乳腺癌患者化疗期间焦虑、抑郁的变化趋势及其相关因素

Changing tendency and influencing factors of anxiety and depression for patients with breast cancer during chemotherapy

摘要:

目的：了解乳腺癌患者化疗期间焦虑、抑郁的变化趋势，探讨影响每一疗程焦虑、抑郁的因素，并探讨干预措施。方法：采用Anderson症状调查量表和医院焦虑抑郁量表对194名采用多西紫杉醇、阿霉素、环磷酰胺化疗方案的乳腺癌患者，在其手术后化疗前和每次化疗结束后5～7 d进行问卷调查。结果：乳腺癌患者化疗期间的焦虑、抑郁水平呈现一定的变化趋势，在手术后化疗前最为严重，至第1次化疗结束后呈下降趋势，但是第3次化疗后再次加重，此后逐渐下降。在化疗期间焦虑和抑郁总呈显著正相关，相关系数在0.625～0.908（P值均<0.05），并且每一疗程均有不同的因素影响患者的焦虑、抑郁水平，其中在第3次化疗后影响患者焦虑、抑郁的因素最多，分别是悲伤、疼痛、疲乏、苦恼、健忘和悲伤、疼痛、麻木感、昏昏欲睡。结论：应加强乳腺癌患者化疗期间的心理护理，做好每一疗程相关症状和不良反应的预防和针对性护理，以减轻患者的焦虑、抑郁水平。

Abstract:

Objective：To know about the changing tendency of anxiety and depression，to probe into influencing factors of breast can－cer during chemotherapy and to discuss intervention measures. Methods：Anderson symptom survey scale and hospital anxiety and de－pression scales were used to evaluate 194 patients with breast cancer who planed to adopt（docetaxel，doxorubicin，cyclophosphamide chemotherapy regimen after operation. Evaluation was made on these patients at least 24 h before chemotherapy and every 5-7 d after chemotherapy. Results：Anxiety and depression levels of patients with breast cancer presented a certain changing tendency，which were the most serious at first，then significantly reduced after the first chemotherapy，but reached the peak after the third chemotherapy，then got better gradually. Anxiety and depression levels were always positive correlated during the whole process of chemotherapy and there were different symptoms affecting anxiety and depression levels at different courses of chemotherapy. Conclu－sions：Nurses should enhance the psychological care for patients with breast cancer during the chemotherapy，give preventative and targeted nursing care to alleviate the patients’ anxiety and depression levels.