年轻乳腺癌患者心理健康状况与心理需求的测评和分析

目的 探讨年轻乳腺癌患者的心理健康状况以及心理需求,为制定临床决策,给予患者社会支持,开展关怀计 划提供参考。方法 选取于我院就诊的年龄小于35 岁的乳腺疾病患者 74 例,经病理证实 50 例恶性患者为研究组,24 例 良性者为对照组。采用艾森克人格量表、焦虑和抑郁评价量表评测患者的心理健康状态,通过心理需求调查表,对患者 关注的心理需求实施调查,并采用社会支持评定量表调查患者的社会支持利用程度。调查方法采用面谈和电话回访。记 录并统计分析得分。结果 年轻乳腺癌患者存在明显的焦虑、抑郁状态及神经质倾向（t1=5.439,t2=1.454,t3=3.758,P ＜ 0.05）。心理需求主要集中在治疗费用、乳房缺损补救、婚姻生活质量以及生育能力方面,其中88% 患者有生育计 划,而患者生育知识回答正确率仅为 8.6%~42.9%。两组患者社会支持利用度得分均较低,且二者比较差异无统计学意义 （t=0.798,P ＞ 0.05）。结论 年轻乳腺癌群体存在着明显的紧张、焦虑、易怒等神经质倾向应给与患者专业的心理疏导。 应高度重视青年乳腺癌患者的心理需求,增加针对性的生育知识宣传,给予有效支持与帮助,及时调整治疗决策。同时, 年轻乳腺癌患者对社会支持的利用程度明显不足,应增加渠道、创新方式,优化社会支持网络。     

乳腺癌患者及其配偶的生活质量调查

目的：描述乳腺癌家庭中患者及配偶的心理健康水平和生活质量水平,探讨影响患者生活质量的相关因素。方法：对55例乳腺癌家庭中患者和配偶应用症状自评量表(SCL-90)及简明健康状况调查表(SF-36)测定心理健康水平和生活质量水平,分析生活质量的影响因素。结果：①SCL-90量表测量结果提示,患者组在总分、阳性项目数、躯体化、强迫、人际关系、抑郁、焦虑及恐惧方面因子分高于常模；配偶在总分、阳性项目数、人际关系、抑郁及焦虑方面因子分高于常模；患者在躯体化、强迫、恐惧因子分上显著高于配偶；②与常模相比较乳腺癌患者生活质量各维度得分均显著下降,配偶在活力、社会功能、情绪角色、精神健康维度得分下降；③影响患者生活质量的因素包括年龄、教育程度、家庭收入、肿瘤分期、病程、治疗方式；患者的SCL-90总分、躯体化、焦虑、抑郁、恐惧因子分以及配偶的SCL-90总分、焦虑、抑郁因子分也与患者生活质量显著相关。结论：除了患者本人和疾病因素外,配偶存在的心理失衡也影响患者的生活质量,提示针对乳腺癌家庭的心理特点制定护理措施将有利于提高患者的生活质量。     

乳腺癌化疗患者社会支持与创伤后成长的相关性研究

目的探讨乳腺癌化疗患者创伤后成长和社会支持状况及两者之间的联系。方法选取2016年2月至2017年3月间中国医学科学院北京协和医学院肿瘤医院收治的160例乳腺癌化疗患者,采用一般情况调查表、创伤后成长量表和社会支持量表对患者进行问卷调查。探讨乳腺癌化疗患者创伤后成长和社会支持状况及两者之间的联系。结果乳腺癌化疗患者创伤后成长总分为(68.98±19.31)分,5个维度中人际关系得分最高;社会支持总分(42.48±6.37)分高于国内常模,差异有统计学意义(P<0.05)。社会支持总分和创伤后成长总分呈一定正相关,差异有统计学意义(P<0.01)。结论乳腺癌化疗患者社会支持较好,创伤后成长处于中等水平,有待进一步提高,可通过提高乳腺癌患者社会支持度,更好地促进患者创伤后成长。     

社会心理因素、5-HTTLPR多态性与乳腺癌患者抑郁症状的相关性研究

目的：探讨乳腺癌患者5-羟色胺转运体基因启动子区多态性（5-HTTLPR）、社会心理因素与抑郁症状发生及严重程度的相关性。方法：对115例乳腺癌患者采用汉密尔顿抑郁量表（HAMD）评定其抑郁症状,生活事件量表（LES）、应对方式问卷、社会支持量表评价其社会心理特征。运用PCR检测115例乳腺癌患者及51例正常对照女性的5-HTTLPR基因多态性。结果：（1）115例乳腺癌患者中合并抑郁症为31例,占27%。（2）115例乳腺癌患者中5-HTTLPR三种基因型HAMD总分比较,差异有显著性（P=0.000）。（3）经多元逐步回归分析,5-HTTLPR基因多态性、家庭成员关系、社会支持总分影响乳腺癌患者HAMD总分。结论：5-HTTLPR基因多态性、家庭成员关系和社会支持总分是乳腺癌患者产生抑郁症状及抑郁严重程度的影响因素。     

