乳腺癌患者术后心理社会适应能力及应对方式与生存质量关系

目的 了解乳腺癌患者术后心理社会适应能力及应对方式与生存质量的关系,为提高乳腺癌患者的生存质量提供参考依据。方法 采用乳腺癌患者心理社会适应测评问卷、医学应对问卷(MCMQ)和乳腺癌生存质量量表(FACT-B)对江苏省无锡市妇幼保健院乳腺外科随机抽取的100例2012年1月-2015年5月首次实施乳腺癌根治术后女性患者进行调查,并采用Spearman等级相关分析方法分析乳腺癌患者术后心理社会适应能力及应对方式与生存质量的关系。结果 乳腺癌患者心理社会适应能力测评问卷焦虑/抑郁、自尊/自我接纳、态度、归属感、自我控制和自我效能维度得分分别为(25.21±4.26)、(30.28±6.15)、(29.64±4.81)、(31.58±4.12)、(32.13±4.14)和(33.16±4.25)分;MCMQ面对、回避和屈服维度得分分别为(21.32±2.18)、(17.68±2.65)和(8.26±1.92)分;FACT-B生理状况、社会-家庭状况、情感状况、功能状况和附加关注维度得分分别为(21.33±4.03)、(13.28±1.69)、(17.56±3.27)、(7.58±1.62)和(25.26±3.15)分;相关分析结果显示,乳腺癌患者自尊/自我接纳、态度、自我控制、自我效能的心理社会适应能力和面对的应对方式均与生理状况的生存质量呈正相关,回避和屈服的应对方式均与生理状况的生存质量呈负相关(均P<0.05);自尊/自我接纳、态度、自我效能的心理社会适应能力和面对的应对方式均与社会-家庭状况的生存质量呈正相关,屈服的应对方式与社会-家庭状况的生存质量呈负相关(均P<0.05);态度、自我效能的心理社会适应能力和面对的应对方式均与情感状况的生存质量呈正相关,屈服的应对方式与情感状况的生存质量呈负相关(均P<0.05);焦虑/抑郁、态度、归属感、自我控制、自我效能的心理社会适应能力和面对的应对方式均与功能状况的生存质量呈正相关,屈服的应对方式与功能状况的生存质量呈负相关(均P<0.05);自尊/自我接纳、态度、归属感、自我控制、自我效能的心理社会适应能力和面对的应对方式均与附加关注的生存质量呈正相关,回避和屈服的应对方式均与附加关注的生存质量呈负相关(均P<0.05)。结论 乳腺癌患者术后生存质量与其心理社会适应能力和应对方式相关,应提高乳腺癌患者心理社会适应能力和应对能力以改善其生存质量。

Associations of psychosocial adaptability and coping style with quality of life in breast cancer patients after operation

Objective To examine the relationship of psychosocial adaptability and coping style with the quality of life(QOL)in breast cancer patients after modified radical mastectomy and to provide references for improving QOL of the patients.Methods Psychological and Social Adaptation Questionnaire for Breast Cancer Patient(PSAQ-B),Medical Coping Modes Questionnaire(MCMQ),and Functional Assessment of Cancer Therapy-Breast(FACT-B)were used to investigate 100 breast cancer patients randomly selected from Wuxi Municipal Maternal and Child Health-Care Hospital after modified radical mastectomy from January 2012 to May 2015.Spearman rank correlation analysis was used to analyze the associations of psychosocial adaptability and coping style with QOL among the patients.Results Among the patients,the domain score of PSAQ-B was 25.21±4.26 for anxiety/depression,30.28±6.15 for self-esteem/self acceptance,29.64±4.81 for attitude,31.58±4.12 for sense of belonging,32.13±4.14 for self control,and 33.16±4.25 for self efficacy;the domain score of MCMQ was 21.32±2.18 for confronting,17.68±2.65 for avoidance,and 8.26±1.92 for surrender;the score of FACT-B domain status was 21.33±4.03 for physiology,13.28±1.69 for society and family,17.56±3.27 for emotion,7.58±1.62 for function,and 25.26±3.15 for and additional concerns,respectively.The results of correlation analysis for the patients showed that the physical functioning of FACT-B was positively correlated with PSAQ-B domains of self-esteem/self acceptance,attitude,self-control,and self-efficacy and negatively with MCMQ domains of voidance and surrender(all P<0.05);the social and familial functioning of FACT-B was positively related to PSAQ-B domains of self-esteem/self acceptance,attitude,and self-efficacy and negatively to MCMQ domain of surrender(all P<0.05);the emotional functioning of FACT-B had positive correlation with PSAQ-B domains of attitude and self efficacy and MCMQ domain of confronting and negative correlation with MCMQ domain of surrender(all P<0.05);the FACT-B domain of function was relevant positively to PSAQ-B domains of anxiety/depression,attitude,sense of belonging,self control,and self efficacy and MCMQ domain of confronting and negatively to MCMQ domain of surrender(all P<0.05);the additional concerns of FACT-B was correlated positively to PSAQ-B domains of self-esteem/self acceptance,attitude,sense of belonging,self control,and self efficacy and MCMQ domain of confronting and negatively to MCMQ domains of avoidance and surrender(all P<0.05).Conclusion The QOL in breast cancer patients relates to their psychosocial adaptability and coping style and relevant interventions should be implemented among the patients to improve QOL among the patients.