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晚期癌症患者创伤后应激障碍、创伤后成长及其对生命质量的预测研究
其他题名The predictive role of posttraumatic stress disorder and posttraumatic growth in quality of life amo
李宁
学位类型同等学力硕士
2014-07
学位授予单位中国科学院研究生院
学位授予地点北京
学位专业心理学
关键词创伤后应激障碍 创伤后成长 癌症 生命质量
摘要目前,全球癌症的发病率呈现持续升高的总体趋势,严重威胁人类生命健康。癌症作为重大应激源,会给患者带来重大的心理影响。一方面,癌症可能会带来一些负性的影响,导致一系列严重的心理疾患,创伤后应激障碍是其中最具特异性的一种。另一方面,癌症经历还能够带来积极变化,例如创伤后成长。已有研究表明创伤后应激障碍和创伤后成长均会对生命质量产生重要影响。本研究主要以299名晚期癌症患者为研究对象,采用问卷法进行研究。 目的:考察晚期癌症患者创伤后应激性障碍、创伤后成长的流行情况及预测因素,探讨二者对生命质量的预测作用。 方法:被试为299名晚期癌症患者,其中男性188人,女性111人,年龄17-86岁,平均54.44±12.86岁。消化系统肿瘤115人,肺癌100人,泌尿及生殖系统肿瘤26人,淋巴瘤25人,乳腺癌23人,纵膈肿瘤3人,神经系统肿瘤2人,妇科肿瘤2人,原发灶不明1人,不清楚2人;确诊时间1-3月103人,3月以上194人,不清楚2人。采用创伤后成长问卷(Posttraumatic Growth Inventory, PTGI)、创伤后应激障碍检查量表特别版(PTSD Check List-Specific Version,PCL-S)、癌症患者生命质量测定量表(EORTC-QLQ-C30)中文版进行评估。 结果: (1)299名晚期癌症患者中共有73人为可能的PTSD患者,发生率为25.3%;PTSD总分为37.4±14.5;一元回归分析显示:患者生活区域(β=0.180,P<0.05)、疼痛情况(β=-0.243,P<0.05)、正在进行的治疗(β=0.176,P<0.05)、领悟社会支持总分(β=-0.204,P<0.05)、积极应对平均分(β=-0.149,P<0.05)可以分别显著地预测患者PTSD症状严重程度;多元回归分析显示:疼痛情况(β=-0.047,P<0.05)、正在进行的治疗情况(β=0.135,P<0.05)、生活区域(β=0.181,P<0.05)以及领悟社会支持(β=-0.153 ,P<0.05)能够显著预测PTSD症状严重程度。 (2)299名晚期癌症患者中创伤后成长总分64.2±20.3;具有PTG的患者159人,占57.2%;一元回归分析显示:患者生活区域(β=0.126,P<0.05)、领悟社会支持总分(β=0.436,P<0.05)、积极应对平均分(β=0.497,P<0.05)、消极应对平均分(β=0.252,P<0.05)可以分别地显著影响患者PTG程度;多元回归分析显示:领悟社会支持(β=0.240,P<0.05)、积极应对方式(β=0.398,P<0.05)可以显著预测患者PTG程度。 (3)299名晚期癌症患者中PTSD严重程度能够预测QOL各维度得分(躯体功能:β=0.118,P<0.001;角色功能:β=0.138,P<0.001;情绪功能:β=0.095,P<0.001;认知功能β=0.105,P<0.001;社会功能:β=0.139, P<0.001;总体健康状况:β=0.109, P<0.05);PTG不能预测QOL的各个维度,同时也无法调节PTSD对QOL的预测作用。 结论: (1) PTG在晚期住院癌症患者中是一种常见的心理现象,其主要的预测因素包括:患者生活区域、领悟社会支持情况、积极应对方式。 (2) PTSD在晚期住院癌症患者中是一种常见的心理疾患,其主要的预测因素包括:患者生活区域、疼痛情况、正在进行的治疗情况、领悟社会支持情况。 (3) PTSD严重程度可以很好地预测QOL,PTG则无法预测QOL,同时PTSD对QOL的预测作用也不会受到PTG的调节。
其他摘要Currently, the high incidence of cancer has not been overcome. Cancer as a major source of stress could bring a significant psychological impact to patients. The posttraumatic stress disorder (PTSD) is one of the most specific and serious mental health problems. In addition to negative effects, Cancer experience can also bring positive change. Studies have shown that posttraumatic stress disorder and posttraumatic growth will have a significant impact on quality of life. This study focused on 299 hospitalized advanced cancer patients with questionnaires for the study. Objective: To investigate the prevalence and predictive factors of posttraumatic stress disorder (PTSD), posttraumatic growth (PTG) of hospitalized advanced cancer patients, and to analyze the predictive role of PTSD and PTG in quality of life. Methods: A total of 299 participants (188 men, 111 women; mean age=54.44, SD=12.86) were recruited to this survey. 