發(fā)布時(shí)間：2019-02-21 08:43

【摘要】：目的為探索大腸癌的歸因風(fēng)格的特征及影響因素，比較大腸癌患者歸因風(fēng)格的差異，以期改善大腸癌患者的心理健康狀況，更好的為大腸癌的預(yù)防、保健、臨床治療、護(hù)理及心理干預(yù)提供理論依據(jù)。 方法采用病例對照的研究方法，應(yīng)用統(tǒng)一的心理學(xué)問卷：歸因方式問卷（ASQ），大五人格問卷簡化版（NEO-FFI），漢密爾頓抑郁量表（HAMD）、漢密爾頓焦慮量表（HAMA）對108例大腸癌患者（研究組）及110名健康人（對照組）進(jìn)行測評，使用卡方檢驗(yàn)(χ~2)、t檢驗(yàn)、相關(guān)分析、多元線性回歸進(jìn)行統(tǒng)計(jì)分析。 結(jié)果1.與正常對照組相比，大腸癌組歸因風(fēng)格的得分明顯高于對照組，差異有統(tǒng)計(jì)學(xué)意義（P㩳0.001）；大腸癌組與正常對照組在人格特征神經(jīng)質(zhì)、外傾性、宜人性及盡責(zé)性的差異均有統(tǒng)計(jì)學(xué)意義（P㩳0.05）；大腸癌組與正常對照組在抑郁和焦慮各因子的差異有顯著統(tǒng)計(jì)學(xué)意義P㩳0.001），大腸癌組抑郁和焦慮各因子得分明顯高于對照組。 2.多元逐步回歸分析顯示：依次進(jìn)入負(fù)性事件歸因風(fēng)格總體回歸方程的有：焦慮、開放性、外傾性、盡責(zé)性、抑郁，可解釋方程的總變異量為27.6%；依次進(jìn)入負(fù)事件歸因風(fēng)格內(nèi)外維度回歸方程的有：開放性、神經(jīng)質(zhì)，，對方程解釋的總變異量為12.8%；依次進(jìn)入負(fù)事件歸因風(fēng)格穩(wěn)定維度回歸方程的有：焦慮、外傾性、開放性，對方程解釋的總變異量為13.6%；依次進(jìn)入負(fù)性事件歸因風(fēng)格整體維度回歸方程的有：焦慮、外傾性，對方程解釋的總變異量為22.6%。 結(jié)論1.大腸癌患者的歸因風(fēng)格與正常對照組明顯不同，歸因風(fēng)格的總體趨向于內(nèi)在、穩(wěn)定、普遍的消極歸因。 2.大腸癌患者神經(jīng)質(zhì)、外傾性、宜人性、盡責(zé)性人格特征得分高于正常對照組。 3.大腸癌患者焦慮、抑郁較正常問題得分高。 4.焦慮、抑郁情緒、開放性、外傾性、盡責(zé)性人格對大腸癌患者負(fù)性事件的歸因風(fēng)格有預(yù)測作用。 因此，臨床醫(yī)護(hù)工作人員在與患者溝通過程中給予恰當(dāng)?shù)囊龑?dǎo)，避免在得知身患癌癥這個(gè)刺激時(shí)產(chǎn)生消極歸因，從而影響治療的效果和依從性。
[Abstract]:Objective to explore the characteristics and influencing factors of attribution style of colorectal cancer and to compare the difference of attribution style in patients with colorectal cancer, so as to improve the mental health status of patients with colorectal cancer and to improve the prevention, health care and clinical treatment of colorectal cancer. Nursing and psychological intervention provide theoretical basis. Methods A case-control study was conducted using a unified psychological questionnaire: attribution style questionnaire (ASQ), Big five Personality questionnaire (NEO-FFI) and Hamilton Depression scale (HAMD),). Hamilton anxiety scale (HAMA) was used to evaluate 108 patients with colorectal cancer (study group) and 110 healthy persons (control group). Chi-square test (蠂 ~ 2), t test, correlation analysis, multivariate linear regression) was used for statistical analysis. Result 1. Compared with normal control group, the score of attribution style in colorectal cancer group was significantly higher than that in control group (P0. 001). There were significant differences in personality neuroticism, extroversion, amenity and due diligence between colorectal cancer group and normal control group (P < 0.05). There was significant difference in depression and anxiety between colorectal cancer group and normal control group (P < 0.001). The scores of depression and anxiety in colorectal cancer group were significantly higher than those in control group. 2. Multiple stepwise regression analysis showed that the total regression equation of negative event attribution style in turn was anxiety, openness, extroversion, due diligence, depression, and the total variance of the equation was 27.6; The regression equation of internal and external dimension of negative event attribution style in turn is open, neurotic, and the total variation of interpretation of the equation is 12.8b; In turn, the regression equation of negative event attribution style stability included anxiety, extroversion, openness, and the total variation of the interpretation of the equation was 13.6; The regression equations of the whole dimension of negative event attribution style are anxiety, extroversion, and the total variation of the interpretation of the equation is 22.6. Conclusion 1. The attribution style of colorectal cancer patients is obviously different from that of the normal control group, and the overall attribution style tends to be internal, stable and general negative attribution. 2. The scores of neuroticism, extroversion, humanity and due diligence in colorectal cancer patients were higher than those in the normal control group. 3. The scores of anxiety and depression in patients with colorectal cancer were higher than those in normal subjects. 4. Anxiety, depression, openness, extroversion and due diligence can predict the attribution style of negative events in colorectal cancer patients. Therefore, the clinical medical staff should give appropriate guidance in the process of communicating with the patients so as to avoid negative attribution when they are informed of the stimulation of cancer, thus affecting the effectiveness and compliance of the treatment.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R735.34;R395

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