老年多发性骨髓瘤患者心理弹性调查及其与应对方式和疾病不确定感的相关性研究

目的研究老年多发性骨髓瘤(MM)患者心理弹性水平及其与应对方式与疾病不确定感的相关性,为治疗该病症提供临床依据。方法以2018年6月-2020年6月四川大学华西医院老年MM患者130例为样本开展横断面研究,在化疗等综合干预基础上,采集患者基本资料,评估心理弹性(CD-RISC)、应对方式(MCMQ)和疾病不确定感(MUIS-A)各量表评分,并分析各评分间相关性,然后采用线性回归分析研究影响老年MM患者心理弹性的因素。结果130例老年MM患者CD-RISC量表平均评分为(49.76±8.24)分;MCMQ量表中,"面对"平均评分为(18.95±3.72)分,"回避"平均评分为(12.06±2.83)分,"屈服"平均评分为(13.84±2.19)分.MUIS-A量表平均评分为(97.94±10.45)分。CD-RISC量表总分和乐观维度评分与MUIS-A量表总分以及各维度评分均呈负相关,另外坚韧维度评分与不明确性、不可预测性评分和MUIS-A量表总分均呈负相关,自强维度评分与不明确性和不可预测性评分呈负相关,相关性均有统计学意义(P<0.05)。CD-RISC量表总分及各维度评分与MCMQ量表中面对评分呈正相关,与屈服评分呈负相关,相关性有统计学意义(P<0.05);MUIS-A量表总分以及各维度评分与MCMQ量表中面对评分呈负相关,与回避和屈服评分呈正相关,相关性有统计学意义(P<0.05);线性回归分析显示,不明确性、不可预测性、疾病不确定感、面对以及屈服是影响老年MM患者心理弹性的重要因素(P<0.05)。结论老年MM患者心理弹性水平普遍较低,且与应对方式和疾病不确定感存在密切联系。

Investigation on psychological resilience of elderly patients with multiple myeloma and its correlation with coping style and disease uncertainty

Objective To study the psychological resilience level of elderly patients with multiple myeloma(MM)and its correlation with coping styles and disease uncertainty,and to provide clinical basis for the treatment of this disease.Methods A cross-sectional study was conducted on 130 elderly MM patients in West China Hospital of Sichuan University from June 2018 to June 2020.The basic data of patients were collected on the basis of comprehensive interventions such as chemotherapy.The scores of psychological resilience(CD-RISC),coping styles(MCMQ)and disease uncertainty(MUISA)were evaluated,and the correlation among the scores was analyzed.Linear regression analysis was used to study the factors affecting the psychological resilience of elderly patients with MM.Results The average score of CD-RISC scale of 130 elderly MM patients was(49.76±8.24)points.In the MCMQ scale,the average score of"facing"was(18.95±3.72)points,the average score of"avoidance"was(12.06±2.83)points,and the average score of"yielding"was(13.84±2.19)points.The average score of MUIS-Ascale was(97.94±10.45)points.The total score of the CD-RISCscale and the optimistic dimension score were negatively correlated with the total scores of the MUIS-A scale and the scores of each dimension.In addition,toughness dimension score was negatively correlated with uncertainty score,unpredictability score and total score of MUIS-A,while self-improvement dimension score was negatively correlated with uncertainty and unpredictability scores,and the correlation was statistically significant(P<0.05).The total score of the CD-RISC scale and the scores of each dimension were positively correlated with the facing score in the MCMQ scale,and negatively correlated with the yielding score,and the correlation was statistically significant(P<0.05).The total scores of the MUIS-A scale and the scores of each dimension were negatively correlated with the facing scores in the MCMQscale,and positively correlated with the avoidance and yielding scores,and the correlation was statistically significant(P<0.05).Linear regression analysis showed that uncertainty,unpredictability,disease uncertainty,facing and yielding were important factors affecting the psychological resilience of elderly patients with MM(P<0.05).Conclusion The psychological resilience level of elderly patients with MMis generally low,and it is closely related to coping styles and disease uncertainty.