients were investigated, and the level of mental resilience was evaluated by Resilience Scale-14 RS-14. The influencing factors of measuring patient's psychological elasticity were (Medical Coping Modes questionnaire (Medical coping style questionnaire), Social support scale (Social Support Rating scale), Family function questionnaire (APGAR), Family function questionnaire (APGAR), Social support scale (Social Support Rating), Family function questionnaire (APGAR). The M.D.Anderson Symptom inventory (M.D.Anderson Symptom inventory) and the Chinese version of Mish-el's Uncertainty In Illness scale (Mish-el's Uncertainty In Illness scale Adult- MUIS-A) were composed of (Herth Hope Inderma (HHI). The statistical software SPSS 17.0 was used to build the database with Epi Data3.1 for statistical analysis. A descriptive analysis was made on the scores of psychological elasticity and its dimensions, and a single factor and a correlation analysis were carried out, and the influencing factors of the patients' psychological elasticity in the two stages of chemotherapy were analyzed by multiple linear regression method. A pair test was used to compare the changes of psychoelasticity in two stages of chemotherapy. Result 1. A total of 214 questionnaires were sent out after the first chemotherapy and 177 effective questionnaires were followed up six months after the first chemotherapy. The scores of psychological elasticity of the patients with digestive tract cancer were 72.64 鹵7.91 鹵76.00 鹵7.01 after the first chemotherapy and 76.00 鹵7.01 after the first chemotherapy respectively, which were above the average level. The scores of total psychological elasticity, personal ability, self acceptance and life acceptance were 72.64 鹵7.91 鹵5.77 鹵20.22 鹵2.96 and 76.00 鹵7.01 鹵54.42 鹵5.03 鹵21.58 鹵2.60 respectively after the first chemotherapy. The scores of psychological elasticity and dimension after the first chemotherapy were significantly higher than those after the first chemotherapy (P = 0.000, P = 0.000, P = 0.000, P = 0.000, P = 0.000, P = 0.000, P = 0.000, P = 0.000, P = 0.000, P = 0.000). Multiple linear regression analysis showed that sex, family location, disease stage, yield, social support, family function, symptom severity and symptom distress were the factors influencing the psychological elasticity of patients with digestive tract cancer during chemotherapy. The influencing factors of psychological elasticity after the first chemotherapy were gender, family location, disease stage, social support, family function, symptom severity and hope. Six months after the first chemotherapy, the influencing factors of patients' psychological elasticity were gender, yield, social support, family function, symptom distress, hope, among which, hope had the greatest effect on the patient's psychological elasticity. Conclusion the scores of psychological elasticity of patients with digestive tract cancer after the first chemotherapy and six months after the first chemotherapy were higher than those after the first chemotherapy, and the scores of the resilience and the dimensions after the first chemotherapy were higher than those after the first chemotherapy. Resilience showed an upward state. The influencing factors of psychological elasticity in two stages of chemotherapy in patients with digestive tract cancer are different, among which the important influence of hope and protective factors on psychological elasticity should be paid special attention to. The study of these influencing factors can provide scientific basis for the patients with digestive tract cancer to construct the whole structure of psychological elasticity in different stages and to provide scientific basis for the targeted intervention of psychological elasticity.
【學(xué)位授予單位】：安徽醫(yī)科大學(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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