头颈肿瘤住院患者术前心理学特征初步分析  

Assessment of psychological status of inpatients with head and neck cancer before surgery

作　　者：李乐[1] 王斌全[2] 高太虎[1] 田俊[2] 

机构地区：[1]山西省肿瘤医院头颈外科一病区,太原030013 [2]山西医科大学第一医院耳鼻咽喉头颈外科,太原030001

出　　处：《中华耳鼻咽喉头颈外科杂志》2018年第1期21-26,共6页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：2015年山西医科大学博士启动基金（03201535）

摘　　要：目的对头颈肿瘤住院患者手术前的心理学特征进行评估。方法连续选取2015年9月至2016年12月间在山西省肿瘤医院行手术治疗的头颈恶性肿瘤患者237例，于手术前收集患者的一般资料并联合采用症状自评性量表（SCL-90）、Zung焦虑自评量表（SAS）、Zung抑郁自评量表（SDS）评估术前心理状态，采用SPSS 17.0软件进行统计学分析，与中国常模进行比较，P≤0.05有统计学意义。结果回收有效问卷228份，有效率96.2%。头颈肿瘤患者SCL-90（1.60±0.44，t＝3.093, P＝0.003）、SAS（46.67±8.51，t＝17.29, P＝0.001）、SDS（47.50±11.43，t＝4.29, P＝0.001）得分显著高于中国常模，差异有统计学意义。其中，SAS筛查阳性患者81例（35.5%）；SDS得分异常84例（36.8%），同时合并焦虑和抑郁的患者有42例（18.4%），SCL-90筛查患有精神病症状的患者75例（32.9%）。头颈肿瘤患者躯体化、强迫、焦虑、敌对、恐怖、精神病性因子得分显著高于中国常模（t值分别为4.47、3.04、2.87、2.58、5.46、4.15, P值均〈0.05）。结论头颈肿瘤住院患者手术前焦虑抑郁等情绪明显高于普通人群，术前采用适当的心理测量工具对头颈肿瘤患者心理健康状态进行评估对患者的全面诊断和综合治疗均具有重要的临床意义。ObjectiveTo investigate the prevalence and psychosocial characteristics in inpatients with head and neck cancer before surgery.MethodFrom September 2015 to December 2016, 237 consecutive inpatients with head and neck cancer who had been scheduled for surgery were prospectively enrolled in Department of Head and Neck Surgery of Shanxi Provincial Tumor Hospital. Mental health symptoms were systematically investigated using three psychological instruments： symptom checklist-90 （SCL-90）, Zung self-rating anxiety scale （SAS） and Zung self-rating depression scale （SDS）. SPSS 17.0 software was used to analyze the data. And he results of SCL-90, SAS and SDS were compared with the Chinese norm. For all statistical analyses, a P value 〈0.05 was considered statistically significant.ResultOf 237 patients, 228 （96.2%） completed all the questionnaire. The scores of SCL-90 （1.60±0.44）, SAS （46.67±8.51）and SDS（47.50±11.43）in patients with head and neck cancer were significantly higher than those of Chinese norm （t=3.093, t=17.29, t=4.29 respectively and P=0.003, P=0.001, P=0.001 respectively）. Positive proportion identified by three measure tools are 32.9%, 35.5% and 36.8% respectively. And 42 patients （18.4%） suffered from both anxiety and depression. The SCL-90 scores were significantly higher than those of the normal standard population, including dimension of somatization obsessive-compulsive, anxiety, hostility, phobic-anxiety and psychoticism （t=4.47, 3.04, 2.87, 2.58, 5.46, 4.15 respectively, all P〈0.05）.ConclusionsThis study offers important information regarding psychological status in inpatients with head and neck cancer before surgery. Identifying these patients using proper screening instrument is of great important clinical implications for the early detection, management, and reduction of the distress associated with head and neck cancer.

关 键 词：头颈部肿瘤 心理健康 焦虑 抑郁 

分 类 号：R739.91[医药卫生—肿瘤]