社会支持及抗逆性对老年胃癌患者抑郁情绪影响的相关性研究 ^*

Correlation between social support and stress resistance on depression in elderly patients with gastric cancer

摘要

目的 研究社会支持及抗逆性对老年胃癌患者抑郁情绪影响的相关性以及对身体不适症状引起抑郁情绪的缓解作用。方法 选取2019年6月—2024年6月武汉市精神卫生中心收治的接受化疗的老年原发性Ⅱ期胃癌患者154例进行前瞻性研究。收集患者的临床资料, 分别采用生命质量测定量表体系之胃癌量表、社会支持评定量表、抗逆性量表及汉密尔顿抑郁量表对患者进行评估, 分析上述变量的线性关系, 并采用分层回归分析各变量对抑郁情绪的影响。结果 抑郁平均得分为(16.73±4.24)分, 男性、家人照顾、退休收入较高患者抑郁得分较低(P<0.05)。胃癌患者身体不适症状平均评分为(56.63±7.15)分。社会支持平均得分为(35.36±4.77)分; 抗逆性平均得分为(36.73±5.42)分; 抑郁平均得分为(16.73±2.07)分。身体不适症状得分与社会支持评分、抗逆性评分呈负相关(P<0.05), 与抑郁评分呈正相关(P<0.05); 社会支持评分与抗逆性评分呈正相关(P<0.05), 与抑郁评分呈负相关(P<0.05); 抗逆性评分与抑郁评分呈负相关(P<0.05)。分层回归分析显示: 模型1, 临床资料对患者抑郁评分的影响无统计学意义(P>0.05); 模型2, 身体不适症状得分、社会支持评分及抗逆性评分对患者抑郁评分的影响均有统计学意义(P<0.05); 模型3, 抗逆性评分×身体不适症状得分加入协变量, 对患者抑郁评分的影响有统计学意义(P<0.05)。结论 身体不适症状严重程度影响患者抑郁情绪, 高抗逆性可显著缓解老年胃癌患者的抑郁情绪。

Abstract

Objective To investigate the correlation between social support and resilience and their impact on depressive mood in elderly gastric cancer patients, as well as their role in alleviating depression caused by physical discomfort symptoms. Methods A prospective study was conducted on 154 elderly patients with primary stage Ⅱ gastric cancer who received chemotherapy at Wuhan Mental Health Center from June 2019 to June 2024. Clinical data were collected, and the patients were evaluated using the Quality of Life Instrument for Gastric Cancer, Social Support Rating Scale, Resilience Scale, and Hamilton Depression Rating Scale. Linear relationships among the above variables were analyzed, and hierarchical regression was used to assess the impact of each variable on depressive mood. Results The depression score was (16.73±4.24) scores. Male patients, those cared for by family members, and those with higher retirement income had lower depression scores (P<0.05). The physical discomfort symptom score in gastric cancer patients was (56.63±7.15) scores. The average social support score was (35.36±4.77) scores; The average resilience score was (36.73±5.42) scores; The average depression score was (16.73±2.07) scores. Physical discomfort symptom scores were negatively correlated with social support and resilience scores (P<0.05), and positively correlated with depression scores (P<0.05); Social support scores were positively correlated with resilience scores (P<0.05), and negatively correlated with depression scores (P<0.05); Resilience scores were negatively correlated with depression scores (P<0.05). Hierarchical regression analysis showed: Model 1, clinical data had no statistically significant effect on patients' depression scores (P>0.05); Model 2, physical discomfort symptom scores, social support scores, and resilience scores all had statistically significant effects on patients' depression scores (P<0.05); Model 3, adding the interaction term of resilience scores × physical discomfort symptom scores as covariates had a statistically significant effect on patients' depression scores (P<0.05). Conclusion The severity of physical discomfort symptoms affects patients' depressive mood, and high resilience can significantly alleviate depression in elderly gastric cancer patients.

关键词

抑郁 / 胃癌 / 抗逆性 / 社会支持

Key words

Depression / Gastric cancer / Stress resistance / Social support

参考文献

[1] Ma Y H, Miao X, Zhu H B, et al. Prognosis prediction of elderly patients with gastric cancer based on geriatric nutrition risk index before adjuvant chemotherapy[J]. Chin J Clin Oncol, 2023, 17(6): 319-324.

[2] Zhang X L, Geng M F, Di Q, et al. Potential categories of emotional intelligences among clinical nurses and their relationship with communication ability[J]. Chin Nurs Res, 2024, 38(18): 3227-3234.

[3] Ma Y, Wei Q F, Niu R X, et al. Research progress of emotional inhibition in cancer patients[J]. Chin Nur Res, 2024, 38(16): 2877-2880.

[4] Xie N, Chen X . Correlation between stress resistance, social support and daily activities and depression in hemodialysis patients[J]. Chin J Practi Nur, 2019, 7(11): 830-836.

[5] Li X, Wang Q, Fu C Y, et al. Association between social support and subjective and objective cognitive functions among the middle—aged and elderly population in Pingyin County, Jinan City[J]. Chin J Epidemiol, 2025, 6(2): 218-225.

[6] Ministry of Health of the People's Republic of China. " Diagnostic criteria for gastric cancer (WS 316—2010)"[S]. Beijing: China Standards Press, 2010.

[7] Meng Q, Wan C H, Luo J H, et al. Study on psychometrical characteristics of different scales among instruments measuring quality of life for patients with cancer[J]. Tumor, 2011, 6(3): 245-249.

[8] Xiao S Y . Social support rating scale[J]. Chin J Mental Heal, 1999(Supplement): 127-131.

[9] Ahern N R, Kiehl E M, Sole M L, et al. A review of instruments measuring resilience[J]. Issues Compr Pediatr Nurs, 2006, 29(2): 103-125.

[10] Hamilton M . A rating scale for depression[J]. J Neurol Neurosurg Psychiatry, 1960, 23(1): 56-62.

[11] Zhai F F, Feng X N . Analysis of the current situation of psychological distress in patients with gastric cancer undergoing chemotherapy and its related influencing factors[J]. J Aerosp Med, 2023, 34(9): 1053-1055.

[12] Cao J, Liu Y, Yan S, et al. The association between perceive social support and post—traumatic stress disorder symptoms among medical staff in Hubei, China: a chain mediating effect of resilience and positive coping[J]. BMC Public Health, 2024, 24(1): 3042.

[13] Jiang Y . Analysis of the current situation and influencing factors of supportive care needs for postoperative patients with gastric cancer[D]. Changsha: Hunan Normal University, 2021.

[14] Qiu Y X . The relationship between negative emotions, psychological resilience and social support in patients with gastric cancer[J]. Int J Nur, 2018, 37(5): 615—617, 695.

基金资助

^*湖北省自然科学基金(ZRMS2023001806)