巴楚医学

目的:调查城乡晚期肿瘤患者的心理痛苦和生命质量,分析两者之间的相关性和城乡差异,为制定有效的干预方案提供参考。方法:采用随机抽样的方法选择2018年4月~2018年10月期间住院的城乡晚期肿瘤患者,应用心理痛苦管理筛查工具、癌症患者生命质量测定量表和一般情况调查表对其心理痛苦和生命质量进行调查。结果:本研究共纳入308例晚期肿瘤患者,49.35%有显著心理痛苦(DT≥4分)。性别、受教育程度、经济状况和体力状况是影响其心理痛苦的主要因素。乡村患者较城市患者心理痛苦程度高(P=0.006),显著心理痛苦检出率更高(P=0.017)。乡村患者的生理状况、社会/家庭状况较城市患者差(P=0.046,P=0.040),而情感状况较城市患者好(P=0.038)。城乡患者心理痛苦程度与生命质量呈负相关,生理状况与心理痛苦程度呈较强相关(r=-0.573,r=-0.566),情感状况与心理痛苦程度均呈强相关(r=-0.776,r=-0.811)。在心理痛苦程度低(DT 0³分)的患者中,乡村患者的社会/家庭状况与心理痛苦程度的相关性较城市患者弱(r=-0.366vs r=-0.573),而功能状况与心理痛苦程度的相关性较城市患者强(r=-0.504vs r=-0.391)。结论:晚期肿瘤患者伴随着较为严重的心理痛苦,以乡村患者为甚,在生理状况、社会和家庭状况方面存在较多问题。心理痛苦程度与生命质量密切相关、互为影响。

Objective:To investigate the psychological distress and life quality in patients with advanced cancer in urban and rural areas,analyze the correlation between them,distinguish differences between the urban and the rural area,so as to provide reference for formulating effective intervention programs.Methods:Patients with advanced tumors who were hospitalized from April 2018 to October 2018 in urban and rural areas were selected for the further study using random sampling method.The evaluating tools,including psychological distress management screening,quality of life measurement for cancer patients and general situation questionnaire were used to investigate their psychological distress and life quality.Results:There were 308 cases of advanced cancer enrolled,with the detection rate of significant psychological distress(DT more than4)up to 49.35%.Gender,education,economic status,and physical status were the main influence factors of psychological distress.The degree of psychological distress and the detection rate of significant psychological distress were both higher in rural patients than those of urban patients(P =0.006,P =0.017).The physiological and social/family status were worse(P=0.046,P=0.040),while the emotional status was better(P=0.038)in rural patients than those of urban patients.The degree of psychological distress was negatively correlated with the life quality.The physiological status had a bit strong correlation with the degree of psychological distress in urban and rural patients(r=-0.573,r=-0.566).Moreover,the emotional status was strongly correlated with psychological distress(r=-0.776,r=-0.811).Among patients with low degree of psychological distress(DT 0 to 3),the correlation between social/family status and psychological distress was weaker,while the correlation between functional status and psychological distress was stronger in rural patients than that of urban patients(r=-0.366 vs r=-0.573;r=-0.504 vs r=-0.391),respectively.Conclusion:The patients with advanced cancer are facing more serious psychological distress,especially in rural areas.There are many problems with rural patients in terms of physical,social and family status.The degree of psychological distress is closely related to the life quality.