中青年癌症患者住院期间反刍性沉思现状及影响因素的调查研究

doi:10.3761/j.issn.0254-1769.2019.07.015

摘要/Abstract

摘要：

目的了解中青年癌症患者反刍性沉思水平并分析其影响因素,为临床医护人员实施个体化干预提供依据。方法采用一般资料调查表、事件相关反刍性沉思问卷和情绪调节量表对山东省某三级甲等医院肿瘤科共373例癌症患者进行调查。结果癌症患者的反刍性沉思总得分为（28.64±12.13）分,其中侵入性反刍性沉思和目的性反刍性沉思得分分别为（13.92±6.42）分和（14.72±6.80）分;表达抑制、宗教信仰共解释侵入性反刍性沉思总变异的14.2%;表达抑制、家庭关系、文化程度共解释目的性反刍性沉思总变异的22.1%。结论中青年癌症患者的反刍性沉思处于中等偏下水平,表达抑制、宗教信仰、家庭关系及文化程度是癌症患者反刍性沉思的重要影响因素。临床医护人员需针对不同特征的癌症患者采取相应的个体化干预,帮助患者采取积极的态度应对疾病,促进其身心康复。

关键词: 癌症, 反刍性沉思, 情绪调节, 影响因素

Abstract:

Objective To investigate the level and influencing factors of rumination in young and middle-aged cancer patients,to provide a basis for clinical medical staff to implement personalized intervention.Methods Totally 373 cancer patients in the department of oncology at a tertiary hospital in Shandong Province were investigated using general information questionnaire,Chinese Version of Event Related Rumination Inventory,and Emotion Regulation Scale.Results The score of rumination of cancer patients was（28.64±12.13）,intrusive rumination score was（13.92±6.42）,the purpose of rumination score was（14.72±6.80）. Expression suppression and religion could explain 14.2% of the total variance of invasive rumination. Expression suppression,family relationship and education level could explain 22.1% of the total variance of purposive rumination.Conclusion The rumination level was low in cancer patients. Expression suppression,religion,family relationship and educational level are important influencing factors of rumination in cancer patients. To promote the development of positive cognitive processing and the recovery of physical and mental,personalized intervention should be taken by clinical medical staff in cancer patients with different characteristics.

Key words: Cancer, Rumination, Emotion Regulation, Influencing Factors

李秋环, 赵雯雯, 田汝香, 栾晓嵘. 中青年癌症患者住院期间反刍性沉思现状及影响因素的调查研究[J]. 中华护理杂志, 2019, 54(7): 1038-1043.

LI Qiuhuan, ZHAO Wenwen, TIAN Ruxiang, LUAN Xiaorong. Rumination status and influencing factors in young and middle-aged cancer patients during hospitalization[J]. Chinese Journal of Nursing, 2019, 54(7): 1038-1043.

