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接受手术的妇科患者的情绪状态与应对方式

Emotional state and coping style among gynecologic patients undergoing surgery.

作者信息

Matsushita Toshiko, Murata Hinako, Matsushima Eisuke, Sakata Yu, Miyasaka Naoyuki, Aso Takeshi

机构信息

Section of Liaison Psychiatry and Palliative Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.

出版信息

Psychiatry Clin Neurosci. 2007 Feb;61(1):84-93. doi: 10.1111/j.1440-1819.2007.01615.x.

Abstract

The aim of the present study was to investigate changes in emotional state and the relationship between emotional state and demographic/clinical factors and coping style among gynecologic patients undergoing surgery. Using the Japanese version of the Profile of Mood States (POMS), 90 patients (benign disease: 32, malignancy: 58) were examined on three occasions: before surgery, before discharge, and 3 months after discharge. They were also examined using the Coping Inventory for Stressful Situations (CISS) on one occasion before discharge. The scores for the subscales depression, anger, and confusion were the highest after discharge while those for anxiety were the highest before surgery. The average scores of the POMS subscales for all subjects were within the normal range. With regard to the relationship between these emotional states and other factors, multiple regressions showed that the principal determinants of anxiety before surgery were religious belief, psychological symptoms during hospitalization and emotion-oriented (E) coping style; further, it was found that depression after discharge could be explained by chemotherapy, duration of hospitalization, and E coping style. The principal determinants of anger after discharge and vigor before surgery were length of education and E coping style, and severity of disease, chemotherapy, E coping style and task-oriented coping style, respectively. Those of post-discharge fatigue and confusion were length of education, psychological symptoms, and E coping style. In summary it is suggested that the following should be taken into account in patients undergoing gynecologic surgery: anxiety before surgery, depression, anger, and confusion after surgery, including coping styles.

摘要

本研究的目的是调查接受手术的妇科患者的情绪状态变化,以及情绪状态与人口统计学/临床因素和应对方式之间的关系。使用日语版的情绪状态量表(POMS),对90例患者(良性疾病:32例,恶性肿瘤:58例)在三个时间点进行了检查:手术前、出院前和出院后3个月。他们还在出院前一次使用应激情境应对量表(CISS)进行了检查。抑郁、愤怒和困惑分量表的得分在出院后最高,而焦虑分量表的得分在手术前最高。所有受试者POMS分量表的平均得分均在正常范围内。关于这些情绪状态与其他因素之间的关系,多元回归显示,手术前焦虑的主要决定因素是宗教信仰、住院期间的心理症状和情绪导向(E)应对方式;此外,还发现出院后的抑郁可以用化疗、住院时间和E应对方式来解释。出院后愤怒和手术前活力的主要决定因素分别是受教育年限和E应对方式,以及疾病严重程度、化疗、E应对方式和任务导向应对方式。出院后疲劳和困惑的主要决定因素是受教育年限、心理症状和E应对方式。总之,建议对接受妇科手术的患者应考虑以下方面:手术前的焦虑、手术后的抑郁、愤怒和困惑,包括应对方式。

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