乳腺癌患者全乳切除术后心理健康状况调查及其影响因素分析  

Surveys of postoperative psychological health status and analysis of its influencing factors in breast cancer patients undergoing total mastectomy

作　　者：董巍 符冬梅 石华歌 杨保枝[1] Dong Wei;Fu Dongmei;Shi Huage;Yang Baozhi(The Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450015,Henan,China)

机构地区：[1]郑州大学第三附属医院,河南郑州450015

出　　处：《临床心身疾病杂志》2025年第2期116-120,共5页Journal of Clinical Psychosomatic Diseases

基　　金：河南省医学科技攻关计划联合共建项目(编号LHGJ20220522)。

摘　　要：目的 探讨乳腺癌患者全乳切除术后心理健康状况及其影响因素。方法 将152例行全乳切除术的乳腺癌患者作为研究对象,收集相关临床资料。采用医院焦虑抑郁量表(HADS)评估乳腺癌患者全乳切除术后焦虑和抑郁状况,并根据是否出现焦虑、抑郁症状分为焦虑组(67例)和非焦虑组(85例),抑郁组(62例)和非抑郁组(90例)。通过随访,采用匹兹堡睡眠质量指数(PSQI)评估患者睡眠质量。采用Logistic回归分析探讨影响乳腺癌患者全乳切除术后焦虑、抑郁的影响因素。结果 焦虑组患者家庭月收入>5 000元、已婚、有医疗保险占比低于非焦虑组,肿瘤分期Ⅲ期、睡眠障碍占比高于非焦虑组(P<0.05或0.01);抑郁组患者家庭月收入>5 000元、已婚、有医疗保险占比低于非抑郁组,肿瘤分期Ⅲ期、睡眠障碍、辅助化学治疗占比高于非抑郁组(P<0.05或0.01)。多因素Logistic回归分析结果显示,家庭月收入≤5 000元,未婚、离婚或丧偶,无医疗保险,睡眠障碍是乳腺癌患者全乳切除术后焦虑、抑郁的危险因素(P<0.01)。结论 乳腺癌患者全乳切除术后焦虑和抑郁的发生率较高,其影响因素较多,临床应根据其影响因素开展针对性干预,改善其心理健康状况。Objective To explore the postoperative mental health status and its influencing factors of breast cancer patients undergoing total mastectomy.Methods A total of 152 breast cancer patients undergoing total mastectomy were set as research objects and relevant clinical data collected.The Hospital Anxiety and Depression Scale(HADS)was used to assess postoperative anxiety and depression status of the patients and they were divided into anxiety(n=67),non-anxiety(n=85),depression(n=62),and non-depression(n=90)group according to the occurrence of anxious and depressive symptoms or not.The Pittsburgh Sleep Quality Index(PSQI)was used to evaluate patients'sleep quality during follow-up.Logistic regression was used to analyze the influencing factors of postoperative anxiety and depression in the patients.Results The proportion of monthly household income>5,000 yuan,married and medical insurance was lower and that of stage III tumor and sleep disorders higher in anxiety than non-anxiety group(P<0.05 or 0.01);the proportion of monthly household income>5,000 yuan,married and medical insurance was lower and that of stage III tumor,sleep disorders and adjuvant chemotherapy higher in depression than non-depression group(P<0.05 or 0.01).Multi-factor Logistic regression analysis showed that monthly household income≤5,000 yuan,unmarried,divorced or widowed,no medical insurance,sleep disorders are risk factors of post-operative anxiety and depression in breast cancer patients undergoing total mastectomy(P<0.01).Conclusion Incidences of post-operative anxiety and depression in breast cancer patients undergoing total mastectomy are higher,their influencing factors are more,and clinically targeted interventions should be carried out according to their influencing factors to improve psychological status.

关 键 词：乳腺癌 全乳切除术 心理健康 影响因素 

分 类 号：R737.9[医药卫生—肿瘤] R395.6[医药卫生—临床医学]