图/表 1

参考文献 21

[1]	Bray F, Ferlay J, Soerjomataram I , et al. Global cancer statistics 2018:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018,68(6):394-424. DOI URL
[2]	陈万青, 李贺, 孙可欣 , 等. 2014年中国恶性肿瘤发病和死亡分析[J]. 中华肿瘤杂志, 2018,40(1):5-13.
[3]	国家统计局. 中国统计年鉴[J]. 北京: 中国统计出版社, 2016.
[4]	Steiner JL, Wagner CD, Bigatti SM , et al. Depressive rumination and cognitive processes associated with depression in breast cancer patients and their spouses[J]. Fam Syst Health, 2014,32(4):378-388. DOI URL
[5]	巩树梅, 董超群, 梁珍红 , 等. 意外创伤者反刍性沉思水平及影响因素的调查研究[J]. 中华护理杂志, 2015,50(1):88-91.
[6]	Cann A, Calhoun LG, Tedeschi RG , et al. Assessing posttraumatic cognitive process:the event related rumination inventory[J]. Anxiety Stress Coping, 2011,24(2):137-156. DOI URL
[7]	董超群, 巩树梅, 刘晓虹 . 简体中文版事件相关反刍性沉思问卷在意外创伤者中应用的信效度分析[J]. 中华护理杂志, 2013,48(9):831-834.
[8]	Gross JJ, John OP . Individual differences in two emotion regulation processes:implications for affect,relationships,and well-being[J]. J Pers Soc Psychol, 2003,85(2):348-362. DOI URL
[9]	杨军, 李新霞, 张金花 , 等. 乳腺癌病人反刍性沉思水平及影响因素的调查分析[J]. 护理研究, 2016,30(10A):3490-3494.
[10]	陈红涛, 宋小花, 董彩梅 , 等. 喉癌术后患者创伤后成长现状及影响因素分析[J]. 护理学杂志, 2017,32(6):22-25.
[11]	Rand KL, Cripe LD, Monahan PO , et al. Illness appraisal,religious coping,and psychological responses in men with advanced cancer[J]. Support Care Cancer, 2012,20(8):1719-1728. DOI URL
[12]	Ho SM, Chan MW, Yau TK , et al. Relationships between explanatory style,posttraumatic growth and posttraumatic stress disorder symptoms among Chinese breast cancer patients[J]. Psychol Health, 2011,26(3):269-285. DOI URL
[13]	李梦奇, 王颖, 谢海燕 , 等. 癌症患者灵性护理需求的现状及其影响因素研究[J]. 中华护理杂志, 2017,52(8):930-934.
[14]	李慧, 王琛, 李杨 , 等. 胃肠道肿瘤患者的灵性需求及影响因素的调查分析[J]. 中国实用护理杂志, 2018,34(22):1725-1729.
[15]	Madeira N, Alduquerque E, Santos T , et al. Death ideation in cancer patients:contributing factors[J]. J Psychosoc Oncol, 2011,29(6):636-642. DOI URL
[16]	赵燕 . 系统性红斑狼疮患者创伤后成长及影响因素研究[D]. 郑州:郑州大学, 2016.
[17]	罗珠嘉, 陈玉红, 郑雪梅 , 等. 冠心病住院患者认知情绪调节策略及与负性心理的关系[J]. 护理学杂志, 2017,32(19):93-95.
[18]	宋晶, 张爱华 . 冠心病介入治疗患者反刍性沉思水平及影响因素分析[J]. 护理学杂志, 2016,21(1):39-42.
[19]	洪静芳, 张伟, 宋永霞 , 等. 老年癌症患者心理困扰的现况调查[J]. 中华护理杂志, 2015,50(1):92-96.
[20]	董超群, 刘一苇, 梁莉丹 , 等. 情绪调节对脑瘫患儿照顾者情绪体验与创伤后成长的影响[J]. 解放军护理杂志, 2018,35(12):1-5.
[21]	Hu T, Zhang D, Wang J , et al. Relation between emotion regulation and mental health:a meta-analysis review[J]. Psychol Rep, 2014,114(2):341-362. DOI URL

因变量	变量	B	β值	t值	P值
侵人性反刍	常数	6.793	-	4.816	<0.001
性沉思	表达抑制	3.38	0.260	5.191	<0.001
	宗教信仰	2.674	1.290	3.473	<0.001
目的性反刍	常数	5.964	-	4.47	<0.001
性沉思	表达抑制	-3.271	-1.333	-3.803	<0.001
	家庭关系	3.59	0.243	3.021	0.007
	文化程度	4.701	0.092	2.62	0.004

因变量	变量	B	β值	t值	P值
侵人性反刍	常数	6.793	-	4.816	<0.001
性沉思	表达抑制	3.38	0.260	5.191	<0.001
	宗教信仰	2.674	1.290	3.473	<0.001
目的性反刍	常数	5.964	-	4.47	<0.001
性沉思	表达抑制	-3.271	-1.333	-3.803	<0.001
	家庭关系	3.59	0.243	3.021	0.007
	文化程度	4.701	0.092	2.62	0.004