食管癌患者配偶心理状态的影响因素分析

[目的]调查食管患者配偶的焦虑、抑郁情况,并研究其影响因素。[方法]应用焦虑自评量表(SAS)和抑郁自评量表(SDS)对80例食管癌患者配偶心理状态进行调查,影响心理状态因素的差异程度经t检验、单因素方差分析及多重线性回归处理。[结果]食管癌患者配偶的焦虑(48.53±7.67)、抑郁程度(58.91±8.20)明显高于国内常模(37.23±12.59,41.88±10.57)(P<0.05);食管癌患者配偶的焦虑、抑郁程度在不同年龄、月收入、医疗费用的支付方式、夫妻感情的情况、食管癌的临床分期及配偶是否合并慢性病之间差异有统计学意义(P<0.05);影响食管癌患者配偶焦虑程度的因素为:性别、夫妻感情的情况、年龄及食管癌的临床分期;影响食管癌患者配偶抑郁程度的因素为食管癌的临床分期。[结论]食管癌患者配偶存在不同程度的焦虑、抑郁情况;人口学因素、疾病因素均可影响食管癌患者配偶的焦虑、抑郁程度。该研究结果对医务人员为食管癌患者配偶制定有针对性的干预措施有较重要的指导意义。     

乳腺癌术后乳房缺损患者心理健康状况与社会支持度调查分析

目的:调查乳腺癌术后乳房缺损患者心理健康状况与社会支持度情况,探讨二者之间的相关性。方法:应用症状自评量表(SCL-90)和社会支持评定量表(SSRS)对2009年1月～2010年12月在乐山市人民医院肿瘤科治疗的54例乳腺癌术后乳房缺损患者进行问卷调查,对结果进行统计学分析。结果:本组乳腺癌术后乳房缺损患者整体心理健康状况较国内常模差(P<0.05);不同社会支持的患者之间的心理健康状况差异具有统计学意义(P<0.05);SCL-90总均分与社会支持总分和客观支持呈负相关;人际关系敏感和社会支持总分、主观支持呈负相关;抑郁和社会支持总分、主观支持、客观支持呈负相关;焦虑和社会支持总分、主观支持呈负相关(P<0.05)。结论:乳腺癌术后乳房缺损患者的心理健康状况与社会支持度密切相关,良好的社会支持可以改善乳腺癌术后乳房缺损患者的心理健康状况。     

婚姻、社会支持对乳腺癌复发、转移影响的对照研究

目的　探讨婚姻家庭、社会支持对乳腺癌复发、转移的影响。方法　使用社会支持评定量表和Locke Wal lace婚姻调适测定问卷评定转移复发 (81例 )和无转移复发 (90例 )的乳腺癌患者。结果　转移复发组社会支持总分、对支持的利用度 ,婚姻调适与无转移复发组比较 ,差异有显著性 (P <0 .0 5 ) ,表现为转移复发组社会支持总分和对支持的利用度均低于无转移复发组病人 ,转移复发组病人婚姻失调 ,对婚姻的幸福感下降 ;婚姻调适与社会支持具有正相关 (P <0 .0 5 )。结论　婚姻家庭、社会支持对乳腺癌转移复发有着不容忽视的影响 ,因此在乳腺癌的治疗过程中 ,应关注这些因素对患者疾病的作用 ,给予必要而有效地心理干预 ,使患者更好的康复。     

乳腺癌术后乳房缺损患者心理健康状况与社会支持度调查分析

目的：调查乳腺癌术后乳房缺损患者心理健康状况与社会支持度情况,探讨二者之间的相关性。方法：应用症状自评量表（SCL-90）和社会支持评定量表（SSRS）对2009年1月～2010年12月在乐山市人民医院肿瘤科治疗的54例乳腺癌术后乳房缺损患者进行问卷调查,对结果进行统计学分析。结果：本组乳腺癌术后乳房缺损患者整体心理健康状况较国内常模差（P〈0．05）;不同社会支持的患者之间的心理健康状况差异具有统计学意义（P〈0．05）;SCL-90总均分与社会支持总分和客观支持呈负相关;人际关系敏感和社会支持总分、主观支持呈负相关;抑郁和社会支持总分、主观支持、客观支持呈负相关;焦虑和社会支持总分、主观支持呈负相关（P〈0．05）。结论：乳腺癌术后乳房缺损患者的心理健康状况与社会支持度密切相关,良好的社会支持可以改善乳腺癌术后乳房缺损患者的心理健康状况。     

