摘要
目的:调查晚期癌症患者配偶的情感障碍及其生活质量。方法:于2004-03/2005-01选择武警广东总队医院肿瘤科住院癌症患者配偶为观察对象。所有患者均经病理、CT、MRI、PET-CT诊断为晚期癌症,诊断前受试者与患者生活在一起1年以上,并于受试前了解到患者大概的治疗过程、治疗手段及患者的预后。纳入符合标准患者配偶80人作为观察组,并选择与观察组性别、年龄、职业及文化程度无显著差异,配偶及本人无急慢性疾病的已婚健康受试者40人为对照组。同时根据观察组患者配偶的性别分为男配偶组(n=34)和女配偶组(n=46),根据癌症患者发病的不同部位,分为头颈部肿瘤组(n=26),胸部肿瘤组(n=21),腹部肿瘤组(n=14),男性泌尿生殖系统肿瘤组(n=6),女性生殖系统肿瘤组(n=13)。根据癌症患者的治疗情况分为初治组(n=38)和复发转移组(n=42)。采用作者自行设计的一般治疗调查表调查受试者的一般及特殊情况,包括受试者社会人口统计资料及特殊问题调查问卷(让受试者填写最影响生活质量的5个问题,共10个条目)。应用生活质量综合评定问卷对各组受试者的生活质量进行测定,包括躯体功能、心理功能、社会功能、物质生活4个维度,每个维度包括4个方面,其中客观指标40条,主观满意度指标24条,每一条均量化为1(极差)到5(极佳)级记分,每个因子的主观指标以累计得分法记分,最高分为20分,评分越高,生活质量越好。填表答卷前由医护人员采用统一指导语对试题给予解释。主要对各组受试者生活质量综合评定问卷评定结果进行比较并观察影响患者配偶生活质量的主要因素。组间比较采用χ2检验。结果:参加调查的观察组80人及对照组40人,调查问卷全部收回并全部进入结果分析。①各组生活质量综合评定问卷评定结果比较:观察组除了物质生活维度外,生活质量总分、躯体功能、社会功能及心理功能均较正常对照组差(t=7.93-8.89,P<0.01);女性配偶在躯体功能和社会功能维度上较男性配偶低(t=2.52～3.95,P<0.01～0.05);复发转移组在心理功能维度得分高于初治组(t=2.51,P<0.05),而初治组的社会功能维度高于复发转移组(t=2.54,P<0.05);不同部位癌症患者配偶生活质量各维度无显著性差异。②影响患者配偶生活质量的主要因素:依次为担心疾病不能治疗,担心有创治疗,担心病情恶化,担心患者生命危险、担心家庭的经济,担心疾病遗传等。结论:晚期癌症患者配偶的生活质量较差,影响其生活质量的主要因素为担心患者疾病不能治疗,在遇到心理应激时,女性较男性更容易出现情感障碍,经治疗而复发或转移的癌症患者配偶,虽有一定的心理应对,但仍承受着更大的精神及经济压力。
AIM： To investigate the quality of life of the advanced tumor patients＇ spouses. METHODS： Advanced tumor patients＇ spouses were selected from Oneological Department of Guangdong General Hospital of Chinese People＇s Armed Police Force from March 2004 to January 2005. All patients were determinated as advanced tumor with examination of pathology, CT, MRI and PET-CT. The spouses lived with patients more than 1 year and understood the therapeutic course, methods and prognosis generally. Totally 80 spouses, who were coincident with inclusion criteria, were selected as observation group, and other 40 married healthy suhjects, who were similar to the patients on the aspect of sex, age, occupation, culture level, were selected as the control group. According to the sex, spouses in the observation group were divided into male group （n=34） and female group （n=46）. According to episode at different sites, the testees were divided into headcervical tumor group （n=26）, thoracic tumor group （n=21）, abdominal tumor group （n=14）, male genitourinary systematic tumor group （n=6）, and female reproductive systematic tumor group （n=13）. According to therapeutic condition, patients were divided into initial treatment group （n=38） and relapse transfer group （n=42）. General and special states of patients were explored with the general treatment scale designed by the author including social demographic statistics and special questionnaire （5 problems of 10 items in total about effective quality of life）. Quality of life of testee was assayed with Quality of Life Questionnaire including somatic function, psychological function, social function and material life, and each aspect contained 4 sub-aspects with 40 objective indexes and 24 subject satisfactory indexes. In addition, each index was divided into 5 grades with 20 points on the top. The higher scores were, the better quality of life was. Before the survey, doctors and nurses instructed them with unificated words and explained the examination questions in detail. Results of questionnaire were compared mainly and also observed the main factor affected quality of life of patients＇ spouses. X2 test was used to compare the results among groups. RESULTS： All questionnaires of 80 patients in the observation group and 40 suhjeets in the control group were selected in the final analysis. ① Comparison of Quality of Life Questionnaire： Expect life dimension, scores of quality of life, somatic function, social function and psychological function in the obsetvation group were poor than those in the normal control group （t=7.93-8.89, P〈0.01）; somatic function and psychological function of female were poor than those of male （t=2.52-3.95, P 〈 0.01-0.05）; scores of psychological dimension in relapse transfer group were higher than those in initial treatment group （t=2.51, P 〈 0.05）, but social function in initial treatment group was better than that in relapse transfer group （t =2.54, P 〈 0.05）; each dimension of quality of life in spouses of patients with different tumor sites was not significantly different. ② Main effective factor of quality of life： The main factors were as follow： womed about unable treatment, traumatic treatment, patients＇ condition getting worse, life risk, domiciliary economy, disease heredity, etc. CONCLUSION： Quality of life of advanced tumor patients＇ spouses is poor as compared with the controls. The main factor is worried about unable treatment. When they meet psychological stress, affective disorder offemale is induced easily as compared with that of male. Although spouses have a certain of psychological coping after relapse and transfer, they endure mental and economic stress greatly.
出处
《中国临床康复》
CAS
CSCD
北大核心
2005年第36期11-13,共3页
Chinese Journal of Clinical Rehabilitation
