摘要
目的探讨中青年乳腺癌患者改良根治术后不同时间夫妻亲密关系及配偶心理反应,及其对患者抑郁的影响。方法选择151例行乳腺癌改良根治术中青年患者及其配偶为研究对象,采用抑郁自评量表、乳腺癌患者配偶心理反应量表、亲密关系满意度问卷分别与于术后2周、2个月、12个月进行问卷调查。结果患者术后2周、2个月、12个月抑郁得分分别为50.97±9.14、54.60±9.35、47.42±8.72,抑郁检出率分别为85例(56.29%)、107例(70.86%)、55例(36.42%),均P<0.01。配偶心理反应的逃避与回避、体像改变反应及负性情绪是患者抑郁的危险因素,亲密关系是保护因素(均P<0.05)。配偶心理反应既可直接预测患者抑郁,也可通过作用于亲密关系间接影响患者抑郁[95%CI=(0.069,0.508)]。结论中青年乳腺癌改良根治术患者术后存在不同程度的抑郁症状,亲密关系在配偶心理反应影响抑郁的路径中扮演着部分中介作用。关注患者配偶的心理反应和亲密关系变化,有利于早期发现和积极干预患者的抑郁症状,促进患者术后康复。
Objective To explore the husband-and-wife relationship and the changes of spouse′s psychological response in young and middle-aged patients undergoing modified radical mastectomy for breast cancer,and to probe the influence of the 2 variables on depression of patients.Methods A total of 151 young and middle-aged patients having received modified radical mastectomy for breast cancer,as well as their husbands were enrolled in the longitudinal study.The participants were surveyed with the Self-rating Depression Scale(SDS),the Spouse Psychological Response Scale for Breast Cancer Patients,and the Quality of Relationship Inventory(QRI)at 2 weeks,2 months and 12 months after operation.Results The patients scored 50.97±9.14,54.60±9.35 and 47.42±8.72 points at 2 weeks,2 months and 12 months after operation,respectively,with an incidence rate of depression at 56.29%(85 cases),70.86%(107 cases)and 36.42%(55 cases),respectively at 3 time points(P<0.01 for all).The spousal evasion and avoidance,response to body image change and negative emotion were risk factors of depression in patients,while intimate relationship was the protective factor(P<0.05 for all).Pathway analysis showed that spouse′s psychological response could either directly predict patient depression,or indirectly influence patient depression by acting on intimate relationship,with significant indirect effect[95%CI=(0.069,0.508)].Conclusion Young and middle-aged patients undergoing modified radical mastectomy for breast cancer had various degree of depressive symptoms;intimate relationship played a partial mediating role between spouse′s psychological response and depression in patients.Attention should be directed to spouse′s psychological response and changes in intimate relationship,which could be conducive to early detection and intervention of depression in post-operative breast cancer patients,and boost rehabilitation of patients.
作者
赵婷婷
明月
张小杰
Zhao Tingting;Ming Yue;Zhang Xiaojie(Immunotherapy Ward 2,Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital,Zhengzhou 450008,China)
出处
《护理学杂志》
CSCD
北大核心
2021年第23期75-78,共4页
Journal of Nursing Science
关键词
乳腺癌
改良根治术
中青年
配偶
抑郁
亲密关系
心理干预
breast cancer
radical mastectomy
young and middle-age
spouse
depression
intimate relationship
psychological intervention