乳腺癌放疗患者疾病不确定感与社会支持的关系评价

目的 探讨乳腺癌放疗患者疾病不确定感与社会支持的关系.方法 随机抽取100例接受放射治疗的乳腺癌患者的临床资料.对患者进行问卷调查,共发放问卷100份,回收问卷100份,回收率为100.00％.观察患者疾病不确定感、社会支持状况、疾病不确定感和社会支持的相关性.结果 患者疾病不确定感的平均得分为(82.91±8.32)分.患者社会支持总平均得分低于国内常模分值,差异有统计学意义(P＜0.05).患者疾病不确定感总分、与疾病相关信息缺乏或不一致性与社会支持呈负相关,患者不明确性、复杂性与社会支持总均分、客观支持、对支持的利用度呈负相关,不可预测性与社会支持及其三个维度无相关性.结论 护理人员需注重乳腺癌患者疾病不确定感和社会支持,减少患者的疾病不确定感,提高社会支持.     

乳腺癌患者260例心理健康状况调查

 目的　研究乳腺癌患者心理健康状况以及社会支持等因素对其康复的影响。方法　采用人口学特征调查表、症状自评量表（SCL-90）、社会支持评定量表对260例乳腺癌患者进行问卷调查。结果　乳腺癌患者心理健康水平低于健康人,情绪变化明显。乳腺癌患者能获得较好的社会支持,其中城市患者获得的社会支持好于农村患者,差异有统计学意义（t＝7.91,P＝0.000）。SCL-90总分以及强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性等因子与社会支持呈负相关（r值分别为-0.278、-0.259、-0.165、-0.294、-0.215、-0.177、-0.175、-0.167、-0.219,P值均＜0.05）。结论　社会支持程度的高低影响乳腺癌患者的心理健康,故应给予患者较好的社会支持以提高其心理健康水平,促进其康复。     

Reports of information and support needs of daughters and sisters of women with breast cancer

The aim of this study was to describe the information and support needs of women who have primary relatives with breast cancer. The Information and Support Needs Questionnaire (ISNQ) was developed and revised from previous qualitative and pilot studies. The ISNQ addressed concepts of the importance of, and the degree to which, 29 information and support needs related to breast cancer had been met. The study sample consisted of 261 community-residing women who had mothers, sisters, or a mother and sister(s) with breast cancer. Data were collected using a mailed survey. In addition to the ISNQ, additional items addressed family and health history, breast self-care practices, perception of the impact of the relative's breast cancer and other variables. Also included were established and well-validated measures of anxiety and depression. The findings document women's priority information and support needs. The information need most frequently identified as very important was information about personal risk of breast cancer. Other highly rated needs addressed risk factors for breast cancer and early detection measures. Generally, the women perceived that their information and support needs were not well met. These findings illuminate needs of women for more information and support when they have close family relatives with breast cancer and opportunities for primary care providers to assist women in addressing their needs.     

喉癌围手术期患者需求现状及影响因素分析

目的:了解喉癌患者在围手术期需求重要程度及需求满足程度的现状，分析其影响因素，为喉癌围手术期患者治疗、护理方案的制定提供参考。方法:本研究采用横断面调查设计，采用方便抽样方法，选取在西安地区三所大型三级甲等医院耳鼻咽喉头颈外科，住院的行喉切除术（喉全切+喉部分切除）的喉癌患者126例为研究对象，用患者一般情况调查表、患者临床资料调查表及喉癌患者需求自评问卷收集资料，用SPSS 19.0软件包进行统计分析。结果:喉癌围手术期患者需求重要程度得分为（4.50±0.95）分，各维度得分最高为生理需求。喉癌围手术期患者需求满足程度得分为（3.69±0.95）分，各维度得分最高为尊重/自尊需求；多元逐步回归分析显示性别和家庭支持程度对喉癌患者围手术期需求重要程度及需求满足程度均有影响（P＜0.05），患者工作状态仅影响其需求重要程度（P＜0.05），手术方式及居住地影响患者需求满足程度（P＜0.05）。结论:喉癌围手术期患者总需求重要程度较高，而需求满足程度相对偏低。不同的性别、家庭支持程度、工作状态和文化程度会影响喉癌围手术期患者需求重要程度和需求满足程度。医护人员可根据患者需求重要程度、满足程度及影响因素选择手术方式、按需施护，则可满足患者所需，提高患者生活质量。     

