河北医科大学学报 ›› 2022, Vol. 43 ›› Issue (4): 412-416，422.doi: 10.3969/j.issn.1007-3205.2022.04.009

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海南医学院第二附属医院妇科肿瘤患者病耻感、述情障碍现状调查及预测抑郁的效能探讨

  

  1. 海南医学院第二附属医院妇科，海南 海口 570145
  • 出版日期:2022-04-25 发布日期:2022-04-30
  • 作者简介:张湘香（1989-），海南海口人，海南医学院第二附属医院主管护师，医学学士，从事妇产科疾病护理研究。

Investigation into the status quo of stigma and alexithymia in patients with gynecological tumors in the Second Affiliated Hospital of Hainan Medical University and the effectiveness of predicting depression

  1. Department of Gynecology, the Second Affiliated Hospital of Hainan Medical University, Hainan Province, Hainan 570145, China
  • Online:2022-04-25 Published:2022-04-30

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摘要：

目的  探讨海南医学院第二附属医院妇科肿瘤患者病耻感、述情障碍现状调查及预测抑郁的效能。

方法  选取妇科肿瘤患者242例作为研究对象，采用社会影响量表（stroke impact scale，SIS）、多伦多述情障碍量表（Toronto Alexithymia Scale，TAS-20）调查病耻感、述情障碍，Spearman分析病耻感、述情障碍与抑郁的相关性，Logistic回归模型分析妇科肿瘤患者抑郁影响因素，ROC预测病耻感、述情障碍对妇科肿瘤患者抑郁预测价值。

结果  妇科肿瘤患者SIS评分高于国内常模，TAS-20评分高于正常对照组（P＜0.05）。妇科肿瘤患者SIS评分、TAS-20评分与抑郁呈正相关（r=0.605，P＜0.001；r=0.621，P＜0.001）。年龄≥60岁、小学及以下、肿瘤直径≥4 cm、自费、SIS评分≥48分、TAS-20评分≥52分、内向、Ⅲ~Ⅳ期、低分化是妇科肿瘤患者抑郁独立危险因素（P＜0.05）。SIS评分预测抑郁AUC为0.849（95%CI：0.798~0.892），当其截断值为50分，诊断敏感度、特异度分别为74.07%、81.13%；TAS-20评分预测抑郁AUC为0.754（95%CI：0.695~0.807），当其截断值为53分，诊断敏感度、特异度分别为57.14%、84.91%。

结论  妇科肿瘤患者普遍存在病耻感、述情障碍，受其影响，妇科肿瘤患者易出现抑郁情绪；在临床工作中，针对具有病耻感、述情障碍的患者，需加强防范，做好相应心理调节工作，进一步降低抑郁风险。

关键词:

生殖器肿瘤, 女(雌)性, 病耻感, 抑郁

Abstract:

Objective  To investigate the status quo of stigma and alexithymia in patients with gynecological tumors in the Second Affiliated Hospital of Hainan Medical University and the effectiveness of predicting depression.

Methods  In total, 242 patients with gynecological tumor were selected as the research subjects. The Social Impact Scale(SIS) and the Toronto Alexithymia Scale(TAS-20) were used to investigate stigma and alexithymia, and Spearman was used to analyze the correlation between stigma, alexithymia and depression. Logistic regression model was used to analyze the influencing factors of depression in gynecological cancer patients, and ROC was used to predict the predictive value of stigma and alexithymia for depression in gynecological cancer patients.

Results  The SIS score of gynecological tumor patients was higher than the domestic norm, and the TAS-20 score was higher than that of the normal control group(P＜0.05). SIS score and TAS-20 score of gynecological tumor patients were positively correlated with depression(r=0.605, P＜0.001; r=0.621, P＜0.001). Age ≥ 60 years, educational level of primary school and below, tumor diameter≥ 4 cm, self-payment, SIS score≥ 48, TAS-20 score ≥ 52, introversion, stage Ⅲ-Ⅳ and low differentiation were independent risk factors for depression in patients with gynecological tumors(P＜0.05). The AUC of SIS score in predicting depression was 0.849 (95%CI: 0.798-0.892). When the cut-off value was 50, the diagnostic sensitivity and specificity were 74.07% and 81.13% respectively. The AUC of TAS-20 score in predicting depression was 0.754 (95%CI: 0.695-0.807). When the cut-off value was 53, the diagnostic sensitivity and specificity were 57.14% and 84.91% respectively.

Conclusion  Stigma and alexithymia are common in patients with gynecological tumors. Patients with gynecological tumors affected by these factors are prone to depression. In clinical practice, for patients with stigma and alexithymia, it is necessary to strengthen the prevention and perform the corresponding psychological adjustment to further reduce the risk of depression.

Key words: genital neoplasms, female, stigma, depression

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