年轻女性进展期乳腺癌患者的死亡焦虑及相关因素  

Death anxiety and related factors in young women with advanced breast cancer

作　　者：周雨禾 庞英[1] 韩鑫坤 何双智 李金江[1] 唐丽丽[1] ZHOU Yuhe;PANG Ying;HAN Xinkun;HE Shuangzhi;LI Jinjiang;TANG Lili(Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing),Department of Psycho-Oncology,Peking University Cancer Hospital&Institute,Beijing 100142,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所康复科,恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《中国心理卫生杂志》2020年第11期891-897,共7页Chinese Mental Health Journal

基　　金：北京市卫生与健康科技成果和适宜技术推广项目(2018-TG-48)。

摘　　要：目的:了解年轻女性进展期乳腺癌患者的死亡焦虑现状及相关因素,为进行死亡焦虑筛查及干预提供初步参考。方法:选取年龄≤50岁的年轻女性进展期乳腺癌患者109例,使用死亡和临终痛苦量表(DADDS)、9条目病人健康问卷(PHQ-9)、广泛性焦虑自评量表(GAD-7)、生命末期生活质量问卷(QUAL-EC)、多维领悟社会支持量表(MSPSS)和慢病治疗功能评价-灵性健康量表(FACIT-Sp)进行评估,用多元logistic回归模型分析死亡焦虑的相关因素。结果:本样本死亡焦虑的检出率为37.6%,焦虑、抑郁的检出率分别为25.7%和20.2%,低社会支持者占总体样本的2.8%,QUAL-EC的四个分量表与FACIT-Sp的得分分别为(10.42±2.78)分、(19.99±3.75)分、(10.26±4.05)分、(20.79±4.42)分和(29.27±11.05)分。多元logistic回归结果显示,有焦虑和有宗教信仰是死亡焦虑的危险因素(OR=25.17、4.52),与医护人员关系良好和更好的生命末期准备是死亡焦虑的保护因素(OR=0.83、0.75)。结论:在年轻女性进展期乳腺癌群体中,死亡焦虑是普遍存在的精神健康问题,制订干预方案时应加以考虑。Objective:To investigate the prevalence of death anxiety in young women with advanced breast cancer and to explore the related factors of death anxiety in this population.Methods:Totally 109young women with advanced breast cancer,who aged younger than or equal to 50years old were selected.They were assessed with the Death and Dying Anxiety Scale(DADDS),Patient Health Questionnaire-9(PHQ-9),General Anxiety Disorder-7(GAD-7),Quality of Life at the End of Life(QUAL-EC),Multidimensional Scale of Perceived Social Support(MSPSS)and Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale(FACIT-Sp).Multiple logistic regression model was used to analyze the related factors of death anxiety.Result:The detection rate of death anxiety was 37.6%.The detection rates of anxiety and depression were 25.7%and 20.2%,and the low social support accounted for 2.8%of the total sample,the scores of the four subscales of QUAL-EC and FACIT-Sp were(10.42±2.78),(19.99±3.75),(10.26±4.05),(20.79±4.42)and(29.27±11.05)respectively.Multiple logistic regression models showed anxiety and religious belief(OR=25.17,4.52)were risk factors for death anxiety,while a good relationship with healthcare providers and better preparation for end-of-life(OR=0.83,0.75)were protective factors.Conclusion:It suggests that death anxiety is common mental health problem in young women with advanced breast cancer,and it should be considered when designing interventions.

关 键 词：死亡焦虑 进展期乳腺癌 年轻女性 

分 类 号：R749.72[医药卫生—神经病学与精神病学] R737.9[医药卫生—临床医学]