【作者】 王丽；

【导师】 李峰；

【作者基本信息】 吉林大学 ， 护理学， 2017， 硕士

【摘要】 目的:通过对结直肠癌患者述情障碍、抑郁及社会支持的调查,了解结直肠癌患者述情障碍、抑郁及社会支持现状;分析结直肠癌患者述情障碍在人口学特征上的差异;探讨结直肠癌患者述情障碍与抑郁及社会支持之间的关系,为降低结直肠癌患者述情障碍及抑郁水平,改善其社会支持状况提供参考依据。方法:通过方便抽样的方法,选择在长春市两所三级甲等医院进行治疗的结直肠癌患者作为研究对象,于2016年6~12月对符合纳入标准的183名结直肠癌患者进行问卷调查,调查工具采用:一般资料调查表、多伦多述情障碍量表、Zung抑郁自评量表、肖水源社会支持量表。利用均数、标准差、构成比对结直肠癌患者的一般资料、述情障碍、抑郁、社会支持进行描述;利用t检验、单因素方差分析及秩和检验分析患者述情障碍在人口学上的差异;利用多元逐步回归方法分析患者述情障碍的影响因素;采用Pearson相关分析探讨结直肠癌患者述情障碍与抑郁及社会支持两者之间的关系,所有数据均釆用统计软件SPSS20.0进行分析。结果:1.结直肠癌述情障碍的总分为(59.54±7.35)分,三个维度得分情况分别为:识别情感障碍得分为(21.25±4.64)分、描述情感障碍得分为(14.16±2.66)分、外向性思维得分为(24.12±2.50)分,45.4%的患者有述情障碍,40.4%的患者有述情障碍倾向,无述情障碍者占14.2%。2.结直肠癌患者抑郁的总分为(54.37±10.04)分,社会支持的总分为(37.55±6.78)分。3.单因素分析结果显示:结直肠癌患者述情障碍在体重指数、受教育程度、职业状态、居住地、医保类型、家庭平均月收入、距离手术的时间、有无造瘘口、正在接受的治疗9个方面差异具有统计学意义(P<0.05)。4.多因素分析结果显示:体重指数、受教育程度、职业状态、有无造瘘口4项因素是结直肠癌患者述情障碍的主要影响因素。5.结直肠癌患者的抑郁程度不同其述情障碍总分、识别情感障碍、描述情感障碍的差异均具有统计学意义(P<0.05),而与外向性思维的差异不具有统计学意义(P>0.05);结直肠癌患者的社会支持程度不同其述情障碍及其各维度的差异均具有统计学意义(P<0.05)。6.相关性分析结果显示:结直肠癌患者述情障碍与抑郁呈正相关,与社会支持呈负相关(P<0.05)。结论:1.结直肠癌患者存在述情障碍和抑郁,且抑郁处于中度偏上水平。结直肠癌患者的社会支持状况较好;2.结直肠癌患者述情障碍的主要影响因素为体重指数、受教育程度、职业状态、有无造瘘口;3.结直肠癌患者述情障碍与抑郁呈正相关,与社会支持呈负相关。更多还原

【Abstract】 Objective:The porpuse of this reseaech is to describe the status of alexithymia,depression,and social support in colorectal cancer patients and analyze the influencing factors of alexithymia.Besides,the study explore the correlation of alexithymia with depression and social support in order to provide the basis and reference for understanding the status of psychological and social support needs of patients and reducing the level of alexithymia and depression and improving their social support.Methods:With convenience sampling method,We selected colorectal cancer patients who were being treated in two hospital of Changchun as research subjects.Then questionnaires were applied to 183 patients who met the inclusion criteria from July to December in 2016.The questionnaire included four parts: the General Information of colorectal cancer patients,the Toronto Alexithymia Scale(TAS-20),Zung selfrating Depression Scale(SDS),the Social Support Scale of Xiao Shuiyuan.In this study,the measurement data was described by Mean ± SE.The count data was described by frequency and constituent ratio.ANOVA analysis,t-test,and rank sum were used for the one-way analysis of variance.Multiple regression analysis was used for multiple-factor analysis.Spearman analysis and Pearson analysis were used for correlation analysis.All data were analyzed by statistical software SPSS13.0.Results:1.The total score of alexithymia in colorectal cancer patients was 59.54 + 7.35.The three dimensions of alexithymia score respectively:the score of difficulty identifying feelings was 21.25±4.64.The score of difficulty describing feelings was 14.16±2.66.The score of externally oriented thinking was 24.12±2.50.Alexithymia accounted for 45.4%,alexithymia tendencies accounted for 40.4%,nonalexithmia accounted for 14.2%.2.The total score of depression in patients with colorectal cancer was 54.37 +10.04,and the total score of social support was 37.55 +6.78.3.There were statistically differences on the alexithymia between the colorectal cancer patients with different characteristics,such as :BMI,education level,occupation status,residence,health insurance type,family average monthly income,distance from surgery,whether or not the stoma,the treatment is being accepted.4.Multivariate analysis showed that: there were four factors were included in the regression equation of the score of alexithymia in patients with colorectal cancer.Respectively: BMI,education level,occupation status,whether or not the stoma.5.There was statistically significant difference between depression and score of alexithymia including difficulty identifying feelings and difficulty describing feelings.There was not statistically significant difference in externally oriented thinking.There was statistically significant difference between social support and the alexithymia,and its each dimension score.6.The correlation analysis showed that alexithymia and depression was positively related with colorectal cancer,and social support was negatively correlated(P < 0.05).Conclusion:1.Colorectal cancer patients have alexithymia and depression,and depression is medium level.The status of social support of patients with colorectal cancer is better;2.The main influence factors of alexithymia of patients with colorectal cancer were BMI,educational level,occupation status,whether or not the stoma;3.The colorectal cancer patients with alexithymia and depression is positive correlation,between alexithymia and social support is negative correlation.更多还原