综合医院住院化疗恶性肿瘤患者的精神症状及其影响因素  

Mental symptoms and its influencing factors of patients with malignant tumor undergoing chemotherapy in general hospital

作　　者：李园园 黄啸 马丽华 刘文娟 王周烨[3] 季建林 Li Yuanyuan;Huang Xiao;Ma Lihua;Liu Wenjuan;Wang Zhouye;Ji Jianlin(Department of Psychological Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Nursing Department,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Medical Psychology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]复旦大学附属中山医院心理医学科,上海200032 [2]复旦大学附属中山医院护理部,上海200032 [3]上海交通大学医学院附属新华医院临床心理科,200092

出　　处：《中华行为医学与脑科学杂志》2021年第12期1107-1111,共5页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：上海市公共卫生体系建设三年行动计划优秀学科带头人(心理和精神卫生,GWV-10.2-XD26);上海市精神心理疾病临床医学研究中心(19MC1911100)。

摘　　要：目的使用DSM-5跨界症状一级量表对综合医院住院化疗的恶性肿瘤患者进行评估,调查患者精神症状出现的情况并分析影响因素。方法选取在复旦大学附属中山医院住院化疗的恶性肿瘤患者共314例,运用DSM-5跨界症状一级量表对患者进行评估,调查患者各种精神症状的出现情况并进行影响因素分析。采用SPSS 25.0进行χ^(2)检验,Pearson相关分析和多元回归分析。结果正在接受化疗的恶性肿瘤患者伴有多种精神症状,最常见的包括抑郁症状(85/314,27.1%)、躯体症状(79/314,25.2%)、躁狂症状(78/314,24.5%)、焦虑症状(76/314,24.3%)。由其他人员进行照顾的肿瘤患者(26/64,40.6%)焦虑症状的发生率明显高于由直系亲属进行照料的患者(50/250,20.0%)(χ^(2)=12.23,P<0.05);工作状况不稳定的肿瘤患者更容易出抑郁症状(χ^(2)=7.64,P<0.05)。肿瘤患者对疾病的了解程度与抑郁症状、躯体症状、躁狂症状、焦虑症状评分以及精神症状总分呈显著负相关(r=-0.26,-0.15,-0.12,-0.25,-0.22,均P<0.05)。肿瘤患者的精神症状总分还与家庭负担和家庭状况呈显著正相关(r=0.11,0.11,均P<0.05),与患者的受教育年限呈显著负相关(r=-0.13,P<0.05)。多元回归分析结果显示,对疾病的了解程度(β=-0.203)和家庭状况(β=0.197)是综合医院住院化疗恶性肿瘤患者精神症状的影响因素(F=13.653,P<0.001)。结论正在接受化疗的恶性肿瘤患者发生率较高的主要有抑郁症状、躯体症状、躁狂症状和焦虑症状,对疾病的了解程度和家庭情况是其主要的影响因素。Objective To estimate the mental symptoms in malignant tumor patients undergoing chemotherapy using DSM-5 cross cutting symptom measure.Methods A total of 314 patients who undergoing chemotherapy in oncology department of Zhongshan Hospital,Fudan University who met all standards were chosen.The DSM-5 cross cutting symptom measure Level 1 Scale was used to assess the mental symptoms of the patients.SPSS 25.0 software was used forχ^(2) test,Pearson correlation analysis and multiple regression analysis.Results The most common symptoms in the patients were depressive symptoms(85/314,27.1%),somatic symptoms(79/314,25.2%),manic symptoms(78/314,24.5%)and anxiety symptoms(76/314,24.3%).The proportion of anxiety symptoms in malignant tumor patients who were taken care of by other personnel(26/64,40.6%)was significantly higher than that in patients who were taken care of by immediate relatives(50/250,20.0%)(χ^(2)=12.23,P<0.05).Patients with unstable working conditions were more likely to have depressive symptoms(χ^(2)=7.64,P<0.05).There was a significant negative correlation between the patients'understanding of the disease and their scores of depressive symptoms,somatic symptoms,manic symptoms,anxiety symptoms and the total score of mental symptoms(r=-0.26,-0.15,-0.12,-0.25,-0.22,all P<0.05).In addition,the total score of mental symptoms of malignant tumor patients was significantly positively correlated with family burden and family status(r=0.11,0.11,both P<0.05),and negatively correlated with patients'education(r=-0.13,P<0.05).Multiple regression analysis showed that the degree of understanding of the disease(β=-0.203)and family status(β=0.197)were the influencing factors of mental symptoms of inpatients malignant tumors undergoing chemotherapy in general hospital(F=13.653,P<0.001).Conclusion Malignant tumor patients undergoing chemotherapy may have a variety of mental symptoms.The high incidence mainly includes depressive symptoms,somatic symptoms,manic symptoms and anxiety symptoms.The understanding of the patie

关 键 词：恶性肿瘤 化疗 精神症状 DSM-5跨界症状量表 

分 类 号：R730.53[医药卫生—肿瘤]