238例恶性肿瘤患者SCL-90的调查分析

目的：了解恶性肿瘤患者的心理健康状况。方法：对238例恶性肿瘤患者,应用症状自评量表（SCL-90）,根据各自的实际情况作出独立的测试,并与全国常模进行比较。结果：恶性肿瘤患者躯体化、抑郁、焦虑因子分值显著高于国内常模,其严重程度分级多为轻度。人际关系、偏执、精神病性三因子得分较全国常模低,而强迫、敌对、恐怖等因子与全国常模无显著差异。结论：恶性肿瘤患者存在不同程度的心理情绪问题,有必要进行恰当的心理干预。     

238例恶性肿瘤患者SCL-90的调查分析

目的:了解恶性肿瘤患者的心理健康状况.方法:对 238例恶性肿瘤患者,应用症状自评量表(SCL-90 ),根据各自的实际情况作出独立的测试,并与全国常模进行比较.结果:恶性肿瘤患者躯体化、抑郁、焦虑因子分值显著高于国内常模,其严重程度分级多为轻度.人际关系、偏执、精神病性三因子得分较全国常模低,而强迫、敌对、恐怖等因子与全国常模无显著差异.结论:恶性肿瘤患者存在不同程度的心理情绪问题,有必要进行恰当的心理干预.     

恶性肿瘤患者心理状况SCL-90因子特点分析

目的研究影响恶性肿瘤患者心理状况的主要因素，为临床上解决这些患者的心理问题提供依据。方法采用症状自评量表SCL-90对住院恶性肿瘤患者148例进行调查，采用SPSS11．0统计软件，两组之间比较采用t检验。结果恶性肿瘤患者躯体化、强迫、抑郁、焦虑、恐怖、精神病性因子均高于常模（P〈0．05），人际关系得分低于常模（P〈0．05）。结论中晚期、不知情、疼痛、诊断初期恶性肿瘤患者心理状况较差，不同文化水平、性别间差异不大。     

肿瘤患者家属对肿瘤患者心理治疗的态度研究

目的：：分析我院住院肿瘤患者家属对肿瘤患者进行心理治疗的态度。方法：采用自制调查问卷及心理痛苦温度计量表评分法分析肿瘤患者及家属的一般情况及心理痛苦程度,运用统计学方法分析肿瘤患者家属对肿瘤患者进行心理治疗的态度及相关因素。结果：肿瘤患者及家属具有不同程度的心理痛苦,大多数肿瘤患者家属对患者进行心理治疗持积极态度。不同文化程度、是否直系亲属及探望频率的患者家属对患者进行心理治疗的态度差异有统计学意义（P ＜0.05）。患者家属年龄与建议进行心理治疗的模式相关（P ＜0.05）。结论：应加强对肿瘤患者家属关于肿瘤患者心理治疗的健康宣教工作,争取家属的主动配合及支持肿瘤患者进行心理治疗。     

乳腺癌患者SCL-90评分及与癌因性疲乏的相关性研究

目的探讨乳腺癌患者症状自评量表(SCL-90)评分与癌因性疲乏的相关性。方法选取2015年6月至2018年12月间黄州区人民医院收治的109例乳腺癌患者,发放SCL-90和癌因性疲乏量表(CFS)进行调查,采用Pearson对SCL-90和CFS的相关性进行分析。结果化疗后,患者SCL-90中除精神病性外,抑郁、焦虑、敌对、恐怖、偏执、躯体化、强迫症状、人际敏感得分及总分均高于化疗前,差异均有统计学意义(均P <0. 01)。化疗后,患者躯体疲乏、情感疲乏、认知疲乏得分及疲乏总分分别为(17. 28±3. 62)分、(9. 53±1. 01)分、(8. 00±1. 13)分和(34. 90±4. 36)分。Pearson相关性分析发现,SCL-90中抑郁、焦虑、恐怖、人际敏感及总分均与CFS总分呈正相关(均P <0. 01),其他因子与CFS总分之间未见显著相关性。结论乳腺癌患者化疗后心理问题不同程度加重,普遍存在癌因性疲乏,其严重程度与心理问题呈正相关。     

