恶性骨肿瘤患者的心理健康与应对方式的相关性及其对临床效果的影响

目的：了解骨肿瘤患者的心理健康状态及其与患者使用的应对方式的相关性，并探讨其对临床效果的影响。方法采用方便抽样的方法选取恶性骨肿瘤的患者102例，对所有患者的心理状况、应对方式进行问卷调查，并于治疗间歇期进行跟踪随访，调查其生存状态，采用独立样本t检验进行组间差异比较，组间的相关性采用Pearson相关分析。结果 SCL-90总分及各项因子在骨科恶性肿瘤患者得分显著高于常模组，差异具有统计学意义（ P＜0．05）。面对应对与SCL-90评分的相关性分析中，除躯体化、敌对、恐怖外，总分及其他各因子均与面对应对方式呈负相关（ P＜0．05）；回避应对方式与除躯体化、强迫、抑郁外的总分及其他各项因子均呈一定的负相关（P＜0．05）；屈服应对方式与除偏执、精神病性外的其他各因素均呈一定的正相关（ P＜0．05）。评分PIHS＜45分的患者的SCL-90总分及大部分因子（除了躯体化因子）明显低于PIHS＞45分的患者（P＜0．05）。与PIHS＞45分的患者相比，PIHS＜45分的患者面对、回避应对得分明显更高，屈服应对评分明显更低（ P＜0．05）。结论骨科恶性肿瘤患者的心理健康水平明显低于正常人，且与采用消极应对存在明显的相关性。负面情绪及消极应对共同作用，导致患者出现严重的心理障碍，进而导致患者的病情发展和影响治疗效果，不利于病情恢复。

Correlation between Mental Health of Patients with Malignant Bone Tumors and Their Coping Styles and Its Impact on Clinical Effect

Objective To study the mental health status of patients with malignant bone tumor and its correlation with coping styles ,and its impact on clinical effect .Methods 102 cases of confirmed malignant bone tumor patients were selected by convenient sampling method .The psychological status , coping styles questionnaire survey were investigated , and follow up were conducted to study living condition in the intermittent period .Using independent sample t test to compare differences between the 2 groups,and the correlation were analyzed by Pearson correlation analysis .Results The SCL-90 total score and factor scores in patients with malignant bone tumor were significantly higher than the normal group ,the difference was statistically significant ( P<0.05).For the correlation of facing coping and SCL-90 scores,the SCL-90 aggregate score and other factor score showed the nega-tively correlated except for somatization,hostility and terror factors(P<0.05).Except somatization,forced and depression factors, the avoidance coping styles in certain were negative correlated with the SCL -90 total score and other various factors (P<0.05), while the resignation coping had a certain positive correlation part from the paranoia and psychoticism factors (P<0.05).The SCL-90 total score and most factors ( except somatization factors ) in patients with PIHS scores less than 45 were significantly lower than the patients with PIHS over 45 (P<0.05).Compared with the patients of PIHS scores over 45,the facing coping and avoid-ance coping styles scores in patients PIHS less than 45 were significantly higher ,while the resignation coping styles score was sig-nificantly lower(P<0.05).Conclusion The mental health level of the patients with malignant bone tumors is significantly lower than the normal patients ,and has obvious correlation with negative coping .Both of them have serious effects on patients and lead to the psychological barriers ,which influence the development and treatment of the patient ,and are against disease recovery .