摘要目的 调查乳腺癌术后化疗患者社交回避及苦恼现状,并分析其影响因素,为制定心理干预措施提供依据.方法 便利抽样法选择2016年2月-2017年3月在郑州大学附属肿瘤医院乳腺外科化疗的乳腺癌患者300例为研究对象.采用患者一般情况调查表、乳腺癌身体意象量表(BIBCQ)、社交回避及苦恼量表(SADS)对其进行问卷调查.采用多因素分层回归分析进行SADS得分的影响因素分析.结果 本研究共发放300份问卷,回收272份有效问卷.乳腺癌术后化疗患者的BIBCQ总分为(106.53±19.38)分,SADS总分为(19.36±4.22)分,患者的SADS总分与BIBCQ总分呈正相关(r=0.283, P<0.01).单因素分析结果显示,不同年龄、文化程度、家庭人均月收入、手术方式、癌症分期及化疗时间的乳腺癌术后化疗患者SADS得分差异有统计学意义(F/t值分别为28.17、40.64、23.21、9.98、27.79、61.11;P<0.01).分层回归分析结果显示,年龄、文化程度、家庭人均月收入、手术方式、癌症分期、化疗时间、易感性、羞耻感、限制性、身体关注度、透视度和患肢关注度是乳腺癌术后化疗患者社交回避及苦恼的影响因素(P<0.05).结论 乳腺癌术后化疗患者的身体意象不良是社交功能缺失的重要原因,提示临床医护人员可通过加强患者对自我形象的认知,提升其社交信心和社会适应能力.

abstractsObjective To investigate the clinical status of social avoidance and distress in chemotherapy patients after breast cancer surgery, so as to provide reference for psychological intervention. Methods A total of 300 cases of breast cancer patients who received chemotherapy in the Affiliated Tumor Hospital of Zhengzhou University from February 2016 to March 2017 were selected by convenience sampling method. The self-designed general situation questionnaire, Body Image after Brest Cancer Questionnaire (BIBCQ) and Social Avoidance and Distress Scale (SADS) were used in the investigation. Multi-factor hierarchical regression analysis was used to analyze the influencing factors. Results A total of 300 questionnaires were distributed, and 272 valid questionnaires were collected. The total scores of BIBCQ and SADS were (106.53±19.38) and (19.36±4.22) respectively, and the total score of SADS was positively correlated with the total score of BIBCQ (r=0.283, P<0.01). The results of single factor analysis indicated that the difference of SADS score among different ages, education level, percapita income, operation type, cancer staging and chemotherapy time in the chemotherapy patients after breast cancer surgery were statistically significant (t=28.17, 40.64, 23.21, 9.98, 27.79, 61.11; P<0.01). Hierarchical regression analysis showed that age, education level, percapita income, operation type,cancer staging, chemotherapy time, susceptibility, shame, restriction, body concern, clairvoyance, and limb concern were the factors affecting the social avoidance and distress of breast cancer patients after surgery (P<0.05). Conclusions Poor physical image of patients with chemotherapy after breast cancer is an important reason of lack of social function, which suggests that medical staff can enhance their social confidence and adaptability by strengthening the cognitive level of the patients' self image.