D型人格与直肠癌患者就诊延迟、精神状态及生存质量的关系  

Type D personality is associated with longer symptom duration, poor mental health status, and poor quality of life among rectal cancer patients

作　　者：张家魁[1] 李永双[1] 金俊哲[1] 刘继超[1] 张春东[1] 戴冬秋[1] 

机构地区：[1]中国医科大学附属第四医院胃肠外科,沈阳110032

出　　处：《中国普外基础与临床杂志》2017年第3期297-306,共10页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探索D型人格(type D personality)与直肠癌患者症状时间(symptom duration,SD)、急诊就诊、精神健康状态及术后生存质量(quality of life,QOL)之间的关系。方法前瞻性收集2010年10月至2012年10月期间中国医科大学附属第四医院收治的直肠癌患者,于确诊疾病(基线)时采用14项D型人格量表(DS14)检测患者的人格;于基线时和诊断6个月时采用欧洲肿瘤治疗研究组织(EORTC)的QLQ-C30量表和QLQ-CR38量表测定患者的生存质量,采用医院焦虑与抑郁量表(HADS)测定患者的焦虑和抑郁情况。比较D型人格患者和非D型人格患者的社会人口学特征、临床病理学特征、精神健康状态及生存质量。结果本研究最终入组596例直肠癌患者,其中有131例患者具有D型人格(22%)。1社会人口学特征。相较于非D型人格组患者,D型人格组患者的经济状况较差、无医保比例较高、合并症种类多、SD≥1个月的比例高、就诊时为急诊的比例高(P<0.050)。2 EORTC QLQ-C30。基线时,D型人格组患者的角色功能、情绪功能、认知功能、社会功能以及总体健康状态得分均低于非D型人格组(P<0.050),但疲劳、便秘及经济困难得分均高于非D型人格组(P<0.050)。6个月时D型人格组患者的角色功能、情绪功能、认知功能、社会功能以及总体健康状态得分均低于非D型人格组(P<0.050),但疲劳、失眠、便秘及经济困难得分均高于非D型人格组(P<0.050)。3 EORTC QLQCR38。基线时,D型人格组患者的未来期望得分低于非D型人格组(P<0.001),而泌尿问题得分高于非D型人格组(P<0.001)。6个月时,D型人格组患者的未来期望和性功能得分均低于非D型人格组(P<0.050),但泌尿问题、胃肠道症状、男性性功能障碍及排泄困难得分均高于非D型人格组(P<0.050)。4精神状态。基线和6个月时,D型人格组患者的焦虑和抑郁发生率均高于非D型人格组(P<0.001)。D型人格组患者中,6个月时的�Objective The aim of this research was to explore the relationship between type D personality and symptom duration/emergency admissions/mental health status/quality of life （QOL） in Chinese rectal cancer patients. Methods Rectal cancer patients who were treated in our hospital form Oct. 2010 to Oct. 2012 were selected prospectively, and then their type D personality was measured with the 14-item Type D Personality Scale （DS 14）. Mental health status was measured with the Hospital Anxiety and Depression Scale （HADS）. The QOL was assessed longitudinally by using the European Organization for Research and Treatment of Cancer （EORTC） QLQ-C30 and QLQ- CR38 questionnaires at the baseline and 6 months after diagnosis. Comparison between the type D personality group and non-type D personality group in social-demographic characteristics, clinicopathological features, mental health status, and QOL was performed. Results Of the 596 patients （92%） who responded, 131 patients （22%） had type D personality. （1） Compared with non-type D personality group, the proportions of patients with duration of symptoms≥ 1 month, without medical insurance, and emergency admissions in type D personality group were all higher, as well as the poor economic situation and more complication （P〈0.050）. （2） EORTC QLQ-C30. At the baseline, scores of role function, emotional function, cognitive function, social function, and overall health status in type D personality group were all lower than those of non-type D personality group （P〈0.050）, but scores of fatigue, constipation, and financial difficulties in type D personality group were all higher than those of non-type D personality group （P〈0.050）. In 6 months after diagnosis, scores of role function, emotional function, cognitive function, social function, and overall health status in type D personality group were all lower than those of non-type D personality group （P〈0.050）, but scores of fatigue, insomnia, constipation, and financial dif

关 键 词：D型人格 直肠癌 就诊途径 生存质量 精神健康状态 

分 类 号：R473.73[医药卫生—护理学]