目的性反刍性沉思与家庭环境交互作用对首诊前列腺癌骨转移老年患者心理痛苦的影响

目的 分析首诊前列腺癌骨转移老年患者的目的性反刍性沉思与家庭环境及二者交互作用对心理痛苦的影响,为后期提供针对性降低患者心理痛苦水平的干预方法提供依据。 方法 于2015年12月—2017年12月选取唐山市人民医院首诊为前列腺癌骨转移的老年患者471例,根据心理痛苦温度计(DT)问卷评测结果分为轻中度心理痛苦组212例和重度心理痛苦组259例。同时应用中文版目的性反刍性沉思分量表(C-ERRI)、家庭亲密度和适应性量表(FACES Ⅱ)、视觉模拟评分表(VAS)和自制的一般资料调查表进行调查。 结果 单因素分析显示2组在年龄、Gleason评分、合并慢性疾病情况、疼痛评分、家庭环境和目的性反刍性沉思水平等分布情况上差异有统计学意义(均P＜0.05);多因素logistic回归分析在调整了年龄、疼痛评分、合并慢性疾病等因素后,低水平目的性反刍性沉思、家庭环境一般老年前列腺癌患者严重心理痛苦发生风险显著增高,OR(95% CI)分别为2.944(1.891～4.584)、3.670(2.347～5.737);相加交互模型结果显示低水平目的性反刍性沉思及家庭环境一般的患者较高水平目的性反刍性沉思及家庭环境良好者严重心理痛苦发生风险显著增高,OR(95% CI)为12.252(7.660～13.691),两者交互作用指数(SI)和交互作用归因百分比(AP)分别为11.322(7.242～12.622)和19.710%。 结论 低水平目的性反刍性沉思与家庭环境一般是初首诊老年前列腺癌骨转移患者严重心理痛苦的危险因素,二者存在一定交互作用。 

Interaction of rumination meditations in purpose and family environment on psychological pain in elderly patients with first diagnosed bone metastasis of prostate cancer

Objective To investigate the influence of interaction of rumination meditations in purpose and family environment on psychological pain in elderly patients with first diagnosed bone metastasis of prostate cancer, so as to provide insights for further intervention approaches foe reducing the psychological pain of patients. Methods We selected 471 cases of elderly patients with first diagnosed bone metastasis of prostate cancer from December 2015 to December 2017 treated in Tangshan People's Hospital and they were divided into mild-moderate psychological pain group (n=212) and severe psychological pain group (n=259) according to the scores of distress thermometer (Distress Thermometer,DT). Meanwhile, all subjects were investigated using the Chinese Version of Event Related Rumination Inventory (C-ERRI), Family Adaptability and Cohesion Scale Ⅱ (FACES Ⅱ), Visual Analog Scale (VAS) and the general material lists. Results Univariate analysis showed that the psychological pain was statistically significant in patients age, Gleason score, pain score, ruminant meditation level and family environment on the distribution difference (all P<0.05). Multiple regression analysis displayed that after adjusting age, pain score, combined with chronic disease, low level of ruminant meditation and general family environment significantly increased the risk of severe psychological pain in patients and the OR (95%CI) respective 2.944(1.891-4.584) and 3.670(2.347-5.737). Additive interaction analysis showed that those with low level of ruminant meditations and general family environment increased the risk of severe psychological pain than those with high level of ruminant meditations and good family environment OR(95%CI)=12.252(7.660-13.691). The synergy index (SI) and attributable proportion due to interaction (AP) were 11.322(7.242-12.622) and 19.710%, respectively. Conclusion Low level of rumination meditations in purpose and general family environment are risk factors of psychological pain in patients with first diagnosed bone metastasis of prostate cancer, and there might be interaction between them.