育龄期甲状腺癌女性患者生育忧虑的潜在剖面分析

doi:10.3761/j.issn.0254-1769.2022.22.008

摘要/Abstract

摘要：

目的了解育龄期甲状腺癌女性患者生育忧虑的类别特点，并探讨不同类别患者生育忧虑之间的特征差异。方法采用便利抽样法，于2020年9月—2021年5月选取苏州市某三级甲等医院的195例育龄期甲状腺癌女性患者作为调查对象。采用一般资料调查表、癌症后生育忧虑量表进行调查。结果回收188份有效问卷。育龄期甲状腺癌女性患者生育忧虑特征可分为3个潜在类别：低生育忧虑-担忧自身健康组（28.7%）、中等生育忧虑-高不孕接受度组（41.5%）、高生育忧虑-高不孕接受度组（29.8%）。多元Logistic回归分析结果显示，年龄、文化程度、子女个数、辅助治疗、主要照顾者是育龄期甲状腺癌女性患者生育忧虑的影响因素。结论育龄期甲状腺癌女性患者生育忧虑有明显的分类特征，医护人员应根据影响因素对不同类别患者进行心理疏导及信息支持等干预，以降低患者的生育忧虑水平。

关键词: 育龄期, 甲状腺癌, 生育忧虑, 潜在剖面分析, 影响因素分析, 肿瘤护理

Abstract:

Objective This article aims to classify reproductive concern characteristics among female thyroid cancer patients at reproductive age，and to explore the characteristics of various types of reproductive concerns among patients. Methods A total of 195 female thyroid cancer patients at reproductive age from a tertiary first-class hospital in Suzhou city were enrolled as investigation subjects via convenience sampling methodology. General information questionnaire and Reproductive Concerns After Cancer scale（RCAC） were utilized as the investigating tools. Results The characteristics of reproductive concerns among female thyroid cancer patients at reproductive age were sub-grouped to 3 potential categories，namely low reproductive concern group-self-health worry（28.7%），moderate reproductive concern group-high infertility acceptance group（41.5%），and high reproductive concern group-high infertility acceptance group（29.8%）. Multivariate logistic regression outputs demonstrated that age，education level，child numbers，auxiliary treatment and primary caregivers were influencing factors regarding to reproductive concerns among female thyroid cancer patients at reproductive age. Conclusion The reproductive concerns among female thyroid cancer patients at reproductive age had apparent classification characteristics. Medical staff should carry out psychological counseling and information support for different types of patients following relevant influencing factors to reduce the level of reproductive anxiety among the patients.

Key words: Reproductive Age, Thyroid Cancer, Reproductive Concerns, Latent Profile Analysis, Root Cause Analysis, Oncologic Nursing

高文君, 黄慧, 田凤美, 谭丽萍, 郑力. 育龄期甲状腺癌女性患者生育忧虑的潜在剖面分析[J]. 中华护理杂志, 2022, 57(22): 2738-2744.

GAO Wenjun, HUANG Hui, TIAN Fengmei, TAN Liping, ZHENG Li. Latent profile analysis of reproductive concerns among female thyroid cancer patients at reproductive age[J]. Chinese Journal of Nursing, 2022, 57(22): 2738-2744.

图/表 4

图1 育龄期甲状腺癌女性患者生育忧虑3个潜在类别的特征分布

Figure 1 The characteristic distribution of 3 potential categories of reproductive concerns among female thyroid cancer patients at reproductive age

表1 育龄期甲状腺癌女性患者生育忧虑潜在类别指标

Table 1 Potential categories of reproductive concerns among female thyroid cancer patients at reproductive age

表2 育龄期甲状腺癌女性患者生育忧虑潜在类别的单因素分析[例（百分比/百分率，%）]

Table 2 Univariate analysis of potential categories of fertility anxiety in women of reproductive age with thyroid cancer[case（percentage，%）]

表3 育龄期甲状腺癌女性患者生育忧虑类别影响因素的多元Logistic回归分析

Table 3 Multivariate Logistic regression analysis of influencing factors of reproductive concerns among female thyroid cancer patients at reproductive age

