CAJ | 학술논문

背景:女性生殖器官良、恶性肿瘤是严重影响女性生活质量的妇科疾病,其对患者社会心理影响如何?目的:分析女性生殖器官肿瘤患者的心身健康状况,为制定切实有效、有针对性的心理干预措施提供参考.设计:以诊断为依据,病例对照研究.单位:武汉大学人民医院精神科.对象:武汉大学人民医院和中南医院妇产科、肿瘤科病房及放疗门诊的77例女性生殖器官恶性肿瘤患者(宫颈癌38例,卵巢癌30例,子宫内膜癌9例)、40例良性肿瘤患者和40例健康对照者.干预:所有研究对象均按指导语填写临床症状自评量表(SCL-90),评定近1周来患者的心身健康状况.文化程度低,填写困难者由研究者按统一标准代为填写,所有研究病例均在入院后1～3 d完成以上量表的评定.主要观察指标:SCL-90的总分、阳性项目数、阳性项目均分、及各因子分(包括躯体化、强迫、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性及其他等).结果:恶性肿瘤组除恐怖、敌对因子分与健康对照组无差异外,其余各项指标均极显著高于健康对照组,差异均有显著性意义(q=4.279～9.936,P均＜0.01).与良性肿瘤组相比除焦虑、敌对、恐怖和阳性项目数差异无显著性外,其余各项因子分亦显著较高(q=3.128～4.825,P＜0.05～0.01).良性肿瘤组SCL-90总分、阳性项目数、阳性项目均分、躯体化、强迫、抑郁、焦虑及其他(包括睡眠和食欲)等因子分亦显著高于健康对照组,差异有显著性意义(q=3.123～5.348,P＜0.05～0.01).结论:生殖器官良性、恶性肿瘤均对患者的心身健康有着不良影响,应采取积极的社会心理干预措施.
배경:녀성생식기관량、악성종류시엄중영향녀성생활질량적부과질병,기대환자사회심리영향여하?목적:분석녀성생식기관종류환자적심신건강상황,위제정절실유효、유침대성적심리간예조시제공삼고.설계:이진단위의거,병례대조연구.단위:무한대학인민의원정신과.대상:무한대학인민의원화중남의원부산과、종류과병방급방료문진적77례녀성생식기관악성종류환자(궁경암38례,란소암30례,자궁내막암9례)、40례량성종류환자화40례건강대조자.간예:소유연구대상균안지도어전사림상증상자평량표(SCL-90),평정근1주래환자적심신건강상황.문화정도저,전사곤난자유연구자안통일표준대위전사,소유연구병례균재입원후1～3 d완성이상량표적평정.주요관찰지표:SCL-90적총분、양성항목수、양성항목균분、급각인자분(포괄구체화、강박、인제관계민감、억욱、초필、활대、공포、편집、정신병성급기타등).결과:악성종류조제공포、활대인자분여건강대조조무차이외,기여각항지표균겁현저고우건강대조조,차이균유현저성의의(q=4.279～9.936,P균＜0.01).여량성종류조상비제초필、활대、공포화양성항목수차이무현저성외,기여각항인자분역현저교고(q=3.128～4.825,P＜0.05～0.01).량성종류조SCL-90총분、양성항목수、양성항목균분、구체화、강박、억욱、초필급기타(포괄수면화식욕)등인자분역현저고우건강대조조,차이유현저성의의(q=3.123～5.348,P＜0.05～0.01).결론:생식기관량성、악성종류균대환자적심신건강유착불량영향,응채취적겁적사회심리간예조시.
BACKGROUND: Benign and malignant tumors of female reproductive organs are gynaecological diseases that seriously affect female quality of life. However, how are socio-psychological impacts on patients?OBJECTIVE: To analyze the physical and mental health of female patients with carcinomas of reproductive organs for the establishment of effective and pertinent mental invention.DESIGN: A case-controlled study based on the diagnosis.SETTING: Department of Psychiatry of the Renmin Hospital of Wuhan University.PARTICIPANTS: Totally 77 female cases of malignant tumors of the female reproductive organs including 38 cases of cervical carcinoma, 30 cases of ovarian carcinoma and 9 cases of carcinoma of the endometrium, 40 cases of benign tumour and 40 healthy subjects were selected from the department of gynecology, department of ohcology and outpatient department of radiotherapy of the Renmin Hospital of Wuhan University and Zhongnan Hospital.INTERVENTIONS: SCL-90 was filled by all the subjects with instructive language to evaluate the physical and mental health of the patient within one week. SCL-90 was filled by the researchers for those patients with low education background and difficulty in writing with standard criteria. The above evaluations were completed within 1 to 3 days after admissions of all subjects.MAIN OUTCOME MEASURES: Total scores of SCL-90, positive item numbers, average score of positive items, and the scores of each factor (including somatization, compulsion, sensitive human relationship, depression, anxiety, hostility, phobia, crankiness, lunacy and others).RESULTS: Scores of each indicator of malignant tumour group except the scores of phobia and hostility were significantly higher than that of healthy control group( q = 4. 279 to 9. 936, P ＜ 0. 01 ). Scores of each indicator of malignant tumour group except the scores of anxiety, hostility, phobia and positive item numbers were significantly higher than that of benign tumour group(q =3. 128 to 4.825, P ＜ 0.05 to 0.01) . The SCL-90 total score,positive item numbers, and the average scores of positive items, somatization, compulsion, depression, anxiety and others(including sleeping and appetite) were all significantly higher than that of healthy control group (q=3. 123 to 5. 348, P ＜0.05 to 0.01).CONCLUSION: Benign and malignant tumours of productive organs have adverse effects on physical and mental health of the female patients, which should be actively intervened socio-psychologically.