辛迎迎 刘美凤 于成娥 刘超 孙莉

[摘要]目的：了解乳腺癌根治術后形体改变患者的生活质量水平，并探讨其与心理社会因素的关系。方法：采用一般资料调查表、焦虑自评量表（Self-rating anxiety scale，SAS）、抑郁自评量表（Self-rating depression scale，SDS）、Connor-Davidson心理弹性量表（Connor-Davidson resilience scale，CD-RISC）、社会支持量表和生活质量测定量表（Functiond assessment of cancer therapy-breast，FACT-B）对98例乳腺癌根治术后患者进行调查分析;以FACT-B评分平均值作为分界点将患者分为生活质量高水平组和生活质量低水平组。结果：98例乳腺癌根治术后患者SAS量表评分为（53.90±6.80）分、SDS量表评分为（55.96±6.13）分、CD-RISC量表评分为（64.91±7.62）分、社会支持量表评分为（35.70±4.38）分、FACT-B量表评分为（70.27±13.61）分。生活质量高水平组SAS评分、SDS评分显著低于生活质量低水平组，差异有统计学意义（P<0.05）;CD-RISC评分、社会支持量表得分显著高于生活质量低水平组，差异有统计学意义（P<0.05）。Pearson相关性分析显示，FACT-B评分与年龄、CD-RISC评分、社会支持量表得分呈显著正相关（P<0.05），与SAS评分、SDS评分呈显著负相关（P<0.05）。多元线性回归分析结果显示，年龄、CD-RISC评分、社会支持量表得分是影响乳腺癌根治术后患者生活质量水平的独立相关因素（P<0.05）。结论：年龄、心理弹性水平及社会支持水平是乳腺癌根治术后患者生活质量水平的独立相关因素，在临床工作中应加强对乳腺癌根治术后患者心理弹性、社会支持等心理社会因素的评估，采取针对性干预措施以改善患者生活质量水平。

[关键词]乳腺癌根治术;生活质量;焦虑;抑郁;心理弹性;社会支持

[中图分类号]R737.9    [文献标志码]A    [文章编号]1008-6455（2021）06-0164-04

Correlation Between Psychosocial Factors and Quality of Life In Patients with Physical Changes after Radical Mastectomy

XIN Ying-ying，LIU Mei-feng，YU Cheng-e，LIU Chao，SUN Li

（Department of Health Care General Surgery，Provincial Hospital Affiliated to Shandong First Medical University，Liaocheng 250021，Shandong，China）

Abstract： Objective  To understand the quality of life in patients with physical changes after radical mastectomy， and to explore its relationship with psychosocial factors. Methods  A total of 98 patients after radical mastectomy were investigated and analyzed by general data questionnaire， self-rating anxiety scale （SAS）， self-rating depression scale （SDS）， Connor-Davidson resilience scale （CD-RISC）， social support scale and functional assessment of cancer therapy-B （FACT-B）. Taking the average value of FACT-B scores as the cut-off point， they were divided into high level group and low level group. Results  Of the 98 patients after radical mastectomy， the scores of SAS， SDS， CD-RISC， social support scale and FACT-B were （53.90±6.80） points， （55.96±6.13） points， （64.91±7.62） points， （35.70±4.38） points and （70.27±13.61） points， respectively. The scores of SAS and SDS in high level group were significantly lower than those in low level group， the differences were statistically significant （P<0.05）. While scores of CD-RISC and social support scale were significantly higher than those in low level group （P<0.05）. Pearson correlation analysis showed that FACT-B score was significantly positively correlated with age， scores of CD-RISC and social support scale （P<0.05）. While significantly negatively correlated with SAS and SDS scores （P<0.05）. The results of multivariate linear regression analysis showed that age， scores of CD-RISC and social support scale were independent related factors of quality of life level in patients after radical mastectomy （P<0.05）. Conclusion  Age， levels of psychological resilience and social support are independent related factors of quality of life level in patients after radical mastectomy. Thus， its neccisary to the enhance the evaluation of psychosocial factors such as psychological resilience and social support during clinical work， and take targeted measures to improve the quality of life of patients after radical mastectomy.

Key words： radical mastectomy; quality of life; anxiety; depression; psychological resilience; social support

乳腺癌是女性最常见的恶性肿瘤之一，发病率逐年升高且呈年轻化趋势。乳腺癌改良根治术是目前治疗乳腺癌的主要方法，对于清除癌灶、改善患者预后效果确切，但术后患者乳房缺失、女性特征改变，同时辅助化疗引起脱发副作用往往对患者的身心造成较大的负性影响[1-3]。在各种生理改变及压力影响下，患者往往表现为心理社会适应不良，极大地影响其生活质量水平[4]。目前针对乳腺癌根治术后患者生活质量水平与心理社会因素关系的研究尚少且尚无统一结论。为此，本研究以乳腺癌根治术后患者作为研究对象，对其生活质量水平与心理社会因素进行调研分析，并探讨两者的相关性，以期为改善乳腺癌根治术后生活质量水平提供依据，现报道如下。……