惡性腫瘤患者創(chuàng)傷后應(yīng)激障礙癥狀與應(yīng)激相關(guān)因素的初步研究
發(fā)布時間：2018-11-19 13:59
【摘要】：目的： 惡性腫瘤是威脅生命的創(chuàng)傷性生活事件,患者承受著巨大的心理壓力,易導(dǎo)致創(chuàng)傷后應(yīng)激障礙。本研究的目的是調(diào)查研究惡性腫瘤患者創(chuàng)傷后應(yīng)激障礙癥狀特征和共病情況,并探討創(chuàng)傷后應(yīng)激障礙癥狀的影響因素,分析應(yīng)對方式、社會支持、人格特征與創(chuàng)傷后應(yīng)激障礙的關(guān)系,并進一步分析創(chuàng)傷后應(yīng)激障礙作用規(guī)律。以期能夠在此研究的基礎(chǔ)上,對惡性腫瘤患者的創(chuàng)傷后應(yīng)激障礙提出更有效、針對性的心理干預(yù)措施。 方法： 采用自制一般情況調(diào)查表和以下問卷對浙江省腫瘤醫(yī)院215名惡性腫瘤患者進行調(diào)查研究,了解惡性腫瘤患者創(chuàng)傷后應(yīng)激障礙癥狀與心理健康狀況、相關(guān)的應(yīng)激因素。 1、醫(yī)學(xué)應(yīng)對方式問卷(MCMQ),用以評估患者的應(yīng)對方式。 2、社會支持評定量表(SSRS),用以評估患者可利用的外部資源。 3、艾森克人格問卷簡式量表中國版(EPQ-RSC),用以評估患者獨特而穩(wěn)定的行為風(fēng)格和思維方式。 4、創(chuàng)傷后應(yīng)激障礙自評量表(PTSD-SS),用以評估患者創(chuàng)傷后心理癥狀,包括反復(fù)重現(xiàn)、警覺性增高、回避癥狀等。 5、癥狀自評量表(SCL-90),用以評估患者心理健康狀況。 數(shù)據(jù)輸入計算機后采用SPSS15.0統(tǒng)計軟件,作頻數(shù)分析、相關(guān)分析(Pearson相關(guān)系數(shù))和多元線性回歸,檢驗水準(zhǔn)為α=0.05。采用LISREL8.7作結(jié)構(gòu)方程模型分析。 結(jié)果： 1、惡性腫瘤患者創(chuàng)傷后應(yīng)激障礙癥狀的總分以50、60為輕度異常、中重度異常的標(biāo)準(zhǔn),有輕度異常者以上占30.5%,中重度異常以上24.7%。 2、創(chuàng)傷后應(yīng)激障礙癥狀總分及不同維度與社會支持總分及客觀支持、支持利用度,神經(jīng)質(zhì)存在一定程度的相關(guān)(P0.05)。 3、回歸分析顯示只有神經(jīng)質(zhì)最終進入回歸方程,可解釋因變量的27.4%。 4、結(jié)構(gòu)方程模型顯示神經(jīng)質(zhì)、社會支持對PTSD癥狀有明顯影響,標(biāo)準(zhǔn)化路徑系數(shù)達0.502,社會支持的標(biāo)準(zhǔn)化路徑系數(shù)為0.148。 5、惡性腫瘤患者創(chuàng)傷后應(yīng)激障礙癥狀與癥狀自評量表中的軀體化、強迫、抑郁、偏執(zhí)因子存在相關(guān)(P0.05)。 結(jié)論： 1、惡性腫瘤患者表現(xiàn)出較高的創(chuàng)傷后應(yīng)激障礙癥狀,近三分之一患者呈現(xiàn)中高度異常,當(dāng)引起臨床重視。 2、社會支持對惡性腫瘤患者創(chuàng)傷后應(yīng)激障礙癥狀起緩沖作用,其中客觀支持、對支持的利用度是重要因素。 3、人格特征、社會支持能顯著預(yù)測惡性腫瘤患者創(chuàng)傷后應(yīng)激障礙癥狀,其中神經(jīng)質(zhì)(敏感、情緒化、易焦慮抑郁)是易感因素。 4、在應(yīng)激相關(guān)因素中,人格特征是預(yù)測惡性腫瘤患者創(chuàng)傷后應(yīng)激障礙癥狀的核心要素。社會支持、應(yīng)對方式通過人格因素起作用。 5、惡性腫瘤患者存在創(chuàng)傷后應(yīng)激障礙癥狀的同時伴發(fā)多種心理健康問題。
[Abstract]:Objective: malignant tumor is a life-threatening traumatic life event, patients are subjected to great psychological pressure, prone to lead to post-traumatic stress disorder. The purpose of this study was to investigate the symptoms and syndromes of post-traumatic stress disorder (PTSD) in patients with malignant tumors, and to explore the influencing factors, coping styles and social support. The relationship between personality traits and posttraumatic stress disorder (PTSD), and further analysis of posttraumatic stress disorder (PTSD). On the basis of this study, we can put forward more effective and targeted psychological intervention measures for post-traumatic stress disorder (PTSD) in patients with malignant tumor. Methods: 215 patients with malignant tumor in Zhejiang Cancer Hospital were investigated with self-made general information questionnaire and the following questionnaire to understand the symptoms and mental health status of post-traumatic stress disorder (PTSD) in patients with malignant tumor. Related stress factors. 1. The medical coping style questionnaire (MCMQ),) was used to evaluate the coping style of patients. 2. The Social support rating scale (SSRS),) was used to evaluate the external resources available to patients. Chinese version of Eysenck Personality questionnaire (EPQ-RSC) is used to evaluate patients' unique and stable behavior style and thinking style. 4. Post traumatic stress disorder self-rating scale (PTSD-SS) was used to evaluate the psychological symptoms of patients with post-traumatic stress disorder, including repeated recurrence, increased alertness, avoidance symptoms and so on. Symptom Checklist (SCL-90) was used to evaluate the mental health status of patients. After the data was input into the computer, SPSS15.0 statistical software was used to make frequency analysis, correlation analysis (Pearson correlation coefficient) and multivariate linear regression. The test level was 偽 = 0.05. LISREL8.7 is used for structural equation model analysis. Results: 1. The total score of the symptoms of post-traumatic stress disorder in malignant tumor patients was 50 ~ 60 as the standard of mild abnormal, moderate to severe abnormal, 30.5% of the patients with mild abnormality and 24.7m of moderate to severe abnormality. 2. The total scores and different dimensions of post-traumatic stress disorder symptoms were correlated with the total score of social support and objective support, the degree of support utilization and neuroticism to some extent (P0.05). 3. Regression analysis showed that only neuroticism finally entered the regression equation, which could explain 27.4% of dependent variables. 4. The structural equation model showed neuroticism, and social support had obvious influence on PTSD symptoms. The standardized path coefficient of social support was 0.502, and the standardized path coefficient of social support was 0.148. 5. Posttraumatic stress disorder symptoms in malignant tumor patients were correlated with somatization, compulsion, depression and paranoid ideation in SCL-90 (P0.05). Conclusion: 1. Malignant tumor patients showed high post-traumatic stress disorder symptoms, and nearly 1/3 patients showed moderate and high abnormality, which should be paid more attention to. 2. Social support acts as a buffer against symptoms of post-traumatic stress disorder (PTSD) in malignant tumor patients, among which objective support and utilization of support are important factors. 