The psychosocial needs of breast cancer survivors; a qualitative study of the shared and unique needs of younger versus older survivors

Due to improvements in medical treatment and survival following breast cancer, researchers have turned their attention to investigating the needs of breast cancer survivors. There is disagreement about the extent to which survivors continue to experience psychological morbidity after treatment ends. Whilst the majority of women adjust well to breast cancer, some may have continued psychosocial needs. Available research suggests that younger pre-menopausal women are at increased risk of psychological morbidity following breast cancer. The present study aimed to gather preliminary qualitative data on the psychosocial needs of breast cancer survivors and to identify the shared and unique needs of younger versus older survivors. A qualitative methodology was chosen as this was a relatively unexplored area of enquiry. Patients treated for early-stage breast cancer who had completed their hospital-based treatment 6-24 months prior to participation were recruited. Sampling was discontinued when informational redundancy was achieved. Eighteen telephone interviews were conducted. A wide variety of on-going psychosocial and information needs were reported by breast cancer survivors including support needs, psychological needs, practical needs, physical needs and information needs. Younger women reported more needs than their older counterparts. Several needs reported by younger women were directly related to being of younger age or pre-menopausal at the time of diagnosis. Clinical implications are discussed.     

Postmastectomy educational needs and social support

Due to shorter hospitalization periods and changes in surgical procedures, breast cancer patients have less inpatient contact with rehabilitation resources. A questionnaire related to educational needs and social support was mailed statewide to 2,000 postmastectomy women who had received a Reach to Recovery visit. The findings are based on quantitative data reported by 933 women and from 27 women in follow-up interviews. Respondents ranked their educational needs in six categories from greatest to least importance as follows: (1) information about breast cancer, (2/3) personal hygiene/exercise and nutrition/weight control (both ranked of equal importance), (4) prosthesis/clothing information, (5) social support, and (6) sexual issues. Performance on the knowledge assessment correlated directly with the amount of educational experience and inversely with age. Respondents who lived in communities of less than 2,500 were less informed than those from other locations. Participation in formalized support groups was infrequent (11%). The major source of information was the media, with 88% indicating they would watch television programs about breast cancer. Thirty-three percent of the respondents indicated they owned a video cassette recorder (VCR); about 93% said VCRs were available for rent in their community. Work associates were identified as a group that encouraged information seeking; health care professionals were the most successful in motivating women to participate in support groups.     

Socio‐demographic predictors of high support needs in newly diagnosed breast cancer patients

GRIESSER A.‐C., VLASTOS G., MOREL L., BEAUME C., SAPPINO A.‐P. & HALLER G. (2010) European Journal of Cancer Care
Socio‐demographic predictors of high support needs in newly diagnosed breast cancer patients This study aimed to identify high support needs and their socio‐demographic predictors to improve supportive care for newly diagnosed breast cancer patients. A cross‐sectional study measured patients' needs and unsatisfied support needs by the supportive care needs survey (SCNS‐34), administered after surgery, chemotherapy or radiotherapy. Socio‐demographic, disease and treatment characteristics completed data collection. A total of 308 questionnaires were completed with a response rate of 88%. The most frequent support needs (73.3% of patients) related to information and the highest unsatisfied support needs to the management of emotions and daily life (36.3–39.6% of patients). Younger age predicted high and dissatisfied support needs (P < 0.05). Patients born outside Switzerland or with a lower level of education had more needs in daily living and psychological domains (P < 0.05). Being born outside Switzerland also predicted dissatisfaction with information provided. Being parent was a predictor of significant needs in the daily living domain after adjusting for disease and treatment characteristics (P= 0.01). Therefore, information, psychological and daily living support for newly diagnosed breast cancer patients should be strongly reinforced, particularly in patients being born outside Switzerland, those with children or being younger. For the latter, support in sexuality domain should also be emphasised.     

The role of community-based and philanthropic organizations in meeting cancer patient and caregiver needs

We examined information from community-based and philanthropic organizations to document the cancer-related services that are currently available, establish which services are still needed, and determine who utilizes these formal support networks. In Phase I, 32 of 41 eligible organizations participated in a survey conducted from December 1999 to March 2000. The most common mission focus among participating organizations was information/referral-centered. The most common services provided were referrals to information resources and provision of cancer-related information. Only two of the organizations in Phase I provided client demographic information and both indicated that client populations were predominantly white, female, and over age 40. Phase II of the study involved analyzing patient data from Cancer Care, Inc., a national service organizations for cancer patients. Between 1983 and 1997, there were 2,714 prostate cancer patients and 9,451 breast cancer patients included in the Cancer Care database. Their most commonly reported problems were related to personal adjustment to illness, financial, home care, and transportation needs. There were significant differences in problems reported depending upon age and disease status. In addition, the results of this study support the idea that those at highest risk for developing and dying of cancer are the least likely to utilize formal support networks. Further, a gap in service provision for assistance with practical needs (e.g., transportation, home care, child care, psychosocial support) was identified. Due to the increasing use of outpatient care for cancer patients, a greater demand for practical assistance can be expected in the future. The availability of practical services will need to be increased in order to effectively meet cancer patient needs.     

