CAJ | 학술논문

背景与目的：晚期肿瘤患者的生活质量、心理状况等正在受到广泛的关注和重视，本研究初步评估晚期恶性肿瘤患者的心理状况，并分析其影响因素。方法：对2011年9月—2013年3月于复旦大学附属肿瘤医院综合治疗科住院治疗的晚期肿瘤患者，在家属陪同及医师的指导下，分别完成焦虑自评量表(self-rating anxiety scale，SAS)、抑郁自评量表(self-rating depression scale，SDS)、生活质量调查问卷(EORTC QLQ-C30)、社会支持评定量表、90项症状清单(symptom checklist 90，SCL-90)等调查量表，并对各量表的结果进行统计学分析。结果：共56例患者入组。所有患者中，18例有抑郁倾向，24例有焦虑倾向，16例焦虑合并抑郁。分析显示，有心理障碍组，除认知功能外，躯体、角色、情绪、社会功能评分明显较无心理障碍组低，而SCL-90评分及疲倦、疼痛、呼吸困难、失眠、食欲丧失、经济困难等方面，有心理障碍组评分较无心理障碍组明显升高。患者SAS、SDS评分与整体生活质量呈负相关，而与患者的症状评分呈正相关。结论：晚期恶性肿瘤患者中，存在心理障碍的患者比例较高，且心理障碍会严重影响患者的生活质量。对于主诉症状较多或者自觉生活质量较差的患者，需要更多地关注其心理状况，必要时进行一定的干预，以缓解症状，提高生活质量。
배경여목적：만기종류환자적생활질량、심리상황등정재수도엄범적관주화중시，본연구초보평고만기악성종류환자적심리상황，병분석기영향인소。방법：대2011년9월—2013년3월우복단대학부속종류의원종합치료과주원치료적만기종류환자，재가속배동급의사적지도하，분별완성초필자평량표(self-rating anxiety scale，SAS)、억욱자평량표(self-rating depression scale，SDS)、생활질량조사문권(EORTC QLQ-C30)、사회지지평정량표、90항증상청단(symptom checklist 90，SCL-90)등조사량표，병대각량표적결과진행통계학분석。결과：공56례환자입조。소유환자중，18례유억욱경향，24례유초필경향，16례초필합병억욱。분석현시，유심리장애조，제인지공능외，구체、각색、정서、사회공능평분명현교무심리장애조저，이SCL-90평분급피권、동통、호흡곤난、실면、식욕상실、경제곤난등방면，유심리장애조평분교무심리장애조명현승고。환자SAS、SDS평분여정체생활질량정부상관，이여환자적증상평분정정상관。결론：만기악성종류환자중，존재심리장애적환자비례교고，차심리장애회엄중영향환자적생활질량。대우주소증상교다혹자자각생활질량교차적환자，수요경다지관주기심리상황，필요시진행일정적간예，이완해증상，제고생활질량。
Background and purpose:The quality of life and psychological status of the advanced cancer patients has been widely valued. This study aimed to analyze the psychological status of the advanced cancer patients and its influence factors.Methods:The patients who were hospitalized in the palliative care department of Fudan University Cancer Center from Sep. 2011 to Mar. 2013 were included in this study. Self-rating anxiety scale(SAS), self-rating depression scale (SDS), EORTC QLQ-C30, social support revalued scale and symptom checklist 90 (SCL-90) were recorded and analyzed.Results:Fifty-six patients were included in this study, 18 were depression and 24 were anxiety while 16 of them were depression together with anxiety. The patients were divided into 2 groups according to their psychological status. There’s no signiifcant difference between the age and the social support between the two groups, while the mental disorders group have lower scores on body function, role function, emotional function and social function. The mental disorders were positive correlated with the symptoms score while negative correlated with the quality of life.Conclusion:There’s a high ratio of mental disorders in advanced cancer patients, the symptom scores and quality of life are related to mental disorders. We should pay more attention to the patients who were suffered more from the illness or had lower QOL scores.