职业及经济收入对乳腺癌妇女人格和心理障碍的影响

背景乳腺癌的诊断和治疗,会使人产生严重的负性应激反应和精神障碍。特别是自费和没有医疗保险的农村和低经济收入乳腺癌妇女的精神心理状况令人堪忧。国内外对这一弱势群体的研究少见报道。目的找出农民与不同经济收入水平对乳腺癌妇女精神心理障碍的影响程度,为有效的临床干预治疗提供科研依据。设计病例对照研究。地点、对象和方法对大连医科大学附属一、二医院肿瘤科术后接受抗癌治疗的妇女216例采用临床晤谈、明尼苏达多项人格问卷(Minnesotamultiphasicpersonalityinventory,MMPI)和生活事件量表及基本情况问卷的方法进行精神心理状态和人格评定。主要观察指标乳腺癌妇女MMPI评定结果。结果①208例年龄为24～83岁乳腺癌妇女,平均47岁,89%为已婚妇女;受教育程度各水平均衡,其中农民40例,占19.2%,工人占35.6%,职员和干部比例为45.2%。接受乳房保留术22例,根除术186例;182例接受化疗,176例接受放疗;15.4%患者不知道自己患病真相;患病时间为术后1～204个月。②多元Logistic分析显示,农民是疑病和抑郁量表值增高的危险因素。农民与工人疑病、抑郁相对比,OR=3.64,4.42(P<0.05);脑力劳动者与工人疑病、抑郁相对比,OR=1.05,1.11(P<0.05)。而年龄是抑郁的保护因素,随着年龄的增加抑郁反而减低,确诊时年龄与

Effects of occupation and income on the personality and mental disorder of women with breast cancer

BACKGROUND: The diagnosis and treatment of breast cancer will lead to severely negative stress reaction and mental disorder, especially to the rural women and low income women without medical insurance and have to pay at own expense. There are few reports about this population at home and abroad.OBJECTIVE: To explore the effects of occupation and income level on the mental disorder degree to women with breast cancer and provide scientific basis for effective interventions.SETTING, PARTICIPANTS and INTERVENTIONS: Totally 216 women who are taking against cancer treatment after operation in Oncology Department of First Attached Hospital of Daliang Medical University are selected to evaluate their psychological states and personality by using interview, Minnesota multiphasic personality inventory(MMPI), life event scale and questionnaire of basic information.MAIN OUTCOME MEASURES: Assessment of MMPI of women with breast cancer.years old, average age is 47, 89% of them are married. The education background of them is in balance. There are 40 rural women(19. 2% ), 35.6%are manual workers and 45.2% are office workers. 22 cases have taken breast retention operations and 186 cases taken eradicative operations. There are 182 cases taking chemical therapy and 176 with radiotherapy. 15.4% of the patients do not know the truth of their disease. The time with disease is pation as peasant is the risk factor for suspicion and the increased score of depression scale. Compared with workers on the incidence of suspicion and depression, OR = 3.64, 4.42 ( P ＜ 0.05) . When comparing the suspicion and depression between brainworkers and manual workers, OR = 1.05, 1.11( P ＜ 0.05) . Age is the protective factor of depression, the incidence of depression will reduce with the increase of age. The OR between the age of diagnosis and the different age groups below 39 years old is 0. 72, 0.51,0.37 and 0.26 respectively( P =0.03).CONCLUSION: Peasant is the important risk factor of suffering suspicion and depression, especially those poor young farm women are easy getting extremely fear and depression when suffering breast cancer and taking anticancer therapy, even have mindwill of suicide or suicidal behaviors. Age increase is the protective factor of depression. There is no obvious effect of income level to the MMPI scales.