直肠癌造口患者术后心理健康、应对方式与生存质量的相关性

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[目的]分析直肠癌造口患者术后心理健康、应对方式的特点和生存质量,探讨三者之间的关系。[方法]选取直肠癌造口手术患者150例,采用症状自评量表(SCL-90)、癌症患者生存质量核心量表(EORTC QLQ-C30)、和医学应对问卷(MCMQ)分别测评患者的心理健康状况、生存质量状况和应对方式。[结果]直肠癌造口患者术后SCL-90总分为179.898分,高于全国常模160分。直肠癌造口患者术后面对因子、回避因子、屈服因子得分依次降低。肠癌造口患者术后总体健康状况得分、躯体功能、角色功能、认知功能得分低于参考值;疲乏症状、睡眠困难、经济困难得分高于参考值。直肠癌造口患者术后SCL-90总分与患者总体健康状况、躯体功能、角色功能、认知功能得分呈负相关,与疲乏、睡眠困难、经济困难得分呈正相关;应对方式中,面对因子与患者总体健康状况、躯体功能、社会功能呈正相关,与疲乏、疼痛、经济困难呈负相关;回避因子与食欲下降呈正相关;屈服因子与总体健康状况、认知功能、情绪功能、社会功能呈负相关,与疲乏、疼痛、恶性呕吐、呼吸困难、睡眠困难、食欲下降、便秘、经济困难呈正相关。[结论]直肠癌造口术后患者术后存在一定的心理健康问题。健康的心理状况、多采取积极的应对方式,有助于提高患者直肠癌造口术后生存质量水平。 [Objective] To analyze the postoperative mental health, characteristics of coping style and quality of life of rectal cancer patients and discuss the relationship among the three. [Methods] 150 patients with rectal cancer ostomy were selected and assessed by SCL-90, EORTC QLQ-C30 and MCMQ. Mental health, quality of life, and coping styles. [Results] The total score of SCL-90 after operation was 179.898, which was higher than the national norm 160. The scores of face factor, avoidance factor, and yield factor of patients with rectal cancer and stoma decreased in turn. The scores of total health status, physical function, role function, and cognitive function scores of patients with colorectal cancer after surgery were lower than the reference values; fatigue symptoms, sleep difficulties, and economic difficulties scored higher than the reference values. The total score of SCL-90 in patients with rectal cancer and stoma was negatively correlated with the overall health status, physical function, role function, cognitive function scores, and was positively correlated with fatigue, difficulty in sleep, and economic difficulty scores; Factors positively correlated with overall patient health status, physical function, and social function, and negatively correlated with fatigue, pain, and economic difficulties; avoidance factors were positively correlated with decreased appetite; yield factors and general health status, cognitive function, emotional function, social function Negative correlation was positively correlated with fatigue, pain, nausea, vomiting, dyspnea, sleep difficulties, decreased appetite, constipation, and economic difficulties. [Conclusion] There are certain mental health problems after rectal cancer patients. Healthy psychological conditions and more active responses can help improve the quality of life of patients with rectal cancer after ostomy.
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