鼻咽癌患者综合性心理干预的治疗效果

 目的　探讨综合性心理干预对鼻咽癌患者情绪和生活质量的影响。方法　将100例鼻咽癌患者随机分为2组, 干预组在常规放疗、化疗及生物治疗的基础上联合应用综合性心理干预;对照组仅用常规肿瘤治疗。试验前后分别采用焦虑自评量表（SAS）、抑郁自评量表（SDS）及症状自评量表（SCL-90）进行评定。结果　干预组SAS标准分（35.52±3.45）、SDS标准分（42.04±4.68）、SCL-90躯体化（1.65±0.65）、强迫（1.62±0.12）、人际关系（1.56±0.75）、抑郁（1.63±0.08）、焦虑（1.72±0.07）、偏执（1.63±0.18）及精神病性因子分（1.43±0.13）干预后评定显著低于干预前（1.74±0.63,1.99±0.19,1.83±0.13,2.54±0.15,2.77±0.14,1.70±0.14,1.70±0.14）（P＜0.01）,干预组SCL-90总分低于干预前（95±7.81,102±15.83,P＜0.05）。SAS标准分（11.14±5.98）、SDS标准分（7.76±5.64）、SCL-90躯体化（0.90±0.09）、强迫（0.36±0.20）、人际关系（0.27±0.14）、抑郁（0.91±0.17）、焦虑（1.05±0.15）、敌对（1.05±0.15）及精神病性（0.26±0.19）的减分值显著高于对照组（0.56±0.49,1.16±5.39,-0.02±0.07,-0.24±0.18,0.01±0.19,0.06±0.23,0.14±0.74,0.14±0.74,-0.06±0.25）（P＜0.01）。结论　综合性心理干预能有效地改善鼻咽癌患者的不良情绪, 提高患者的生活质量。     

终末期肿瘤患者及家属的哀伤辅导研究进展

<正>终末期患者是指所患疾病在目前医疗条件和水平下已经没有治愈希望,病情不断恶化,并且预期存活时间不超过6个月的患者。我国癌症发病率和病死率正在逐年攀升,肿瘤目前已成为我国死亡率最高的疾病,因此临终患者家属和丧亲者的数量也呈上升趋势~([1])。如何促使家属早日脱离哀伤情绪回归社会,已逐渐得到医务工作者和一些学者的重视与关注。现将国内外关于哀伤辅导的研究进展报告如下。     

成都地区妇女乳房疼痛症影响因素的初步探讨：100例病例对照研究

目的初步探讨成都地区妇女乳房疼痛症的影响因素。方法对四川省人民医院体检中心就诊妇女进行问卷调查,选择50例乳房疼痛者作为病例组及50例无疼痛者作为对照组。统计分析采用单因素及多因素非条件logistic回归分析和非参秩和检验。结果单因素分析结果显示,服用避孕药（OR=6．00）、有流产史（OR=2．74）、亚急性失眠（OR=7．03）和慢性失眠（OR=30．60）是患乳房疼痛症的危险因素,偶尔饮酒（每月〈1次,OR=0．36）和食用植物油是患乳房疼痛症的保护因素。将以上几个变量引入多因素回归分析,结果显示亚急性失眠（OR=6．38）、慢性失眠（OR=65．42）为乳房疼痛症的危险因素,适当食用植物油（每天1次,OR=0．27;每周1次,OR=0．11;每月1次,OR=0．10）为乳房疼痛症的保护因素。非参秩和检验结果显示,病例组在身体症状、强迫感、抑郁症状、焦虑状态、敌对心理、偏执状态、精神症状方面得分均高于对照组（P〈0．05）。结论失眠是导致成都地区妇女发生乳房疼痛的危险因素,每天食用1次植物油可能减轻乳房疼痛,乳房疼痛症患者有更多的精神心理问题。     

胸外科肿瘤住院患者对家属需求的调查分析与对策

目的:通过胸外科肿瘤住院患者对家属需求进行调查分析,为患者及家属提供优质护理服务。方法:随机对150名胸外科肿瘤住院患者进行问卷调查,运用SPSS13.0软件对调查结果进行分析。结果:胸外科肿瘤住院患者对家属的需求最高的前三项依次为:掌握更多疾病康复的知识为最高,其次为希望家属对疾病如实告知,第三为希望家属提供心理支持。患者对家属基本需求调查得分显示:希望家属给予更多关心需求最高;其次是帮忙照看输液;再次为提供可口食物;希望家属与医务人员沟通的需求也相对较高。经统计分析显示,不同学历及不同职业患者在疾病知识、疾病知情权、支持性需求方面存在统计学差异(P<0.01或P<0.05)。结论:胸外科肿瘤住院患者对家属健康教育知识、心理支持、和自身疾病的知情权需求较高,对基础的照顾如照看输液,提供可口食物也较为依赖家属。护士应针对不同需求对患者和家属同时采取相应的对策,以提高家属的照护能力,同时针对不同学历及不同职业的患者,对患者及家属采取个体化的健康教育策略,以满足患者优先需求,提高肿瘤住院患者的生活质量。     

