乳腺癌术后患者病耻感影响因素分析及与自尊、生活质量和心理社会适应能力的关系  

Influencing Factors of Stigma in Breast Cancer Patients after Operation and Its Relationship with Self-esteem,Quality of Life and Psychosocial Adaptability

作　　者：肖海敏[1] 周鲜艳[1] 张晓娟[1] 李娜[1] 李兴珍[2] XIAO Hai-min;ZHOU Xian-yan;ZHANG Xiao-juan;LI Na;LI Xing-zhen(First Department of General Surgery,Shaanxi Provincial People's Hospital,Xi'an,Shaanxi,710068,China;Department of Emergency Surgery,Shaanxi Provincial People's Hospital,Xi'an,Shaanxi,710068,China)

机构地区：[1]陕西省人民医院普外一科,陕西西安710068 [2]陕西省人民医院急诊外科,陕西西安710068

出　　处：《现代生物医学进展》2021年第23期4522-4526,4568,共6页Progress in Modern Biomedicine

基　　金：陕西省科技厅社会发展领域重点研发项目(2016KTCL03-05)。

摘　　要：目的:分析乳腺癌术后患者病耻感的影响因素,并探讨病耻感与自尊、生活质量和心理社会适应能力的关系。方法:选取2017年2月~2020年4月期间我院收治的经乳腺癌改良根治术患者83例,均为女性。采用自行设计的一般资料调查问卷收集患者的临床资料,采用社会影响量表(SIS)对患者的病耻感进行调查。采用乳腺癌心理社会适应问卷、欧洲生命质量核心问卷(EORTC QLQ-C30)、自尊量表(SES)评价患者的心理社会适应能力、生活质量和自尊。采用Pearson相关分析法分析SIS评分与SES、EORTC QLQ-C30和乳腺癌心理社会适应问卷评分的关系。采用单因素及多因素Logistic回归分析乳腺癌术后患者病耻感的影响因素。结果:本研究总计发放83份调查问卷,回收到3份无效问卷,80份有效问卷,有效回收率96.39%(80/83)。乳腺癌术后患者社会排斥、经济歧视、内在羞愧、社会隔离评分和总评分均高于国内常模(P<0.05)。乳腺癌术后患者SES、EORTC QLQ-C30和心理社会适应能力评分低于国内常模(P<0.05)。乳腺癌术后患者SIS总评分与SES、EORTC QLQ-C30和乳腺癌心理社会适应问卷评分呈负相关(P<0.05)。不同婚姻状况、文化程度、家庭人均月收入、年龄、职业、居住地患者的SIS评分差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄≤39岁、职业情况为兼职或其他、婚姻状况为未婚/离异/丧偶、家庭人均月收入<3000元、文化程度大专及以下、居住地为农村均是乳腺癌术后患者病耻感的影响因素(P<0.05)。结论:乳腺癌术后患者存在明显的术后病耻感,年龄、职业、婚姻状况、家庭人均月收入、文化程度以及居住地均会对乳腺癌术后患者病耻感产生影响,且病耻感与患者自尊、生活质量和心理社会适应能力息息相关。Objective:To analyze the influencing factors of stigma in patients with breast cancer after operation,and to explore the relationship between stigma and self-esteem,quality of life and psychosocial adaptability.Methods:83 patients with modified radical mastectomy who were admitted in our hospital from February 2017 to April 2020 were selected,all women.The clinical data were collected by self-designed general information questionnaire,the social impact scale(SIS)was used to investigate the stigma of patients.The psychosocial adaptability,quality of life and self-esteem of patients with breast cancer were evaluated by psychosocial adaptation questionnaire for breast cancer,European core quality of life questionnaire(EORTC QLQ-C30),self esteem scale(SES)which were designed by Cheng ran and Wang Aiping.Pearson correlation analysis was used to analyze the relationship between SIS score and SES,EORTC QLQ-C30 and psychosocial adaptation questionnaire score of breast cancer.Univariate and multivariate logistic regression were used to analyze the influencing factors of stigma in breast cancer patients.Results:A total of 83 questionnaires were distributed in this study,3 invalid questionnaires and 80 valid questionnaires were recovered.The effective recovery rate was 96.39%(80/83).The scores of social exclusion,economic discrimination,internal shame,social isolation and total score were higher than the domestic norm(P<0.05).The scores of SES,EORTC QLQ-C30 and psychosocial adaptability of postoperative breast cancer patients were lower than the domestic norm(P<0.05).There was a negative correlation between SIS score and SES,EORTC QLQ-C30 and psychosocial adaptation questionnaire in breast cancer patients(P<0.05).There were significant differences in SIS scores among breast cancer patients with different marital status,education level,family average monthly income,age,occupation status,residence(P<0.05).Multivariate logistic regression analysis showed that,Age≤39 years old,part-time or other occupation,marital status of u

关 键 词：乳腺癌 改良根治术 病耻感 自尊 生活质量 心理社会适应能力 

分 类 号：R737.9[医药卫生—肿瘤] R493[医药卫生—临床医学]