115 digestive oncology, 100 lung cancer, 26 urinary and reproductive system cancer, 25 lymphoma, 23 breast cancer, 3 mediastinal tumor, 2 nervous system tumors, 2 gynecologic oncology, 1 unknown primary tumor, 2 unclear; 103 people diagnosed with the time from 1 to 3 months, 194 people diagnosed with more than 3 months; 2 unclear. The participants were administrated with the Posttraumatic Growth Inventory(PTGI), the PTSD Check List-Specific Version (PCL-S) and EORTC-QLQ-C30. Results (1) There was a total of 73 (25.3%) possible PTSD patients among all participants. The PTSD score of 299 advanced cancer patients was 37.4±14.5. Simple linear regression analysis showed that living area (β=0.180, P<0.05), pain conditions (β=-0.243, P<0.05), ongoing therapy (β=0.176, P<0.05), perceived social support score (β=-0.204, P<0.05), positive response average score (β=-0.149, P<0.05) were significantly influenced the severity of PTSD symptoms. According to multiple linear regression analysis, pain conditions (β=-0.047, P<0.05), ongoing therapy (β=0.135, P<0.05) and living area (β=0.181, P<0.05) could predict for the severity of PTSD symptoms. (2) There was a total of 159 (57.2%) possible PTG patients among all participants. The PTG score of 299 advanced cancer patients was 64.2±20.3.. Simple linear regression analysis showed that living area (β=0.126, P<0.05), perceived social support score (β=0.436, P<0.05), positive response average score (β=0.497, P<0.05) and negative response average score (β=0.252, P<0.05) were significantly influenced PTG. Perceived social support score (β=0.240, P<0.05) and positive response average score (β=0.398, P<0.05) could predict for PTG. (3) In 299 hospitalized advanced cancer patients, the severity of PTSD symptoms could predict QOL’s each dimension (Physical function: β=0.118, P<0.001; role function: β=0.138, P<0.001; emotional function: β=0.095, P<0.001; cognitive function: β=0.105, P<0.001; social function: β=0.139, P<0.001; quality of life: β=0.109, P<0.05); PTG could not predict QOL’s each dimension, PTG could not regulate the effect on PTSD in QOL. Conclusion: (1) PTG was a common psychological phenomenon among hospitalized advanced cancer patients, and the main predictive factors of PTG included living area, perceived social support and positive response. (2) PTSD was a common mental problems among hospitalized advanced cancer patients, and the main predictive factors of PTSD included living area, pain conditions, ongoing therapy, perceived social support and positive response. (3) The severity of PTSD symptoms could well predict QOL while PTG could not predict QOL’s each dimension. PTG could not regulate the effect on PTSD in QOL.
学科领域健康心理学
语种中文
文献类型学位论文
条目标识符http://ir.psych.ac.cn/handle/311026/20608
专题健康与遗传心理学研究室
作者单位中国科学院心理研究所
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李宁. 晚期癌症患者创伤后应激障碍、创伤后成长及其对生命质量的预测研究[D]. 北京. 中国科学院研究生院,2014.
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