心理干预改善癌症患者心身状况的荟萃研究

[目的]了解心理干预对癌症患者心身状况的影响,为癌症的临床心理干预提供依据。[方法]检索CNKI 1999—2008年发表的相关文献,筛选出11组符合入组标准的数据进行Meta分析。[结果]和对照组相比,心理干预后研究组SCL-90九个因子的得分均显著下降．其中“躯体化”因子下降了0．40（95％CI：0.34～0．45）;“强迫”因子下降了0．34（95％CI：0．29～O-39）：“人际关系”因子下降了0．22（95％CI：0．17～0．27）;“抑郁”因子下降了0．47（95％CI：0．42～0.52）：“焦虑”因子下降了0．50（95％CI：0．44-0．55）;“敌对”因子下降了0.31（95％CI：0．24～0.37）：“惊恐”因子下降了0．21（95％CI：0．15～0．26）;“偏执”因子下降了0．18（95％CI：0．12～0．24）;“精神病性”因子下降了0．24（95％CI：0．19～0．30）,合并检验的P值均〈0．001,具有显著的统计学差异。[结论]实施心理干预能有效改善癌症患者的心身状况。     

恶性肿瘤住院患者家属疾病不确定感的现状及影响因素

 目的　调查恶性肿瘤患者家属的疾病不确定感现状, 探讨影响肿瘤患者家属疾病不确定感的因素,为临床医护人员对患者家属实施有效的干预措施提供临床依据。方法　采用中文版疾病不确定感家属量表（MUIS-FM）和自制的家属一般情况调查表、患者疾病资料问卷调查恶性肿瘤住院患者家属的疾病不确定感水平,分析其相关因素。结果　恶性肿瘤患者家属疾病不确定感得分为（82.71±9.93）分,大于总分最高分（75分）的50 %,在家属的受教育程度、家庭收入、居住地以及患者的入院次数方面不同组别的恶性肿瘤患者家属疾病不确定感总分差异有统计学意义（F值分别为8.06、3.14、3.99、4.85,均P＜0.05）。结论　恶性肿瘤患者家属疾病不确定感水平较高,文化程度、家庭收入、居住地以及患者的入院次数对恶性肿瘤患者家属的疾病不确定感水平有一定影响。     

常见脑肿瘤住院患者主要照顾者负担的影响因素

目的：探讨分析影响常见脑肿瘤住院患者主要照顾者的负担影响因素,以期在一定程度上能够针对性的帮助主要照顾者减轻其负担。方法：采用调查问卷的形式开展调查,问卷的内容包括一般资料调查、照顾者负担量表以及症状自评量表（SCL -90）。结果：用负担量表评价脑肿瘤住院患者主要照顾者的负担情况,其中负担最重的是时间依赖,接下来依次为身体负担和情感负担。脑肿瘤患者的主要照顾者在躯体化、抑郁、焦虑、恐怖、偏执、焦虑等六个方面对比常模组有显著性差异。而人际关系敏感度、敌对和精神病性等三个方面对比则没有统计学差异。影响脑肿瘤住院患者主要照顾者负担的影响有患者因素、是否有共同照顾者、照顾持续时间、患者医疗费用支付方法及照顾者的心理状态。结论：肿瘤患者的身心状况是影响肿瘤患者照顾者生活质量的主要因素。     

No excess of early onset cancer in family members of Wilms tumor patients.

BACKGROUND: Wilms tumor is one of the few pediatric cancers with well-defined familial and genetic components. The authors assessed the risk of early-onset cancers in first- and second-degree relatives of patients enrolled by the National Wilms Tumor Study Group. METHODS: Using a stratified sampling scheme that targeted 530 families of patients who were believed a priori to have a genetic contribution to their disease, the authors conducted interviews regarding cancer occurrence in 4258 family members from 296 families of patients with Wilms tumor. Reports of malignant neoplasms that occurred before 55 years of age were confirmed by review of medical records wherever possible. A period of risk was defined for each family member based on calendar time and his or her relationship to the proband. RESULTS: Ninety-nine cancers were observed, whereas 126.8 were expected by applying standard cancer rates for age and calendar period to the 120,885 person-years at risk. The standardized incidence ratio (SIR) was O-E = 0.78 with 95% confidence interval (CI) of (0.64, 0.95). In subgroup analyses, the highest relative risks were observed for parents of the index case (O/E = 21/13.0 = 1.6, 95% CI = 1.0, 2.5) and for leukemia (O/E = 9/4.9 = 1.9, 95% CI= 0.85,3.5). CONCLUSIONS: The results of this study may provide reassurance to families of children who have had Wilms tumor. Potential sources of bias included the low (56%) rate of participation of targeted families. In general, the biases might have led to the underreporting of some cancers, especially in more distant relatives. The possibility of a slight excess of cancer in parents of Wilms tumor patients could not be excluded.     

