摘要
目的探讨早发性结直肠癌患者心理痛苦轨迹变化并分析其影响因素。方法选取2022年3月至2024年3月期间在河南科技大学第一附属医院接受治疗的113例早发性结直肠癌患者作为调查对象。采用心理痛苦温度计(DT)评估患者心理痛苦水平,观察患者入院当日(T1)、出院当日(T2)、出院后1个月(T3)、出院后3个月(T4)和出院后6个月(T5)五个时间点的心理痛苦水平变化。采用Pearson相关系数分析患者在T1~T5任意2个时间点DT评分的相关性。运用潜类别增长模型(LCGA)识别不同患者的心理痛苦轨迹。收集所有患者的一般资料,采用单因素和多因素Logistic回归分析影响早发性结直肠癌患者心理痛苦轨迹变化的因素。结果早发性结直肠癌患者T1~T5时间点的DT评分分别为(4.91±1.11)分、(4.43±1.02)分、(3.68±0.84)分、(3.12±0.62)分、(2.51±0.48)分,持续下降,差异均有统计学意义(P<0.05),且任意两个时间点的DT评分均呈正相关(r>0,P<0.05)。经过计算识别出3条心理痛苦变化轨迹,即持续高痛苦组8例、心理痛苦降低组32例和持续低痛苦组73例。单因素分析结果显示,不同心理痛苦轨迹类别患者的结直肠癌家族史、性格特质、家庭支持度比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,有结直肠癌家族史、低家庭支持度是早发性结直肠癌患者心理痛苦轨迹类别倾向高心理痛苦的危险因素,性格特质为胆汁质及多血质是倾向高心理痛苦的保护因素(P<0.05)。结论早发性结直肠癌患者在治疗期间的心理痛苦情况呈现出不同的演变轨迹,大部分患者能较好地适应,无需特别干预。特定的性格特质、低家庭支持度和有家族病史的患者更可能出现较高水平的心理痛苦,临床应予以针对性干预。
Objective To investigate the changes of psychological distress trajectories in patients with early-onset colorectal cancer and analyze its influencing factors.Methods A total of 113 patients with early-onset colorectal cancer who were treated in the First Affiliated Hospital of Henan University of Science and Technology from March 2022 to March 2024 were selected.The amdpsychological distress level of patients was evaluated by psychological distress thermometer(DT),and the changes of psychological distress level of patients on the day of admission(T1),the day of discharge(T2),1 month after discharge(T3),3 months after discharge(T4),and 6 months after discharge(T5)was observed.The correlation of psychological DT scores at any two time points from T1 to T5 was analyzed by Pearson corre-lation coefficient.The psychological distress trajectories of different patients were identified by Latent Class Growth Model(LCGA).The general data of all patients were collected,and the factors affecting the change of psychological distress trajectory in patients with early-onset colorectal cancer were analyzed by univariate and multivariate Logistic regression analysis.Results The DT scores of patients with early-onset colorectal cancer at T1 to T5 time points were(4.91±1.11)points,(4.43±1.02)points,(3.68±0.84)points,(3.12±0.62)points,and(2.51±0.48)points,respectively,which decreased successively,and the differences were statistically significant(P<0.05).The DT scores at any two time points were positively correlated(r>0,P<0.05).Three changes of psychological distress trajectories were identified by calculation:8 cases in persistent high pain group,32 cases in psychological pain reduction group,and 73 cases in persistent low pain group.Univariate analysis showed that there were statistically significant differences infamily history of colorectal cancer,personality traits,and family support among patients with different psychological distress trajectory categories(P<0.05).Multivariate logistic regression analysis showed that family history of colorectal cancer and low family support were risk factors for high psychological distress in patients with early-onset colorectal cancer,while personality traits of bile and sanguine temperament were protective factors for high psychological distress(P<0.05).Conclusion The psychological distress of patients with early-onset colorectal cancer during treatment shows different evolution trajectories,and most patients can better adapt without special intervention.Patients with specific personality traits,low family support,and family history of colorectal cancer are more likely to have higher levels of psychological distress,and targeted clinical intervention should be performed.
作者
徐伟
李君
刘婧茹
卢鑫
刘娟
XU Wei;LI Jun;LIU Jing-ru;LU Xin;LIU Juan(Department of Gastroenterology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan,CHINA;Department of Nursing,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan,CHINA)
出处
《海南医学》
2025年第1期107-112,共6页
Hainan Medical Journal
基金
河南省医学科技攻关计划项目(编号:LHGJ20210429)。
关键词
早发性结直肠癌
心理痛苦
轨迹
影响因素
Early-onset colorectal cancer
Psychological distress
Trajectory
Influencing factors