Mapping the quality of life and unmet needs of urban women with metastatic breast cancer

Enhancing quality of life and reducing the unmet needs of women are central to the successful management of advanced breast cancer. The objective of this study was to investigate the quality of life and support and information needs of urban women with advanced breast cancer. This study was conducted at four large urban hospitals in Melbourne, Australia. A consecutive sample of 105 women with advanced breast cancer completed a questionnaire that contained the European Organization of Research and Treatment of Cancer Quality of Life Q-C30 and the Supportive Care Needs Survey. Between one quarter and a third of the women reported difficulties with their physical, role and social functioning, and a little over a quarter of the women reported poor global health status. Fatigue was a problem for most women. The highest unmet needs were in the psychological and health information domains. Almost no differences in unmet needs were detected when comparing different demographic and disease characteristics of women. Health care providers should routinely monitor the quality of life and needs of women with advanced breast cancer to ensure that appropriate treatment, information or supportive services are made available.     

Research review of the supportive care needs of spouses of women with breast cancer.

PURPOSE/OBJECTIVES: To conduct an integrative review of the research describing the needs of spouses of women with breast cancer for direction in planning nursing interventions to meet their supportive care needs. DATA SOURCES: Published articles and bibliographies from pertinent articles. DATA SYNTHESIS: A base of knowledge exists regarding the emotional and psychosocial needs of spouses of women with breast cancer. Less is known about their spiritual, practical, and physical needs. Very little research has explored nursing interventions and supportive care needs. CONCLUSIONS: Definite knowledge gaps exist regarding the needs of spouses of women with breast cancer. More research is required to develop and evaluate interventions that focus on these needs. IMPLICATIONS FOR NURSING PRACTICE: A diagnosis of breast cancer is a distressing time for both women and their spouses. Ongoing research and the development of interventions are necessary to help spouses cope with the stress throughout the illness so that they may support their wives.     

Appraising the self-assessed support needs of Turkish women with breast cancer

The purposes of this study were to establish the range of needs of women with breast cancer and to examine how women's needs might form clusters that could provide the basis for developing a standardized scale of needs for use by local breast care nurses in the evaluation of care. The sample consisted of 143 women with breast cancer who were admitted to the outpatient and inpatient oncology clinics in a university hospital in Erzurum, Turkey. The data were collected by questionnaire, and included demographic characteristics and the self-assessed support needs of women with breast cancer. Statistical analyses have shown that the standardized scale of needs has statistically acceptable levels of reliability and validity. The women's support needs mostly clustered in Family and Friends (79%) and After Care (78.3%). The most frequently required support category was Family and Friend; however, the women were in need of support of all categories. In terms of age ranges, there are statistically significant differences in relation to Femininity and Body Image, and Family and Friends of the seven categories. Women experienced a high level of needs associated with a diagnosis of breast cancer. The results in this study should increase awareness among cancer care professionals about a range of psychosocial needs and may help them target particular patient groups for particular support interventions.     

Supportive care of rural women with breast cancer in Tasmania, Australia: changing needs over time

Providing for patients' psychosocial needs is a potential means of minimising cancer morbidity. Needs assessments can guide responsive patient-centred care. A longitudinal survey of women with early breast cancer consulting a breast nurse in a primarily rural state of Australia was undertaken to measure unmet supportive care needs, identify changes in unmet needs across time and compare results with previous studies. Needs assessments were completed with the Supportive Care Needs Survey (SCNS) at 1 month (n = 74) and 3 months (n = 83) post-diagnosis. Access to services was also examined. High levels of psychological and health system and information needs were identified at 1 month post-diagnosis, but these decreased significantly at 3 months post-diagnosis. Sexuality domain needs increased significantly during the same time. Compared to a previous SCNS study of rural women with breast cancer, unmet supportive care needs in this study were significantly lower than previously reported, although assistance with energy levels (i.e. fatigue) continues to be an unmet need for women with breast cancer. Results suggest there have been positive cultural changes within healthcare systems, specifically in better informing patients and providing support. Although services appear to be more responsive to breast cancer patients, significant unmet needs still exist.