Correlation between body image and posttraumatic growth in patients with head and neck tumour after surgery
-
摘要:
目的 调查头颈部癌症术后患者身体意象与创伤后成长水平现状并探讨两者间的相关性。 方法 选取2020年9月—2021年3月在安徽省某三甲医院住院或门诊复查的206例头颈部癌症术后患者作为研究对象,采用一般资料调查表、身体意象量表(BIS)、简体中文版创伤后成长量表(C-PTGI)对研究对象进行调查。 结果 头颈部癌症术后患者BIS总分为(7.12±3.56)分,BIS总分≥10分有61例,BIS总分 < 10分有145例,身体意象失调发生率为29.6%;C-PTGI总分为(60.91±9.74)分;以10分为分界点,BIS总分≥10分组患者C-PTGI总分及各维度得分均高于BIS总分 < 10分组(均P < 0.05);Pearson相关分析结果显示,头颈部癌症术后患者BIS总分及各维度得分与C-PTGI总分及各维度得分之间呈负相关关系,差异有统计学意义(均P < 0.05);分层回归分析模型结果显示,控制一般资料后,身体意象是创伤后成长的影响因素(β=-0.513, ΔR2=0.222,F=41.147, P < 0.001)。 结论 头颈部癌症术后患者身体意象与创伤后成长水平均有待提高,良好的身体意象可以促进创伤后成长,临床医护人员可通过增进身体意象这一视角提高患者创伤后成长水平。 Abstract:Objective To investigate the relationship between body image and posttraumatic growth in patients with head and neck tumours. Methods A total of 206 cases of postoperative head and neck tumour who were hospitalised or out-patients in a third-class A hospital in Anhui Province from September 2020 to March 2021 were selected as the research objects. The self-compiled general data questionnaire, Body Image Scale and C-Posttraumatic Growth Inventory were used to investigate the subjects. Results The total BIS score of patients with head and neck cancer after surgery was (7.12±3.56) points, 61 cases with total BIS score ≥10 and 145 cases with total BIS score < 10. The incidence of body image disorder was 29.6%. The total score of C-PTGI was (60.91±9.74) points. The cut-off point is divided by 10, the score of C-PTGI and the score of all dimensions in patients with BIS score ≥10 were higher than those in patients with BIS score < 10 (all P < 0.05). Pearson correlation analysis showed that the BIS total score and each dimension score of patients with postoperative head and neck cancer were negatively correlated with C-PTGI total score and each dimension score, and the difference was statistically significant (all P < 0.05). The results of the hierarchical regression analysis model showed that body image was the influencing factor of posttraumatic growth after controlling for general data (β=-0.513, ΔR2=0.222, F=41.147, P < 0.001). Conclusion Both body image and post-traumatic growth of patients with head and neck cancer after surgery need to be improved. Good body image can promote post-traumatic growth, and clinical medical staff can improve patients' post-traumatic growth from the perspective of improving body image. -
Key words:
- Head and neck tumour /
- Body image /
- Post-traumatic growth
-
表 1 不同身体意象水平头颈部癌症术后患者创伤后成长水平(x±s, 分)
Table 1. Posttraumatic growth of head and neck cancer patients with different body image levels (x±s, scores)
组别 例数 PTG总分 人生感悟 个人力量 新的可能性 与他人关系 自我转变 BIS总分 < 10分 145 64.55±7.33 20.46±2.73 10.83±1.68 10.54±2.41 9.57±2.11 12.37±2.32 BIS总分≥10分 61 52.26±9.33 15.54±3.82 9.00±1.75 8.54±1.86 8.23±1.76 10.05±2.60 t值 10.103 10.418 7.068 5.801 4.367 6.315 P值 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 表 2 头颈部癌症术后患者身体意象与创伤后成长的相关分析(r值)
Table 2. Head and neck cancer postoperative patients with posttraumatic growth body image correlation analysis (r value)
项目 BIS总分 认知 情感 行为 PTG总分 人生感悟 个人力量 新的可能性 与他人关系 自我转变 BIS总分 1.000 认知 0.939a 1.000 情感 0.850a 0.696a 1.000 行为 0.784a 0.631a 0.521a 1.000 PTG总分 -0.667a -0.620a -0.598a -0.497a 1.000 人生感悟 -0.634a -0.603a -0.557a -0.459a 0.917a 1.000 个人力量 -0.535a -0.476a -0.508a -0.408a 0.831a 0.695a 1.000 新的可能性 -0.438a -0.416a -0.393a -0.306a 0.793a 0.651a 0.661a 1.000 与他人关系 -0.360a -0.324a -0.301a -0.317a 0.581a 0.464a 0.404a 0.453a 1.000 自我转变 -0.420a -0.419a -0.333a -0.317a 0.549a 0.494a 0.376a 0.262a 0.065 1.000 注:aP < 0.05。 表 3 头颈部癌症患者创伤后成长影响因素的分层回归分析