参考文献 27

[1]	范建霞, 关海霞, 吕朝晖, 等. 妊娠期和产后分化型甲状腺癌促甲状腺激素抑制治疗中国专家共识(2019版)[J]. 中国实用外科杂志, 2020, 40(3):255-259.
	Fan JX, Guan HX, Lv CH, et al. Chinese expert consensus on post-operative TSH suppression therapy for differentiated thyroid cancer during pregnancy and the postpartum(2019 edition)[J]. Chin J Pract Surg, 2020, 40(3):255-259.
[2]	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3):209-249. DOI URL
[3]	Benedict C, Thom B, Friedman DN, et al. Fertility information needs and concerns post-treatment contribute to lowered quality of life among young adult female cancer survivors[J]. Support Care Cancer, 2018, 26(7):2209-2215. DOI PMID
[4]	肖盼盼, 王璐, 孙倩, 等. 青年癌症患者生育相关心理痛苦的研究进展[J]. 中华护理杂志, 2020, 55(7):1097-1101. DOI
	Xiao PP, Wang L, Sun Q, et al. Research progress on assessment and intervention strategies of fertility-related psychological distress in adolescents and young adults with cancer[J]. Chin J Nurs, 2020, 55(7):1097-1101.
[5]	张会敏, 孙晓晨, 马红梅. 年轻癌症患者生育忧虑心理体验质性研究的Meta整合[J]. 护理学报, 2022, 29(2):51-56.
	Zhang HM, Sun XC, Ma HM. Psychological experience of reproductive concerns in young cancer patients:a qualitative meta-synthesis[J]. J Nurs China, 2022, 29(2):51-56.
[6]	吴爽, 叶雅雯, 张彬, 等. 青年女性甲状腺癌患者生育忧虑现状及影响因素分析[J]. 护理学杂志, 2019, 34(7):65-68.
	Wu S, Ye YW, Zhang B, et al. Reproductive concerns among young female patients with thyroid cancer:the influencing factors[J]. J Nurs Sci, 2019, 34(7):65-68.
[7]	谢家树, 魏宇民, ZHU Zhuorong. 当代中国青少年校园欺凌受害模式探索:基于潜在剖面分析[J]. 心理发展与教育, 2019, 35(1):95-102.
	Xie JS, Wei YM, Zhu ZR. Patterns of bullying victimization among adolescents in China:based on latent profile analysis[J]. Psychol Dev Educ, 2019, 35(1):95-102.
[8]	Gorman JR, Su HI, Pierce JP, et al. A multidimensional scale to measure the reproductive concerns of young adult female cancer survivors[J]. J Cancer Surviv, 2014, 8(2):218-228. DOI PMID
[9]	乔婷婷, 陈丹丹, 郑蔚, 等. 癌症后生育忧虑量表的汉化及信效度研究[J]. 中华护理杂志, 2016, 51(12):1509-1514.
	Qiao TT, Chen DD, Zheng W, et al. Translation and reliability and validity of the Chinese version of the Reproductive Concerns After Cancer Scale(RCAC)[J]. Chin J Nurs, 2016, 51(12):1509-1514.
[10]	张洁婷, 焦璨, 张敏强. 潜在类别分析技术在心理学研究中的应用[J]. 心理科学进展, 2010, 18(12):1991-1998.
	Zhang JT, Jiao C, Zhang MQ. Application of latent class analysis in psychological research[J]. Adv Psychol Sci, 2010, 18(12):1991-1998.
[11]	冯云碧, 付涛, 江曼. 育龄甲状腺癌女性患者生育忧虑现状及影响因素分析[J]. 中国慢性病预防与控制, 2019, 27(9):684-686.
	Feng YB, Fu T, Jiang M. The present situation and influencing factors of fertility anxiety in female patients with thyroid cancer of childbearing age[J]. Chin J Prev Control Chronic Dis, 2019, 27(9):684-686.
[12]	Ruggeri M, Pagan E, Bagnardi V, et al. Fertility concerns,preservation strategies and quality of life in young women with breast cancer:baseline results from an ongoing prospective cohort study in selected European Centers[J]. Breast, 2019, 47:85-92. DOI PMID
[13]	王玲, 李星, 李莹, 等. 乳腺癌术后化疗患者生育忧虑现状及影响因素分析[J]. 中华现代护理杂志, 2019, 25(1):58-62.
	Wang L, Li X, Li Y, et al. Current status and influencing factors of fertility anxiety in breast cancer patients undergoing postoperative chemotherapy[J]. Chin J Mod Nurs, 2019, 25(1):58-62.
