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目的探索D型人格(type D personality)与直肠癌患者症状时间(symptom duration,SD)、急诊就诊、精神健康状态及术后生存质量(quality of life,QOL)之间的关系。方法前瞻性收集2010年10月至2012年10月期间中国医科大学附属第四医院收治的直肠癌患者,于确诊疾病(基线)时采用14项D型人格量表(DS14)检测患者的人格;于基线时和诊断6个月时采用欧洲肿瘤治疗研究组织(EORTC)的QLQ-C30量表和QLQ-CR38量表测定患者的生存质量,采用医院焦虑与抑郁量表(HADS)测定患者的焦虑和抑郁情况。比较D型人格患者和非D型人格患者的社会人口学特征、临床病理学特征、精神健康状态及生存质量。结果本研究最终入组596例直肠癌患者,其中有131例患者具有D型人格(22%)。1社会人口学特征。相较于非D型人格组患者,D型人格组患者的经济状况较差、无医保比例较高、合并症种类多、SD≥1个月的比例高、就诊时为急诊的比例高(P<0.050)。2 EORTC QLQ-C30。基线时,D型人格组患者的角色功能、情绪功能、认知功能、社会功能以及总体健康状态得分均低于非D型人格组(P<0.050),但疲劳、便秘及经济困难得分均高于非D型人格组(P<0.050)。6个月时D型人格组患者的角色功能、情绪功能、认知功能、社会功能以及总体健康状态得分均低于非D型人格组(P<0.050),但疲劳、失眠、便秘及经济困难得分均高于非D型人格组(P<0.050)。3 EORTC QLQCR38。基线时,D型人格组患者的未来期望得分低于非D型人格组(P<0.001),而泌尿问题得分高于非D型人格组(P<0.001)。6个月时,D型人格组患者的未来期望和性功能得分均低于非D型人格组(P<0.050),但泌尿问题、胃肠道症状、男性性功能障碍及排泄困难得分均高于非D型人格组(P<0.050)。4精神状态。基线和6个月时,D型人格组患者的焦虑和抑郁发生率均高于非D型人格组(P<0.001)。D型人格组患者中,6个月时的焦虑和抑郁发生率均高于基线时(P<0.001)。结论在直肠癌患者中,D型人格患者的SD延长,急诊就诊比例高,且D型人格与不佳的生存质量及精神健康状态相关。
Objective To explore the relationship between type D personality and symptom duration (SD), emergency treatment, mental health and quality of life (QOL) in patients with rectal cancer. Methods A retrospective study was conducted in 14 patients with rectal cancer admitted to the Fourth Affiliated Hospital of China Medical University from October 2010 to October 2012. The 14 personality traits (DS14) were used to detect the personality of the patients at the time of disease diagnosis (baseline) At baseline and at 6 months of diagnosis, the quality of life of the patients was assessed using the European Oncology and Treatment Research Organization (EORTC) QLQ-C30 scale and the QLQ-CR38 scale, and the anxiety and depression scale (HADS) And depression. To compare the demographic characteristics, clinicopathological features, mental health status and quality of life of patients with D-type personality and non-D personality. Results The study eventually enrolled 596 patients with rectal cancer, 131 of whom had D-type personality (22%). 1 socio-demographic characteristics. Compared with non-D personality group, D-personality group patients were in poor economic condition, higher proportion of non-health insurance, more types of complications, higher proportion of SD≥1 month and higher proportion of emergency visits (P <0.050). 2 EORTC QLQ-C30. At baseline, personality, emotional function, cognitive function, social function, and overall health status were significantly lower in the D-personality group than in the non-D personality group (P <0.050), but fatigue, constipation, and financial distress scores were high In non-D personality group (P <0.050). At 6 months, the scores of role function, emotion function, cognitive function, social function and overall health status in D type personality group were lower than those in D type personality group (P <0.050), but fatigue, insomnia, constipation and financial difficulties Scores were higher than non-D personality group (P <0.050). 3 EORTC QLQCR38. At baseline, patients with D-type personality had a lower expected future score than those with non-D-personality (P <0.001), while urinary problems score was higher than those without D-personality (P .001). At 6 months, the D-type personality group had lower expectations and sexual function scores than those with non-D personality group (P <0.050), but urinary problems, gastrointestinal symptoms, male sexual dysfunction, and dyspareunia scores were high In non-D personality group (P <0.050). 4 mental state. At baseline and at 6 months, the incidence of anxiety and depression in the D-personality group was higher than in the non-D personality group (P <0.001). In D-personality group, the incidence of anxiety and depression at 6 months were higher than those at baseline (P <0.001). Conclusion In patients with rectal cancer, type D personality extension of the SD patients, a high proportion of emergency visits, and personality D and poor quality of life and mental health status.