乳腺癌患者首次手术后抑郁与应对方式社会支持相关性研究

Abstract

目的: 探讨乳腺癌首次手术后未放疗化疗患者的抑郁水平及其与应对方式、社会支持之间的相关性。 方法: 采取整群抽样法,对2007年11月—2008年5月在新疆乌鲁木齐市某三级甲等医院就诊的乳腺癌首次手术后2周,尚未进行放疗化疗的124例女性患者采用抑郁自评量表、医学应对问卷、社会支持评定量表分别调查患者的抑郁水平、应对方式、社会支持状况。用单样本资料的t检验对乳腺癌术后患者抑郁水平与国内常模进行比较;用Pearson相关分析确定应对方式、社会支持与抑郁的相关性。 结果: 乳腺癌首次术后未放疗化疗患者的抑郁发生率为59.7%;抑郁总体与应对总体及其分项目中的面对无相关性,但抑郁总体与应对方式中的回避、屈服呈负相关。抑郁总体与社会支持总体及其3个维度呈负相关。 结论: 乳腺癌首次手术后未放疗化疗患者的抑郁水平较高,应对方式中的回避、屈服及社会支持状况均会影响患者的抑郁水平。护士在护理乳腺癌术后患者的过程中应指导患者用适当的应对方式,并且充分地应用各方面的社会支持,以降低患者的抑郁水平,增进其心理健康。 Objective: To study the correlation between the first postoperative depression of breast cancer patients and the coping styles or social supports. Methods: 124 breast cancer patients in a Class Ⅲ Grade A hospital in Urumqi selected two weeks after operation but without chemotherapy by cluster sampling from November 2007 to May 2008 were investigated by filling out Self-rating Depression Scale(SDS), Medical Coping Mode Questionnaire, Social Support Rating Scale(SSRS). The depression level was compared to national norm by t-test. Pearson correlation analysis was used to determine the correlation between depression and the coping style, social support. Results: 59.7% of the patients developed depression. No correlation was found between the depression level and the overall coping style, the sub-item “facing” in the coping style, but depression was negatively correlated with “avoidance” and “obedience” in the coping style. Besides, depression was negatively correlated with social support as well as the three sub-items in the social support. Conclusion: The level of depression is high in the patients without chemotherapy after operation. Avoidance and obedience in the coping styles as well as social support affect the depression level. Nurses should instruct them with right coping styles, make full use of social support to decrease the depression level and enhance their psychological health level.