Table 3. Stratified regression analysis of influencing factors of post-traumatic growth in patients with head and neck cancer
模型 变量 B SE β t值 P值 R2 ΔR2 F值 P值 第一层 (常数) 59.825 5.646 10.595 < 0.01 0.371 19.560 < 0.001 性格类型 -2.614 0.682 -0.227 -3.835 < 0.01 确诊后时间 5.240 0.740 0.424 7.079 < 0.01 肿瘤分期 -2.190 0.925 -0.140 -2.368 < 0.05 第二层 (常数) 68.122 4.625 14.729 < 0.01 0.593 0.222 41.147 < 0.001 家庭人均月收入 1.541 0.702 0.118 2.194 < 0.05 性格类型 -1.676 0.557 -0.146 -3.007 < 0.01 确诊后时间 3.476 0.621 0.281 5.598 < 0.01 身体意象 -1.404 0.135 -0.513 -10.379 < 0.01 -
[1] SHIBATA H, ZHOU L Y, XU N, et al. Personalized cancer vaccination in head and neck cancer[J]. Cancer Sci, 2021, 112(3): 978-988. doi: 10.1111/cas.14784 [2] CHEN W Q, ZHENG R S, BAADE P D, et al. Cancer statistics in China, 2015[J]. Ca A Cancer J Clin, 2016, 66(2): 115-132. doi: 10.3322/caac.21338 [3] 黄志刚. 迎接头颈外科功能修复时代的到来[J]. 中华耳鼻咽喉头颈外科杂志, 2021, 56(9): 903-906. doi: 10.3760/cma.j.cn115330-20210629-00384HUANG Z G. To welcome the era of functional repair of head and neck surgery[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2021, 56(9): 903-906. doi: 10.3760/cma.j.cn115330-20210629-00384 [4] TEDESCHI R G, CALLHOUN L G. Posttraumatic growth: Conceptual foundations and empirical evidence[J]. Psychol Inq, 2004, 15(1): 1-18. doi: 10.1207/s15327965pli1501_01 [5] 张丽娟, 李峥, 陈希伟, 等. 头颈部肿瘤放疗患者创伤后成长的相关因素[J]. 中国心理卫生杂志, 2016, 30(5): 321-326. doi: 10.3969/j.issn.1000-6729.2016.05.001ZHANG L J, LI Z, CHEN X W, et al. Factors related to posttraumatic growth in radiotherapy patients with head and neck cancer[J]. Chinese Mental Health Journal, 2016, 30(5): 321-326. doi: 10.3969/j.issn.1000-6729.2016.05.001 [6] FINGERET M C, YUAN Y, URBAUER D, et al. The nature and extent of body image concerns among surgically treated patients with head and neck cancer[J]. Psycho-Oncolo, 2012, 21(8): 836-844. doi: 10.1002/pon.1990 [7] 苏怡, 方桂珍. 乳腺癌患者创伤后成长与身体意象及性调节的相关性分析[J]. 护理学杂志, 2018, 33(19): 72-75. doi: 10.3870/j.issn.1001-4152.2018.19.072SU Y, FANG G Z. Correlation analysis of posttraumatic growth with body image and sexual regulation in breast cancer patients[J]. Journal of Nursing Science, 2018, 33(19): 72-75. doi: 10.3870/j.issn.1001-4152.2018.19.072 [8] 孙小然, 赵悦, 李文浩, 等. 术后乳腺癌患者体象对创伤后应激障碍和创伤后成长的影响: 反刍的中介作用[J]. 心理与行为研究, 2020, 18(5): 693-699. https://www.cnki.com.cn/Article/CJFDTOTAL-CLXW202005018.htmSUN X R, ZHAO Y, LI W H, et al. Effects of body image on post-traumatic stress disorder and posttraumatic growth in breast cancer patients after surgery[J]. Studies of Psychology and Behavior, 2020, 18(5): 693-699. https://www.cnki.com.cn/Article/CJFDTOTAL-CLXW202005018.htm [9] 尚伟, 郑家伟. 口腔及口咽癌新版TNM分期与NCCN诊治指南部分解读[J]. 中国口腔颌面外科杂志, 2018, 16(6): 533-546. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGKQ201806014.htmSHANG W, ZHENG J W. Partial interpretation of the new TNM staging and NCCN diagnosis and treatment guidelines for oral and oropharyngeal carcinoma[J]. China Journal of Oral and Maxillofacial Surgery, 2018, 16(6): 533-546. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGKQ201806014.htm [10] HOPWOOD P, FLETCHERR L, LEE A, et al. A body image scale for use with cancer patients[J]. Eur J Cancer, 2001, 37(2): 189-197. doi: 10.1016/S0959-8049(00)00353-1 [11] MELISSANT H C, JANSEN F, EERENSTEIN S E, et al. Body image distress in head and neck cancer patients: What are we looking at?[J]. Support Care Cancer, 2021, 29(4): 2161-2169. doi: 10.1007/s00520-020-05725-1 [12] CHEN S C, YU P J, HONG M Y, et al. Communication dysfunction, body image, and symptom severity in postoperative head and neck cancer patients: Factors associated with the amount of speaking after treatment[J]. Support Care Cancer, 2015, 23(8): 2375-2382. doi: 10.1007/s00520-014-2587-3 [13] 汪际. 