口腔癌患者的心理困扰及生存质量研究

目的: 探讨口腔癌患者的心理现状及其影响因素,以及与生存质量相关的因素。方法: 使用心理困扰温度计（distress themometer,DT）和华盛顿大学生存质量量表（University of Washington Quality of Life Questionnaire,UW-QOL）对郑州大学第一附属医院2016年10月—2017年9月收治的250例口腔癌患者进行问卷调查。应用SPSS20.0软件包对数据进行统计学分析。结果: 发放问卷250份,实际回收有效问卷239份。在239例口腔癌患者中,DT分数≥4分139例（58.2%）,UWQOL量表平均得分53.3±17.1;<4分的患者100例（41.8%）,UWQOL量表平均得分52.8±17.4,DT总平均得分4.56±2.18。单因素分析结果显示,心理困扰与年龄、文化程度、收入水平、病理分期、颌骨切除、复发6个因素有关（χ²值分别为5.12、21.31、34.2、10.69、31.3和7.84,P<0.05）。Logistic回归分析显示,年龄、颌骨切除、复发是影响口腔癌患者心理困扰的危险因素（OR值分别为4.06、5.12和5.79,P<0.05）。Spearman相关分析显示,UWQOL量表中疼痛、娱乐、情绪、焦虑4个条目得分与心理困扰得分呈负相关（r分别为-0.58、-0.84、-0.66和-0.69,P<0.05）。结论: 口腔癌患者的心理困扰发生率较高;年龄越小、做过颌骨切除、复发的患者心理困扰程度更严重。对口腔癌患者施行个体化的治疗方案、术后护理及心理疏导,可能会减轻患者的心理困扰程度。

Study of psychological distress and quality of life in patients with oral cancer

PURPOSE: To explore the relationship between the status quo and influencial factors of oral cancer patients and their quality of life. METHODS: Using the Distress Themometer (DT) and the University of Washington Quality of Life Questionnaire (UW-QOL), 250 patients admitted to the First Affiliated Hospital of Zhengzhou University from October 2016 to September 2017 with oral cancer were investigated. Chi-square test, t test, logistic regression analysis and Spearman correlation analysis were used to analyze the data with SPSS20.0 software package. RESULTS: A total of 250 questionnaires were issued, 239 valid questionnaires were available for analysis. In 239 oral cancer patients, 139 (58.2%) had DT score ≥4. The average total score of UWQOL scale was 53.3±17.1, score <4 was noted in 100 patients (41.8%); the average UWQOL scale was 52.8±17.4. Univariate analysis showed that psychological distress was related to age, educational level, income level, pathological stage, jaw resection and recurrence (χ² values were 5.12,21.31,34.2,10.69,31.3 and 7.84, respectively, P<0.05 ). Logistic regression analysis showed that age, jaw resection and relapse were the risk factors of psychological distress in patients with oral cancer (OR=4.06, 5.12 and 5.79, respectively; P<0.05). Spearman correlation analysis showed that the scores of pain, recreation, emotion and anxiety in UWQOL scale were negatively correlated with psychological distress scores (r=-0.58, -0.84, -0.66 and -0.69, respectively; P<0.05). CONCLUSIONS: Oral cancer patients have a higher incidence of psychological distress. Younger patients,and those with maxillectomy and recurrence have more serious symptoms of distress.