甲状腺癌手术患者术前心理痛苦状况调查及影响因素分析

Preoperative psychological distress and influencing factors of patients undergoing thyroid cancer surgery

摘要:

目的 调查甲状腺癌手术患者心理痛苦状况，分析其原因和影响因素，为临床护理提供依据。方法 使用一般资料问卷和心理痛苦温度计对300例甲状腺癌住院患者进行手术前心理状况调查。结果 本研究共发放问卷300份，收回300份，有效回收率100%。300例甲状腺癌手术患者术前心理痛苦得分为0~10分，平均（2.77±2.07）分，心理痛苦评分≥4分101例，占33.67%，其中中度痛苦（4~6分）89例，占29.67%、重度痛苦（7~9分）8例，占2.67%，极度痛苦（10分）4例，占1.33%；问题列表中令患者感到心理痛苦的问题主要为担心复发211例（70.33%）和手术瘢痕152例（50.67%）；Logistic回归分析显示，患者年龄、性别、性格类型（患者自评）3个变量进入甲状腺癌手术患者心理痛苦影响因素模型（P<0.05）。结论 甲状腺癌手术患者存在不同程度的心理痛苦，应重点关注年轻、女性及性格内向的患者。同时根据患者心理痛苦问题进行针对性干预，使患者积极有效应对手术，促进早日康复。

Abstract:

Objective To investigate the preoperative psychological distress, and its the causes and influencing factors in patients undergoing thyroid cancer surgery so as to provide evidence for clinical nursing. Methods A total of 300 preoperative thyroid cancer patients were investigated using a general information questionnaire and a psychological distress thermometer. Results In this study, 300 questionnaires were distributed and recovered with an effective recovery rate of 100%. Their psychological distress scores ranged from 0 to 10 with an average of 2.77±2.07. One hundred and one patients (33.67%) had psychological distress score greater than or equal to 4, including 89 (29.67%) with moderate distress (scored 4~6), 8 (2.67%) with severe distress (scored 7~9), and 4 (1.33%) with extreme distress (scored 10). The list of problems that caused psychological distress was dominated by the fear of recurrence (70.33%) and surgical scar (50.67%). Logistic regression analysis showed that age, gender and personality type (self-reported) of patients were included in the influencing factor model of psychological distress in thyroid cancer patients (P<0.05). Conclusions Patients undergoing thyroid cancer surgery have varying degrees of preoperative psychological distress. Close attention should be payed to young, female and introverted patients. Meanwhile, targeted intervention should be conducted so that the patients can positively and effectively cope with the operation and recover quickly.