肿瘤诊断的告知对前列腺癌患者心理状态的影响

目的评估前列腺癌患者面对恶性肿瘤诊断时的心理反应状况，为心理干预提供依据。方法选择2006年8月至2008年8月在长征医院接受手术治疗的前列腺癌患者为观察对象，随机分成试验组（术前告知组）和对照组（术后告知组），采用焦虑自评量表（SAS）、抑郁自评量表（SDS）和自编症状困扰自评量表10项进行问卷调查。在入院当天填写自编症状困扰自评量表10项问卷，每位患者分4个时间点测试焦虑自评量表SAS和抑郁自评量表SDS，采用SSPS10．0统计学软件进行统计。结果问卷收回有效率为100％，均进入统计分析。两组患者的焦虑、抑郁评分却均高于中国人常模。试验组焦虑、抑郁评分在前3个时段均高于对照组（P〈0．05）；在术后出院当日对照组焦虑、抑郁评分数值虽高于试验组，但无统计学意义（P〉0．05）。试验组患者睡眠障碍、食欲不振、头痛、疲倦和便秘指标的评分显著高于对照组（P〈0．05），而尿频、血尿、尿急、排尿困难、体重减轻指标的评分与对照组无显著性差异（P〉0．05）。结论前列腺癌患者在术前被告知肿瘤诊断时会产生很强烈的心理应激反应并随之出现躯体化症状。因此，知情告知与心理状态评估、干预并重有利于患者保持心理状态的积极、稳定，提高疗效。

Evaluation of Notification Regimen on Mental Status of Patients with Prostate Cancer

Objective To evaluate the mental status of patients with prostate cancer informed of the diagnosis of malignant tumor and provide useful data for mental intervention. Methods All the patients who underwent radical prostatectomy from Aug. 2006 to Aug. 2008 were randomly divided into 2 groups： the experimental group （who were informed before operation） and control group （who were informed after operation）. Self-Rating Anxiety Scale （SAS）, Self-Rating Depression Scale （SDS） and self-made symptom-evaluation scale with 10 items were used by questionnaire survey. The self-made symptom-evaluation scale was finished on the first day in hospital and SAS,SDS were filled at four different time points separately for every patient. The data was analyzed with SSPS 10.0. Results All the questionnaires were retrieved with statistical analysis. The anxiety and depression score of both groups were higher than those in the common model of Chinese people. Both anxiety and depression scores of the experiment group were significant higher in former 3 time point （P〈0.05） and the scores of SAS and SDS in control group were higher than that in the experiment group on the day that they leave the hospital（P〈0.05）. Patients in experimental group suffered more from dyssomnia, anepithymia, cephalalgia, languor and constipation （P〈0.05） with no significant difference in other index including frequent micturition,haematuria,urgency,dysureisa and weight loss. Conclusion Patients with prostate cancer would suffer from vast mental stress followed by somatization symptom when being informed the diagnosis of cancer before operation. Thus, in order to improve optimal therapeutic effect, mental status evaluation and intervention may be favorable to keep patients＇positive and stable when fulfill the notification regimen.