3. Personality characteristics and social support can predict the symptoms of post-traumatic stress disorder (PTSD) in malignant tumor patients, among which neuroticism (sensitive, emotional, anxiety and depression) is the predisposing factor. 4. Among the stress related factors, personality is the core factor in predicting the symptoms of post traumatic stress disorder in malignant tumor patients. Social support and coping style play a role through personality factors. 5. There are many mental health problems associated with posttraumatic stress disorder (PTSD) in patients with malignant tumor.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R395.1
本文編號：2342518
[Abstract]:Objective: malignant tumor is a life-threatening traumatic life event, patients are subjected to great psychological pressure, prone to lead to post-traumatic stress disorder. The purpose of this study was to investigate the symptoms and syndromes of post-traumatic stress disorder (PTSD) in patients with malignant tumors, and to explore the influencing factors, coping styles and social support. The relationship between personality traits and posttraumatic stress disorder (PTSD), and further analysis of posttraumatic stress disorder (PTSD). On the basis of this study, we can put forward more effective and targeted psychological intervention measures for post-traumatic stress disorder (PTSD) in patients with malignant tumor. Methods: 215 patients with malignant tumor in Zhejiang Cancer Hospital were investigated with self-made general information questionnaire and the following questionnaire to understand the symptoms and mental health status of post-traumatic stress disorder (PTSD) in patients with malignant tumor. Related stress factors. 1. The medical coping style questionnaire (MCMQ),) was used to evaluate the coping style of patients. 2. The Social support rating scale (SSRS),) was used to evaluate the external resources available to patients. Chinese version of Eysenck Personality questionnaire (EPQ-RSC) is used to evaluate patients' unique and stable behavior style and thinking style. 4. Post traumatic stress disorder self-rating scale (PTSD-SS) was used to evaluate the psychological symptoms of patients with post-traumatic stress disorder, including repeated recurrence, increased alertness, avoidance symptoms and so on. Symptom Checklist (SCL-90) was used to evaluate the mental health status of patients. After the data was input into the computer, SPSS15.0 statistical software was used to make frequency analysis, correlation analysis (Pearson correlation coefficient) and multivariate linear regression. The test level was 偽 = 0.05. LISREL8.7 is used for structural equation model analysis. Results: 1. The total score of the symptoms of post-traumatic stress disorder in malignant tumor patients was 50 ~ 60 as the standard of mild abnormal, moderate to severe abnormal, 30.5% of the patients with mild abnormality and 24.7m of moderate to severe abnormality. 2. The total scores and different dimensions of post-traumatic stress disorder symptoms were correlated with the total score of social support and objective support, the degree of support utilization and neuroticism to some extent (P0.05). 3. Regression analysis showed that only neuroticism finally entered the regression equation, which could explain 27.4% of dependent variables. 4. The structural equation model showed neuroticism, and social support had obvious influence on PTSD symptoms. The standardized path coefficient of social support was 0.502, and the standardized path coefficient of social support was 0.148. 5. Posttraumatic stress disorder symptoms in malignant tumor patients were correlated with somatization, compulsion, depression and paranoid ideation in SCL-90 (P0.05). Conclusion: 1. Malignant tumor patients showed high post-traumatic stress disorder symptoms, and nearly 1/3 patients showed moderate and high abnormality, which should be paid more attention to. 2. Social support acts as a buffer against symptoms of post-traumatic stress disorder (PTSD) in malignant tumor patients, among which objective support and utilization of support are important factors. 3. Personality characteristics and social support can predict the symptoms of post-traumatic stress disorder (PTSD) in malignant tumor patients, among which neuroticism (sensitive, emotional, anxiety and depression) is the predisposing factor. 4. Among the stress related factors, personality is the core factor in predicting the symptoms of post traumatic stress disorder in malignant tumor patients. Social support and coping style play a role through personality factors. 5. There are many mental health problems associated with posttraumatic stress disorder (PTSD) in patients with malignant tumor.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R395.1
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