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向中国肺癌患者披露诊断结果的心理影响。

Psychological impact of revealing a diagnosis of lung cancer to patients in China.

作者信息

Qian Huimin, Hou Lili

机构信息

Department of Thoracic Surgery, Tongji University School of Medicine, Shanghai 200433, China.

Department of Nursing, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.

出版信息

J Thorac Dis. 2016 Oct;8(10):2879-2884. doi: 10.21037/jtd.2016.10.11.

Abstract

BACKGROUND

In conventional Chinese culture, awareness of a malignant disease is believed to increase a patient's psychological pressure, leading to anxiety or depression. But this notion is in conflict with the patient's right to receive information about their own disease.

METHODS

This study is to investigate whether disclosure of diagnosis increases the level of anxiety or depression in patients diagnosed with lung cancer. Seventy patients who underwent lung resection and diagnosed with lung cancer postoperatively were divided into two groups-the disclosed group (n=35) and the undisclosed group (n=35), depending on the awareness of their diagnosis, as decided by their consigned family members. All patients were asked to fill in a form to evaluate their level of anxiety and depression before discharge.

RESULTS

Disclosure of diagnosis did not affect the degree of anxiety or depression in patients with lung cancer (P>0.05). Age ≤50, relatively more advanced stage (stage II as compared with stage I) of disease, extensive surgery and major postoperative complication were risk factors of anxiety (P<0.05). Major postoperative complication was the only risk factor of depression (P<0.05).

CONCLUSIONS

Disclosure of diagnosis to patients with lung cancer does not induce or aggravate anxiety or depression in modern Chinese population. Factors such as complications, age, stage of disease and extent of surgery do have psychological impacts on patient with lung cancer.

摘要

背景

在中国传统文化中,人们认为知晓恶性疾病会增加患者的心理压力,导致焦虑或抑郁。但这一观念与患者获取自身疾病信息的权利相冲突。

方法

本研究旨在调查告知肺癌患者诊断结果是否会增加其焦虑或抑郁程度。70例行肺切除术且术后被诊断为肺癌的患者,根据其委托家属决定的对诊断结果的知晓情况,分为两组——告知组(n = 35)和未告知组(n = 35)。所有患者在出院前均被要求填写一份表格,以评估其焦虑和抑郁程度。

结果

告知诊断结果并未影响肺癌患者的焦虑或抑郁程度(P>0.05)。年龄≤50岁、疾病分期相对较晚(与I期相比的II期)、广泛手术及术后主要并发症是焦虑的危险因素(P<0.05)。术后主要并发症是抑郁的唯一危险因素(P<0.05)。

结论

向肺癌患者告知诊断结果不会在现代中国人群中诱发或加重焦虑或抑郁。并发症、年龄、疾病分期及手术范围等因素确实会对肺癌患者产生心理影响。

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