[14]	Anderson C, Engel SM, Weaver MA, et al. Birth rates after radioactive iodine treatment for differentiated thyroid cancer[J]. Int J Cancer, 2017, 141(11):2291-2295. DOI PMID
[15]	王娟, 董诗奇, 唐涵, 等. 疾病进展恐惧对青年淋巴瘤患者生育忧虑的影响研究[J]. 解放军护理杂志, 2021, 38(11):4-7.
	Wang J, Dong SQ, Tang H, et al. Fear of progression and reproductive concerns in young adult with lymphoma[J]. Nurs J Chin PLA, 2021, 38(11):4-7.
[16]	孔晓路. 年轻女性甲状腺癌患者生育忧虑状况调查和影响因素分析[J]. 国际护理学杂志, 2021, 40(11):1964-1967.
	Kong XL. Investigation and influencing factors of fertility anxiety in young women with thyroid cancer[J]. Int J Nurs, 2021, 40(11):1964-1967.
[17]	Armuand GM, Wettergren L, Rodriguez-Wallberg KA, et al. Desire for children,difficulties achieving a pregnancy,and infertility distress 3 to 7 years after cancer diagnosis[J]. Support Care Cancer, 2014, 22(10):2805-2812. DOI URL
[18]	Canada AL, Schover LR. The psychosocial impact of interrupted childbearing in long-term female cancer survivors[J]. Psycho-oncology, 2012, 21(2):134-143. DOI PMID
[19]	Bártolo A, Santos IM, Valério E, et al. The European Portuguese version of the Reproductive Concerns After Cancer Scale(RCACS):a psychometric validation for young adult female cancer survivors[J]. Eur J Oncol Nurs, 2020, 47:101781. DOI URL
[20]	汤琳, 孟爱凤, 智晓旭, 等. 青年女性甲状腺癌患者生育忧虑的质性研究[J]. 医药高职教育与现代护理, 2020, 3(3):195-199.
	Tang L, Meng AF, Zhi XX, et al. Qualitative research on the reproductive concerns of young female with thyroid cancer[J]. Med High Vocat Educ Mod Nurs, 2020, 3(3):195-199.
[21]	王锐, 张磊, 苟政江, 等. 育龄期女性甲状腺乳头状癌131Ⅰ治疗后月经规律及生育情况的随访与评价[J]. 中国普外基础与临床杂志, 2018, 25(4):424-427.
	Wang R, Zhang L, Gou ZJ, et al. Follow-up and evaluation of menstrual rhythm and fertility after iodine-131 treatment for papillary thyroid carcinoma in women of childbearing age[J]. Chin J Bases Clin Gen Surg, 2018, 25(4):424-427.
[22]	王艳波, 范素云, 贾彦彦, 等. 甲状腺癌患者对诊断及术后放射性碘治疗心理体验的质性研究[J]. 中国实用护理杂志, 2017, 33(2):126-130.
	Wang YB, Fan SY, Jia YY, et al. A qualitative study on the experience of thyroid cancer patients about diagnosis and post-surgical radioactive iodine treatment[J]. Chin J Pract Nurs, 2017, 33(2):126-130.
[23]	雷蕾, 陈跃, 杜涛, 等. 甲状腺癌患者131I治疗的信息支持护理[J]. 护理学杂志, 2017, 32(4):35-37.
	Lei L, Chen Y, Du T, et al. Information support for patients with thyroid carcinoma undergoing radioiodine 131I therapy[J]. J Nurs Sci, 2017, 32(4):35-37.
[24]	曹志丹. 育龄期女性癌症患者社会支持、自我表露、生育忧虑与创伤后成长的相关性研究[D]. 天津: 天津中医药大学, 2021.
	Cao ZD. Correlation among social support,self-disclosure,reproductive concerns and post-traumatic growth in female cancer patients of childbearing age[D]. Tianjin:Tianjin University of Traditional Chinese Medicine, 2021.
[25]	罗群, 王维利, 周利华, 等. 癌症患者与配偶亲密关系的研究进展[J]. 中华护理杂志, 2016, 51(11):1352-1356.
	Luo Q, Wang WL, Zhou LH, et al. A literature review of intimacy between cancer patients and their spouses[J]. Chin J Nurs, 2016, 51(11):1352-1356.
[26]	康婷婷, 郑蔚, 刘梦丽, 等. 亲密加强疗法对育龄期乳腺癌患者生育忧虑的影响[J]. 护理学杂志, 2021, 36(10):6-9.
	Kang TT, Zheng W, Liu ML, et al. Effect of intimacy enhancement therapy on reproductive concerns of childbearing-age women with breast cancer[J]. J Nurs Sci, 2021, 36(10):6-9.
[27]	郑真真. 生育意愿研究及其现实意义:兼以江苏调查为例[J]. 学海, 2011(2):10-18.
	Zheng ZZ. Fertility desire and its significance[J]. Acad Bimestrie, 2011(2):10-18.