乳腺癌患者首次化疗始于术前或术后的心理痛苦状况调查研究  

The first chemotherapy for breast cancer patients began with preoperative or postoperative psychological distress status investigation

作　　者：路莉静 孟爱凤[2] 程芳[1] 单靖眙[1] 于靖 智晓旭[2] LU Lijing;MENG Aifeng;CHENG Fang;SHAN Jingyi;YU Jing;ZHI Xiaoxu(Department of Breast Surgery,Jiangsu Cancer Hospital/Jiangsu Institute of Cancer Research/Nanjing Medical University Affiliated Cancer Hospital,Nanjing 210009,China;Department of Nursing,Jiangsu Cancer Hospital/Jiangsu Institute of Cancer Research/Nanjing Medical University Affiliated Cancer Hospital,Nanjing 210009,China)

机构地区：[1]江苏省肿瘤医院(江苏省肿瘤防治研究所,南京医科大学附属肿瘤医院)乳腺外科,江苏南京210009 [2]江苏省肿瘤医院(江苏省肿瘤防治研究所,南京医科大学附属肿瘤医院)护理部,江苏南京210009

出　　处：《医药高职教育与现代护理》2020年第6期434-437,共4页Medical Higher Vocational Education and Modern Nursing

基　　金：国家自然科学基金青年项目(71804073);江苏省卫生健康委员会干部保健项目(BJ18032);2020年江苏省研究生科研创新计划(SJCX20_0523)。

摘　　要：目的了解首次化疗时间开始于手术前和开始于手术后对乳腺癌患者所造成的心理痛苦是否不同及其特点。方法采用目的抽样方法选取2019年2月至9月在江苏省肿瘤医院接受首次化疗的216例乳腺癌患者为研究对象,其中新辅助化疗组(首次化疗始于术前)67例,术后化疗组(首次化疗始于术后)149例。采用心理痛苦管理筛查工具(DMSM)对患者进行调查,比较两组患者的心理痛苦状况。结果两组患者的心理痛苦评分差异有统计学意义(P<0.05),新辅助化疗组患者的心理痛苦评分(2.13±2.52)低于术后化疗组(2.88±2.67);术后化疗组中重度心理痛苦患者占比也高于新辅助化疗组,但差异无统计学意义(P>0.05)。引起新辅助化疗组患者心理痛苦相关问题居前三的分别是经济问题、紧张、担忧,术后化疗组患者则为无时间和精力做家务、无时间和精力照顾孩子/老人、紧张。结论化疗会引起乳腺癌患者出现不同程度的心理痛苦,首次化疗时间在手术后的比术前化疗的患者的心理痛苦程度更高,引起心理痛苦的主要问题也有所不同,提示宜早期开展针对性干预,从而改善患者负性情绪,提高其生活质量。Objective To investigate the differences and characteristics of psychological distress in breast cancer patients caused by initial chemotherapy before and after the surgery.Methods Purposive sampling method was used to select 216 breast cancer patients who received the initial chemotherapy in Jiangsu Cancer Hospital from February to September 2019,including 67 patients in the neoadjuvant chemotherapy(NAC)group(the first chemotherapy started before surgery)and 149 patients in the postoperative chemotherapy group(the first chemotherapy started after surgery).The Distress Management Screening Measure(DMSM)was used to investigate the psychological distress status of the two groups of patients.Results The psychological distress scores of the NAC group(2.13±2.52)were lower than that of the postoperative chemotherapy group(2.88±2.67).The proportion of patients with moderate to severe psychological distress in the postoperative chemotherapy group was also higher than that in the neoadjuvant chemotherapy group,but the difference was not statistically significant(P>0.05).Financial problems,tension,worry were the top three causes of psychological distress related problems in NAC group.And no time and energy to do housework and look after children/the elderly,as well as tension were the top three causes of psychological distress related problems in postoperative chemotherapy group.Conclusions Chemotherapy causes different degrees of psychological distress in breast cancer patients.Patients who received the first chemotherapy are higher degree of psychological distress after surgery.And the main problems related to psychological distress are also different.Targeted intervention should be carried out to improve the negative emotions of patients and improve their quality of life timely.

关 键 词：乳腺癌 心理痛苦 心理干预模式 术后化疗 新辅助化疗 

分 类 号：R73[医药卫生—肿瘤]