乳腺癌病人不同时间段焦虑抑郁情绪与生命质量关系分析

杨婷婷; 刘春芳; 王孜恒; 季红敏; 李仪; 李秀川

doi:10.13898/j.cnki.issn.1000-2200.2021.06.031

乳腺癌病人不同时间段焦虑抑郁情绪与生命质量关系分析

Relationship between anxiety, depression and quality of life in breast cancer patients at different time periods

摘要

摘要:
目的分析乳腺癌病人不同时间段焦虑抑郁情绪发生情况以及相关影响因素。
方法采用焦虑自评量表、抑郁自评量表、EORTC生命质量测定量表对82例乳腺癌病人分别在其术前、第4周期化疗、第8周期化疗进行问卷调查。
结果与术前比较，乳腺癌病人焦虑和抑郁评分均在第4周期化疗明显升高（P < 0.01），第8周期化疗恢复到术前。生命质量核心量表各维度得分中的情绪功能、角色功能、社会功能、认知功能、失眠、疲劳、食欲丧失、恶心与呕吐、便秘、经济困难、整体健康状况11个维度在不同时间段差异有统计学意义（P < 0.05~P < 0.01），躯体功能、疼痛、气促、腹泻4个维度在不同时间段差异无统计学意义（P>0.05）。多元线性回归分析显示，年龄大、文化程度低、整体健康状况差低是术前焦虑的危险因素（P < 0.05~P < 0.01）；出现恶心与呕吐、食欲丧失症状是第4周期化疗时焦虑的危险因素（P < 0.05）；认知功能评分低和出现恶心与呕吐是第8周期化疗焦虑的危险因素（P < 0.05）。在职、未婚姻、文化程度低与失眠是术前抑郁的危险因素（P < 0.01）；便秘、疲劳、认知功能低与经济困难是第4周期化疗时抑郁的危险因素（P < 0.05）；经济困难与整体健康状况差是第8周期化疗时抑郁的危险因素（P < 0.05和P < 0.01）。
结论医护人员应加强乳腺癌病人各阶段的心理护理，尤其是第4周期化疗，采取针对性方法处理化疗出现的不良症状可以减轻病人的焦虑抑郁情绪。

Abstract:
ObjectiveTo analyze the occurrence of anxiety and depression in breast cancer patients at different time periods, and its related influencing factors.
MethodsEighty-two breast cancer patients were investigated using the anxiety self-rating scale, depression self-rating scale and EORTC quality of life measurement scale before surgery, and at the fourth cycle and eighth of chemotherapy.
ResultsCompared before operation, the anxiety and depression scores of breast cancer patients significantly increased in the fourth cycle of chemotherapy(P < 0.01), and returned to the preoperative level in the eighth cycle of chemotherapy(P>0.05).Among different time periods, the differences of the emotional function, role function, social function, cognitive function, insomnia, fatigue, loss of appetite, nausea and vomiting, constipation, economic difficulties and overall health status of 11 dimensions of the core quality of life scale were statistically significant(P < 0.05 to P < 0.01), and there was no statistical significance in the four dimensions of physical function, pain, shortness of breath and diarrhea(P>0.05).The results of multiple linear regression analysis showed that the older age, lower education level and poor overall health status were the risk factors of preoperative anxiety(P < 0.05 to P < 0.01), the nausea, vomiting and loss of appetite were the risk factors of anxiety in the fourth cycle of chemotherapy(P < 0.05), and the low cognitive function score, nausea and vomiting were the risk factors of anxiety in the eighth cycle of chemotherapy(P < 0.05).The employment, non-marriage, low educational level and insomnia were the risk factors of preoperative depression(P < 0.01), the constipation, fatigue, low cognitive function and economic difficulties were the risk factors of depression in the fourth cycle of chemotherapy(P < 0.05), and the financial hardship and poor overall health status were the risk factors of depression in the eighth cycle of chemotherapy(P < 0.05 and P < 0.01).
ConclusionsMedical staff should strengthen the psychological nursing of breast cancer patients at all stages, especially the fourth cycle of chemotherapy.Taking targeted methods to deal with the adverse symptoms of chemotherapy can reduce the anxiety and depression of patients.

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