Immune deficiency in family members of patients with Hodgkin's disease

Indirect data supporting a preexisting immunologic impairment in patients with Hodgkin's disease (HD) have been presented in recent years. These immunologic defects are supposed to be related to genetic and/or environmental factors. In this study, 65 first-degree relatives and 12 spouses of 21 consecutive patients with HD were studied immunologically. Furthermore, seven twin pairs in which one partner had HD and four additional nonmatched healthy co-twins were also included in the study. A decreased lymphocyte DNA synthesis induced by Concanavalin A, a high spontaneous DNA synthesis, or a low CD4+/8+ ratio was found in 21 (32%) consanguineous, two (17%) nonconsanguineous relatives, and five (50%) healthy co-twins. The corresponding figures for the untreated patients with HD and the control series were 14 of 21 (65%) and 21 of 127 (16%), respectively. Total lymphocyte counts or lymphocyte subpopulations did not differ between HD relatives and controls. The increased frequency of blood lymphocyte defects among consanguineous first-degree relatives favors the existence of a genetically determined immune deficiency in at least a proportion of apparently healthy relatives of patients with HD. However, nongenetic factors such as age and environment may add to the defect.     

Screening for family members of patients with nasopharyngeal carcinoma

Nasopharyngeal carcinoma (NPC) is well known for its peculiarly skewed distribution with highest incidence in Southern Chinese population. Familial aggregation is evident, hence screening for early detection is offered by oncology centers in Hong Kong to first-degree relatives of patients with NPC. During the period 1994-2001, 929 family members were screened in our center. The screenees were advised to attend an annual examination that includes serological test against Epstein Barr Virus (EBV), physical examination to exclude cervical lymphadenopathy and cranial nerve palsy, and endoscopic examination of the nasopharyngeal region. Two different methods were used for the serology test: indirect immuno-fluorescent (IF) test for IgA against viral capsid antigen; and starting in 1997 enzyme-linked immunosorbent assay (ELIZA) against nuclear antigen and viral capsid antigen. Twelve cases of nasopharyngeal carcinoma were diagnosed, giving a detection rate of 5/1,155 (433/100,000) person-year for male and 7/1,404 (499/100,000) person-year for female participants observed. The corresponding average annual incidence in Hong Kong during this period was 24.1 and 9.6 per 100,000, respectively. Forty-one percent of these detected cases had Stage I disease, whereas only 2% of patients referred to the department for primary treatment presented with such early disease. Six cases were detected at first visit, and all were EBV-positive. Another 78 screenees with positive serology at first visit were followed up for 204 person years, and thus far NPC was detected in 3 after an interval of 6-32 months. Of the 845 initially EBV-negative screenees followed up for 2,337 person-years, NPC was detected in 3 after an interval of 12-45 months. One showed sero-conversion at the time of diagnosis. We conclude that family members of known patients do show a substantially higher risk of developing NPC, and regular screening by current method improves the chance of early detection.     

Reduced natural killer activity in patients with Fanconi's anemia and in family members

Natural killer (NK) activity was measured in the peripheral blood of a family with Fanconi's anemia (FA) and compared to normal controls. One of two children with FA, and 6 of 11 family members had reduced NK activity (less than 30% with an E:T ratio of 25:1) compared to none of 40 controls (p less than 0.001). On retesting 5 of 8 family members and both children with FA had reduced endogenous NK activity compared to 0 of 5 controls (p less than 0.02). The number of NK cells determined by Leu 11b antibody was not reduced in any of the family members. Augmentation with interleukin-2 (IL-2) and alpha interferon (IFN) in those with low endogenous activity was variable. Three demonstrated no response to the 2 immunomodulators, while the 4 others increased to low normal levels. We conclude that some patients with FA and their apparently healthy relatives have reduced NK activity, which appears to be secondary to an intrinsic cell defect.     

Lymphocytes subpopulation in normal family members of patients with alpha-chain disease.

Normal family members of eight diagnosed patients suffering from alpha-chain disease had been investigated by immunoelectrophoresis for abnormal alpha-chain protein in their serum. The pattern was demonstrated in four families only, of different members, but all are of the first-degree relationship. The aim of the study was to determine any possible hereditary defect of the immune system in such patients, as compared to the immune system of the normal members of the family who had abnormal protein in their serum. It was found that in both patients and normal members, the proportion of circulating B-lymphocytes was much higher than normal, whereas that of T-lymphocytes was lower than normal. Neither could be sensitized to DNCB, and their skin tests to tuberculin were negative. From all these findings, it was concluded that the disease was a B-cell disease of IgA type transmitted by a hereditary factor associated with a low level of cellular immunity. Further studies are required to support this hypothesis.