淋巴瘤幸存者复发恐惧的影响因素及认知行为干预对患者生活质量和心理状态的影响

摘要 目的：分析淋巴瘤幸存者复发恐惧（FCR）的影响因素，并分析认知行为干预对患者生活质量和心理状态的影响。方法：本次研究为回顾性调查研究，选取2018年7月~2021年6月期间我院收治的淋巴瘤患者80例，根据病历资料获取患者婚姻状况、疾病分期、工作状况、年龄、治愈时间、文化程度、疾病类型、性别、医疗费用承担情况、家庭人均月收入。采用多因素Logistic回归分析淋巴瘤幸存者FCR的影响因素。将80例淋巴瘤患者分为对照组和干预组，各为40例。对照组给予常规处理，干预组在此基础上接受认知行为干预，对比两组生活质量和心理状态变化。结果：淋巴瘤幸存者FCR总分为（86.90±5.96）分。不同婚姻状况、年龄、疾病分期、家庭人均月收入的患者FCR总分对比差异有统计学意义（P<0.05）。多因素Logistic回归分析显示家庭人均月收入、婚姻状况、疾病分期、年龄是淋巴瘤幸存者FCR的影响因素（P<0.05）。干预后，两组生理职能、躯体疼痛、精神健康、生理功能、总体健康、情感职能、活力、社会功能维度评分均较干预前升高，且干预组高于对照组（P<0.05）。干预组干预后的恐惧疾病进展简化量表（FoP-Q-SF）评分低于对照组（P<0.05）。结论：淋巴瘤幸存者的FCR应得到重视，尤其针对年龄偏低、婚姻状况为离异/未婚/丧偶、家庭人均月收入偏低、疾病分期高的人群，给予认知行为干预后，可提高患者的生活质量和心理状态。

Influencing Factors of Fear of Cancer Recurrence in Lymphoma Survivors and the Effect of Cognitive Behavioral Intervention on Patients' Quality of Life and Psychological State

ABSTRACT Objective: To analyze the influencing factors of fear of cancer recurrence (FCR) in lymphoma survivors, and to analyze the effects of cognitive behavioral intervention on patients'' quality of life and psychological status. Methods: This study was a retrospective investigation. 80 lymphoma patients who were treated in our hospital from July 2018 to June 2021 were selected. According to the medical record data, the marital status, disease stage, working status, age, cure time, education level, disease type, gender, medical cost bearing and per capita monthly income of the family were obtained. Multivariate Logistic regression was used to analyze the influencing factors of FCR in lymphoma survivors. 80 lymphoma patients were divided into control group and intervention group, with 40 cases in each group. The control group was given routine treatment, and the intervention group received cognitive behavioral intervention on this basis. The changes of quality of life and psychological state between the two groups were compared. Results: The total FCR score of lymphoma survivors was (86.90±5.96) scores. There were significant differences in the total score of FCR among patients with different marital status, age, disease stage and family per capita monthly income (P<0.05). Multivariate Logistic regression analysis showed that family per capita monthly income, marital status, disease stage and age were the influencing factors of FCR in lymphoma survivors (P<0.05). After intervention, the scores of physiological function, physical pain, mental health, physiological function, overall health, emotional function, vitality and social function in the two groups were higher than those before intervention, and the intervention group was higher than that in the control group (P<0.05). After intervention, the fear of progression questionnaire-short form (FoP-Q-SF) score in the intervention group was lower than that in the control group (P<0.05). Conclusion: The FCR of lymphoma survivors should be paid attention to, especially for people with low age, marital status are divorced/unmarried/widowed , low family per capita monthly income and high disease stage. Cognitive behavioral intervention can improve the quality of life and psychological state of patients.