本文選題：宮頸癌 + 心理　； 參考：《復(fù)旦大學(xué)》2008年碩士論文

【摘要】： 目的:本研究旨在了解宮頸癌患者的心理狀況及生命質(zhì)量,同時(shí)研究心理狀況和生命質(zhì)量和疾病相關(guān)因素之間的相互影響關(guān)系。 方法: 1、研究對(duì)象:2007年1月到2008年1月,在復(fù)旦大學(xué)附屬婦產(chǎn)科醫(yī)院、虹口區(qū)婦幼保健所、江灣醫(yī)院根據(jù)病史記錄手術(shù)病理證實(shí)為宮頸癌或癌前病變的漢族婦女227例,要求患者本人了解病情,自愿參加調(diào)查,無精神疾病和意識(shí)障礙。以及年齡、學(xué)歷、職業(yè)、婚姻狀況相匹配的正常對(duì)照人群200例,簽署知情同意書,確立為本研究對(duì)象。 2、研究方法:通過Zung抑郁自評(píng)量表(self-rating depression scale,SDS)Zung焦慮自評(píng)量表(self-rating anxiety scale,SAS)、特質(zhì)應(yīng)對(duì)方式問卷(trait coping style questionnaire,TCSQ)及宮頸癌患者生命質(zhì)量測(cè)評(píng)量表FACT-Cx(Functional Assessment of Cancer Therapy-Cervix)和自行設(shè)計(jì)的多項(xiàng)目問卷調(diào)查以了解宮頸癌患者心理狀況和生命質(zhì)量及相關(guān)的影響因素。 3、數(shù)據(jù)處理和統(tǒng)計(jì)分析:采用SPSS15.0統(tǒng)計(jì)分析。描述生命質(zhì)量水平在不同特征人群中的分布,采用單因素分析探討潛在危險(xiǎn)因素,顯著性標(biāo)準(zhǔn)α=0.05。采用多元線性逐步回歸法擬合與相關(guān)因素之間的數(shù)量關(guān)系模型,納入標(biāo)準(zhǔn)為0.05,移除標(biāo)準(zhǔn)為0.10。 結(jié)果 1、宮頸癌患者抑郁發(fā)生率為36.56%(83/227人),焦慮40.52%(92/227人)。宮頸癌組SDS、SAS評(píng)分均高于對(duì)照組。 2、影響宮頸癌患者抑郁癥狀的因素有年齡、經(jīng)濟(jì)負(fù)擔(dān)、手術(shù)方式,而影響宮頸癌患者焦慮癥狀的因素有年齡、文化水平、癌癥分期。手術(shù)切除子宮、年齡越大,經(jīng)濟(jì)狀況差的患者抑郁癥較明顯,年齡小、分期越晚、文化程度高的患者焦慮癥狀較明顯。 3、宮頸癌組積極應(yīng)對(duì)得分與對(duì)照組比較,差異無統(tǒng)計(jì)學(xué)意義(P＞0.05);而消極應(yīng)對(duì)得分明顯高于對(duì)照組(P＜0.01),顯示患者采取的消極應(yīng)對(duì)方式較多。 4、宮頸癌組消極應(yīng)對(duì)得分與SAS、SDS評(píng)分呈正相關(guān)(P＜0.05),即消極應(yīng)對(duì)分高,抑郁、焦慮評(píng)分就高,心理狀況就差;而宮頸癌組積極應(yīng)對(duì)得分與SAS、SDS評(píng)分呈負(fù)相關(guān)(P＜0.05),即積極應(yīng)對(duì)分高,抑郁、焦慮評(píng)分就低,心理狀況就好。 5、宮頸癌患者平均生命質(zhì)量評(píng)分為143.78±16.19(95%CI:141.66～145.17),FACT-G評(píng)分為93.95±12.16(95%CI:93.36～94.94)。 6、生命質(zhì)量水平在年齡、居住地、分期、是否放化療各水平之間的分布差異有統(tǒng)計(jì)學(xué)意義(P＜0.05)�；貧w分析結(jié)果提示,診斷時(shí)期別越晚,采用化放療患者的總體生活質(zhì)量評(píng)分越低。分期越晚,年齡越大的患者生理狀況越差。年齡越大的患者醫(yī)患關(guān)系分?jǐn)?shù)越低。分期越晚,居住在農(nóng)村的比上海本地的患者情緒狀況評(píng)分低。年齡小、采用化放療、分期越晚的宮頸癌患者的其他憂慮評(píng)分低。 結(jié)論: 1、抑郁和焦慮是宮頸癌患者存在的癥狀,并受多種因素影響。因此,在宮頸癌患者治療過程中,輔助有效心理干預(yù)措施減輕或消除心理癥狀具有重要意義。 2、宮頸癌患者采用消極應(yīng)對(duì)方式較多,影響患者的心理狀況,因此采取正確的積極的應(yīng)對(duì)方式,正視自己的疾病,是改善心理狀況的重要因素。 3、宮頸癌患者平均生命質(zhì)量評(píng)分為143.78±16.19(95%CI:141.66～145.17),FACT-G評(píng)分為93.95±12.16(95%CI:93.36～94.94),腫瘤的臨床分期和治療方法是影響生活質(zhì)量的重要因素,早期診斷宮頸癌、提高臨床治療效果對(duì)于宮頸癌患者的生活質(zhì)量有幫助。
[Abstract]:Objective: the purpose of this study was to investigate the psychological status and quality of life of patients with cervical cancer, and to study the relationship between the psychological status and the quality of life and the factors associated with disease.
