胃癌患者述情障碍、健康赋权与其生命质量的研究

Study on Alexithymia, Health Empowerment and Quality of Life in Patients with Gastric Cancer

摘要: 目的：本研究将对胃癌患者述情障碍、健康赋权和其生命质量现状进行分析研究，并探讨其间相关性关系。方法：本研究采用随机抽样法，选取2023年1月~2024年9月在吴起县人民医院及内科、普外科等科室门诊随访或就诊的胃癌患者、选取吴起县乡镇卫生院管理的胃癌患者作为研究对象。采集一般资料调查表、多伦多述情障碍量表(TAS-20)、慢性病患者健康赋权量表、中文版癌症患者治疗功能评价量表(FACT-G)收集患者相关资料，采用SPSS 26.0软件进行数据分析，使用频数和构成比对患者的一般资料进行描述，患者的健康赋权、述情障碍与生命质量的得分情况采用均数 ± 标准差($\overline{X}\pm s$ )进行描述；采用独立样本t检验或方差分析比较患者生活质量在人口学资料及疾病相关资料上的差异；采用Pearson相关分析探究患者健康赋权、述情障碍与其生活质量的相关性。结果：本研究共纳入142例胃癌患者，本次调查的142例胃癌患者生命质量得分介于31~62之间，总得分为(46.41 ± 5.22)分，各维度的条目平均得分“功能状况”最低，为(1.11 ± 0.25)分。胃癌患者述情障碍得分情况为(69.62 ± 8.71)分，其中存在述情障碍的患者80例，占比56.4%，可能发生述情障碍的患者58例，占比40.8%，其中外向性思维维度得分为(29.25 ± 3.44)分，得分最高。胃癌患者健康赋权得分情况为(56.40 ± 11.45)分，5个维度中得分最高的为获取支持维度得分为(15.65 ± 2.75)分，责任信念维度得分最低为(9.20 ± 2.36)分，胃癌患者述情障碍与健康赋权显著负相关，胃癌患者健康赋权与其生命质量显著正相关(P < 0.05)。结论：本研究所纳入的胃癌患者生命质量处于较低水平，存在较为严重的述情障碍，其心理状况较差，患者的健康赋权评估也处在较低等级，患者健康赋权与其生命质量中等正相关，患者的述情障碍得分与其生命质量显著负相关。医护人员应高度关注胃癌患者的述情障碍状况，通过有效的沟通和心理干预，帮助他们更好地识别和表达自己的情绪，并通过增强患者个体的内在动力和外在支持，实现健康行为的自主性和可持续性，以提高其自身的生活质量和健康水平。

Abstract: Objective: This study will analyze and study the status quo of alexithymia, health empowerment and quality of life in patients with gastric cancer, and explore the correlation between them. Methods: Random sampling method was used in this study to select gastric cancer patients who were followed up or treated in the outpatient department of medicine, general surgery and other departments in Wuqi County People’s Hospital from January 2023 to September 2024, and gastric cancer patients managed by Wuqi County township health center as the research objects. The general data questionnaire, the Toronto Alexymia Scale (TAS-20), the Health Empowerment Scale for Chronic Patients, and the Chinese version of the Cancer Patients Therapeutic Function Evaluation Scale (FACT-G) were collected and the relevant data of the patients were collected. SPSS 26.0 software was used for data analysis, and the frequency and composition were compared to describe the general data of the patients. The scores of health empowerment, alexithymia and quality of life were described by mean ± standard deviation ($\overline{X}\pm s$ ). Independent sample t test or analysis of variance was used to compare the difference of patients’ quality of life in demographic data and disease-related data. Pearson correlation analysis was used to explore the correlation between health empowerment, alexithymia and quality of life in patients. Results: A total of 142 patients with gastric cancer were included in this study. The quality of life scores of the 142 patients with gastric cancer in this survey ranged from 31 to 62, with a total score of (46.41 ± 5.22) points. The average score of “functional status” in each dimension was the lowest, which was (1.11 ± 0.25) points. The score of alexithymia in gastric cancer patients was (69.62 ± 8.71), of which 80 patients had alexithymia, accounting for 56.4%, and 58 patients could have alexithymia, accounting for 40.8%. The score of extroversion thinking dimension was (29.25 ± 3.44), the highest score. The score of health empowerment in patients with gastric cancer was (56.40 ± 11.45) points, the highest score was (15.65 ± 2.75) in the dimension of acquisition support, and the lowest score was (9.20 ± 2.36) in the dimension of responsibility belief. There was a significant negative correlation between alexithymia and health empowerment in patients with gastric cancer. There was a significant positive correlation between health empowerment and life quality in patients with gastric cancer (P < 0.05). Conclusion: The quality of life of gastric cancer patients included in this study was at a low level, with relatively severe alexithymia and poor psychological status. The health empowerment assessment of patients was also at a low level, and the health empowerment of patients was moderately positively correlated with their quality of life, while the alexithymia score was significantly negatively correlated with their quality of life. Medical staff should pay close attention to the alexithymia status of gastric cancer patients, help them better identify and express their emotions through effective communication and psychological intervention, and realize the autonomy and sustainability of health behaviors by enhancing the internal motivation and external support of individual patients, so as to improve their own quality of life and health level.