肺癌放疗前患者心理痛苦状况及相关因素分析  

Study of psychological distress and relative influencing factors analysis of lung cancer patients before receiving radiotherapy

作　　者：章敏 谢淑萍[1] 杨希[1] 沈佳琴[1] 叶英俊[1] 叶丽娟 王天泓 杨思雨[1] 王瑾 胡晓[1] 

机构地区：[1]浙江省放射治疗重点实验室浙江省肿瘤医院胸部放疗科,浙江杭州310022

出　　处：《中华全科医学》2018年第3期488-491,共4页Chinese Journal of General Practice

基　　金：浙江省中医药科技计划项目(2018ZB023)

摘　　要：目的探讨肺癌放疗前患者的心理痛苦发生情况及其相关因素,为临床个体化的心理干预治疗提供依据。方法使用一般资料问卷和心理痛苦温度计(DT),对2015年5月—2016年2月浙江省肿瘤医院住院的237例患者进行横断面调查,收集到的资料录入Excel,采用SPSS 19.0统计软件对数据进行统计学分析,P<0.05为差异有统计学意义。结果 DT<4分占89.9%(213/237),有显著心理痛苦(DT≥4分)占比为10.1%(24/237)。影响心理痛苦相关因素前10位的心理痛苦相关因素调查表(problem list,PL)问题分别为经济问题、担忧、无时间精力照顾孩子/老人、便秘、无时间精力做家务、头晕、睡眠问题、与孩子/老人相处、呼吸、疼痛。心理痛苦相关因素占比为情绪问题28.7%(68/237),身体问题38.4%(91/237),实际问题28.7%(68/237),交往问题10.5%(25/237),宗教信仰问题0.8%(2/237)。Spearman相关分析显示,性别与心理痛苦不相关(r=0.103,P=0.113),年龄、治疗方式与心理痛苦呈正相关(r=0.718,P<0.001;r=0.891,P<0.001),而学历水平与心理痛苦呈负相关(r=-0.399,P<0.001)。结论肺癌放疗患者心理痛苦以轻度为主,年龄、学历水平、治疗方式是心理痛苦评分的独立影响因素,经济问题、担忧、无时间精力照顾孩子/老人、便秘、无时间精力做家务是引起心理痛苦的关键因素,这些因素将成为减轻肺癌放疗患者心理痛苦的干预点。Objective To investigate the degree of psychological distress before radiotherapy in patients with lung cancer,and analyze the related factors of distress for providing basis of clinical individual psychological intervention strategies. Methods Through the general information and psychological distress thermometer（ DT）,237 subjects of lung cancer who had been treated before radiotherapy were selected by the cross-sectional survey admitted to Zhejiang Cancer Hospital from May,2015 to February,2016. Data were entered into Excel after investigation,and using SPSS 19. 0 for statistical analysis,P 0. 05 indicating statistically significant differences. Results Lung cancer patients of psychological distress（ DT 4） accounted for 89. 9%（ 213/237）. The significant frequency of psychological distress（ DT≥4） was10. 1%（ 24/237）. The main PL cause of lung cancer psychological distress ranking in the top 10 were economic problems,fear,child care,constipation,housing,dizziness,sleep problems,dealing with children/the old man,breathing,and pain. The psychological distress factors accounted for emotional problems 28. 7%（ 68/237）,physical problems38. 4%（ 91/237）,practical problems 28. 7%（ 68/237）,communication problems 10. 5%（ 25/237）,and religious beliefs 0. 8%（ 2/237）. The Spearman correlation analysis showed that gender and psychological distress was not statistically significant（ r = 0. 103,P = 0. 113）. Age and therapy method were positively related with psychological distress（ r =0. 718,P〈 0. 001; r = 0. 891,P〈 0. 001） and education level was negatively correlated with psychological distress（ r =-0. 399,P〈 0. 001）. Conclusion The psychological distress for lung cancer radiotherapy patients is given priority to with mild. The age,education level and treatment are the independent factors of affecting psychological DT. The key factors of causing psychological distress are economic problems,fear,child care,constipation,housing,which may provide the right way to relieve t

关 键 词：肺癌 心理痛苦 相关因素分析 放疗 

分 类 号：R734.2[医药卫生—肿瘤] R730.55[医药卫生—临床医学]