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背景乳腺癌的诊断和治疗,会使人产生严重的负性应激反应和精神障碍。特别是自费和没有医疗保险的农村和低经济收入乳腺癌妇女的精神心理状况令人堪忧。国内外对这一弱势群体的研究少见报道。目的找出农民与不同经济收入水平对乳腺癌妇女精神心理障碍的影响程度,为有效的临床干预治疗提供科研依据。设计病例对照研究。地点、对象和方法对大连医科大学附属一、二医院肿瘤科术后接受抗癌治疗的妇女216例采用临床晤谈、明尼苏达多项人格问卷(Minnesotamultiphasicpersonalityinventory,MMPI)和生活事件量表及基本情况问卷的方法进行精神心理状态和人格评定。主要观察指标乳腺癌妇女MMPI评定结果。结果①208例年龄为24～83岁乳腺癌妇女,平均47岁,89%为已婚妇女;受教育程度各水平均衡,其中农民40例,占19.2%,工人占35.6%,职员和干部比例为45.2%。接受乳房保留术22例,根除术186例;182例接受化疗,176例接受放疗;15.4%患者不知道自己患病真相;患病时间为术后1～204个月。②多元Logistic分析显示,农民是疑病和抑郁量表值增高的危险因素。农民与工人疑病、抑郁相对比,OR=3.64,4.42(P<0.05);脑力劳动者与工人疑病、抑郁相对比,OR=1.05,1.11(P<0.05)。而年龄是抑郁的保护因素,随着年龄的增加抑郁反而减低,确诊时年龄与
Background Diagnosis and treatment of breast cancer can cause severe negative stress reactions and mental disorders. In particular, the mental and psychological conditions of women with breast cancer in rural areas and low-income families at their own expense and without medical insurance are worrying. Domestic and foreign research on this vulnerable group is seldom reported. Objective To find out the influence of peasants and different economic income levels on mental and mental disorders of breast cancer women and provide scientific basis for effective clinical intervention. Design a case-control study. Location, Subjects and Methods216 cases of women receiving anticancer therapy after cancer surgery in the First and Second Hospital Affiliated to Dalian Medical University were investigated with clinical interviews, Minnesotamultiphasicpersonalityinventory (MMPI), life event scale and questionnaire Methods Psychological status and personality assessment. MAIN OUTCOME MEASURES MMPI results of women with breast cancer. Results ①208 women aged 24-83 years old with breast cancer average 47 years old and 89% were married women. The education level was balanced at all levels, among which 40 were peasants, accounting for 19.2%, workers were 35.6%, and the ratio of staff to cadres was 45.2%. Twenty-two cases underwent breast conserving surgery and 186 cases underwent radical eradication. One hundred and eighty-eight patients received chemotherapy and 176 received radiotherapy. Fifteen patients did not know the truth of their illness. The duration of illness was 1 to 204 months after surgery. ② Multiple Logistic analysis showed that peasants were risk factors for increasing the value of Dyslexia and Depression Scale. OR = 3.64,4.42 (P <0.05). The ratio of mental worker to worker’s dignosis and depression was OR = 1.05,1.11 (P <0.05). Age is a protective factor of depression, depression decreases with age but decreases with age.