Method:
1, study subjects: from January 2007 to January 2008, in the Department of gynaecology and obstetrics hospital affiliated to Fudan University, Hongkou District maternal and child health care institute, and 227 cases of Han women who confirmed cervical cancer or precancerous lesion according to the medical history, Jiangwan hospital, according to the history of medical history, asked the patient to know the condition of the disease and voluntarily participate in the investigation, without mental illness and mental disorder. And the age, and the age. 200 healthy controls, matched by occupation and marital status, signed the informed consent form.
2, the research methods: the self rating Anxiety Scale (self-rating depression scale, SDS) Zung Anxiety Scale (self-rating anxiety scale, SAS), the trait coping style questionnaire (trait coping) and the quality of life assessment of cervical cancer patients and self quality assessment scale, and Self-Evaluation Questionnaire were adopted. A multi item questionnaire survey was designed to understand the psychological status, quality of life and related factors of cervical cancer patients.
3, data processing and statistical analysis: using SPSS15.0 statistical analysis to describe the distribution of the quality of life in different characteristics of the population, using single factor analysis to explore the potential risk factors. The significant standard alpha =0.05. adopts the multiple linear stepwise regression method to fit the quantitative relationship model between the related factors and the standard is 0.05, remove the standard. For 0.10.
Result
1, the incidence of depression in cervical cancer patients was 36.56% (83/227), and anxiety was 40.52% (92/227 people). The SDS and SAS scores in cervical cancer group were higher than those in control group.
2, the factors that affect the depressive symptoms of cervical cancer patients are age, economic burden, and surgical methods, and the factors affecting the anxiety symptoms of cervical cancer patients are age, cultural level, cancer stage. The older the hysterectomy, the older the patients with poor economic conditions are more obvious, the younger, the late stages and the higher level of education, the anxiety symptoms of the patients with high educational level are better than those of the patients. Obviously.
3, the positive coping score of cervical cancer group was compared with the control group, the difference was not statistically significant (P > 0.05), while the negative coping score was significantly higher than that of the control group (P < 0.01), which showed that the patients took more negative coping styles.
4, the negative coping score of cervical cancer group was positively correlated with SAS and SDS score (P < 0.05), that is, the negative coping score was high, depression, anxiety score was high, and the psychological status was poor; the positive coping score of cervical cancer group was negatively correlated with SAS and SDS score (P < 0.05), that is, positive coping height, depression, anxiety score were low, and psychological condition was good.
5, the average life quality score of cervical cancer patients was 143.78 + 16.19 (95%CI:141.66 - 145.17), and the FACT-G score was 93.95 + 12.16 (95%CI:93.36 - 94.94).
6, the level of life quality was statistically significant in age, residence, staging, or whether the levels of chemotherapy were distributed (P < 0.05). Regression analysis showed that the more late the diagnosis, the lower the overall quality of life for patients with chemotherapy. The more late the stages, the worse the age of the patients. The older the patients were. The lower the score of the doctor-patient relationship, the later the stages were lower in the rural areas than in the Shanghai local patients. The younger, the use of chemotherapy, the lower the other anxiety scores of the patients with cervical cancer in the later stages.
Conclusion:
1, depression and anxiety are the symptoms of cervical cancer and are affected by a variety of factors. Therefore, in the treatment of cervical cancer patients, it is of great significance to assist the effective psychological intervention to alleviate or eliminate the psychological symptoms.
2, patients with cervical cancer use more negative coping styles, affecting the psychological status of the patients, so taking the correct and positive coping style and facing their own diseases is an important factor in improving the psychological condition.
3, the average quality of life of cervical cancer patients was 143.78 + 16.19 (95%CI:141.66 to 145.17), and the FACT-G score was 93.95 + 12.16 (95%CI:93.36 to 94.94). The clinical stages and treatment methods of the tumor were important factors affecting the quality of life. The early diagnosis of cervical cancer and the improvement of the clinical treatment effect were helpful to the quality of life of the patients with cervical cancer.
【學(xué)位授予單位】：復(fù)旦大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2008
【分類號(hào)】：R737.33;R395

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