创伤后成长评定量表及其意外创伤者常模的研制[D]. 上海: 第二军医大学, 2011.WANG J. Development of the post-traumatic growth Rating Scale and its contingency model[D]. Shanghai: Second Military Medical University, 2011. [14] 曹家燕, 陈昌连, 王玲玲, 等. 头颈部癌症患者身体意象失调现状及其影响因素研究[J]. 中国护理管理, 2019, 19(9): 1317-1321. doi: 10.3969/j.issn.1672-1756.2019.09.008CAO J Y, CHEN C L, WANG L L, et al. Current status and influencing factors of body image disorders in patients with head and neck cancer[J]. Chinese Nursing Management, 2019, 19(9): 1317-1321. doi: 10.3969/j.issn.1672-1756.2019.09.008 [15] CHEN S C, HUANG C Y, HUANG B S, et al. Factors associated with healthcare professional's rating of disfigurement and self-perceived body image in female patients with head and neck cancer[J]. Eur J Cancer Care(Engl), 2018, 27(2): e12710. DOI: 10.1111/ecc.12710. [16] HUNG T M, LIN C R, CHI Y C, et al. Body image in head and neck cancer patients treated with radiotherapy: The impact of surgical procedures[J]. Health Qual Life Outcomes, 2017, 15(1): 165. doi: 10.1186/s12955-017-0740-7 [17] RHOTEN B A, MURPHY B, RIDNER S H. Body image in patients with head and neck cancer: A review of the literature[J]. Oral Oncol, 2013, 49(8): 753-760. doi: 10.1016/j.oraloncology.2013.04.005 [18] 龚湖萍. 头颈癌术后患者自我形象现状及其与社会支持、应对方式的相关研究[D]. 南昌: 南昌大学, 2018.GONG H P. Current status of self-image of postoperative patients with head and neck cancer and its correlation with social support and coping style[D]. Nanchang: Nanchang University, 2018. [19] 徐国英. 品管圈活动在头颈部肿瘤患者放疗后放射性皮炎中的应用[J]. 中华全科医学, 2017, 15(5): 896-898. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.051XU G Y. Application of quality control circle activity in radiation dermatitis after radiotherapy in patients with head and neck cancer[J]. Chinese general practice, 2017, 15(5): 896-898. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.051 [20] 黄睿睿, 刘安诺, 李伦兰, 等. 创伤性脊髓损伤患者婚姻满意度与创伤后成长的关系研究[J]. 中华全科医学, 2021, 19(12): 2136-2140. doi: 10.16766/j.cnki.issn.1674-4152.002255HUANG R R, LIU A N, LI L L, et al. Relationship between marital satisfaction and post-traumatic growth in patients with traumatic spinal cord injury[J]. Chinese general practice, 2021, 19(12): 2136-2140. doi: 10.16766/j.cnki.issn.1674-4152.002255 [21] 张世慧, 魏清风, 万显秀, 等. 口腔癌患者术后创伤后成长状况及影响因素分析[J]. 护理学杂志, 2017, 32(4): 76-79. doi: 10.3870/j.issn.1001-4152.2017.04.076ZHANG S H, WEI Q F, WAN X X, et al. Status and influencing factors of postoperative posttraumatic growth in patients with oral cancer[J]. Journal of Nursing Science, 2017, 32(4): 76-79. doi: 10.3870/j.issn.1001-4152.2017.04.076 [22] 宋小花, 陈红涛, 董彩梅, 等. 喉癌术后病人创伤后成长与生存质量的相关性研究[J]. 护理研究, 2017, 31(8): 944-947. doi: 10.3969/j.issn.1009-6493.2017.08.014SONG X H, CHEN H T, DONG C M, et al. Correlation between post-traumatic growth and quality of life in patients with laryngeal carcinoma after operation[J]. Chinese Nursing Research, 2017, 31(8): 944-947. doi: 10.3969/j.issn.1009-6493.2017.08.014 [23] SHARP L, REDFEARN D, TIMMONS A, et al. Posttraumatic growth in head and neck cancer survivors: Is it possible and what are the correlates?[J]. Psycho-Oncolo, 2018, 27(6): 1517-1523. doi: 10.1002/pon.4682 [24] 李丽, 袁卫军, 陈巧露, 等. 口腔颌面部创伤患者创伤后积极心理反应及相关影响因素分析[J]. 上海口腔医学, 2017, 26(1): 102-105. https://www.cnki.com.cn/Article/CJFDTOTAL-SHKY201701031.htmLI L, YUAN W J, CHEN Q L, et al. Analysis of positive psychological reaction and related influencing factors in patients with oral and maxillofacial trauma after trauma[J]. Shanghai Journal of Stomatology, 2017, 26(1): 102-105. https://www.cnki.com.cn/Article/CJFDTOTAL-SHKY201701031.htm -

计量
- 文章访问数: 358
- HTML全文浏览量: 191
- PDF下载量: 3
- 被引次数: 0