Study Of Psychological Status And Immune Function In Tumor Patients Receiving Radiotherapy And Intervention On Them

Background and objective: The malignant tumor patients treated by radiotherapy have become a specific and significant groups in our society with the change of spectrum of disease. The tumor patients get many physical symptoms and adverse psychological reactions for the fear of tumor and radiotherapy. Cut down the patients' depression can help them keep good psychological condition and immune function, as a result, put active effect on the therapy. We have made a match-case-control study: (1) To study psychological condition, coping style, personality feature and immune function of the tumor patients treated by radiotherapy; (2) To explore the relationships between psychological status and immune function; (3) To assess the effect of psychological intervention on the patients' psychological condition, coping style and immune function. The aim is accomplish the nursing measures for the tumor patients during radiotherapy and provide theoretical information for the psychological intervention.Methods: A total of 77 patients with cancer before radiotherapy and 42 healthy controls were administered with psychological rating scales (SCL-90, SAS, SDS, TCSQ, EPQ), and test the immune function (CD3+, CD4+, CD8+ cells percentage, CD4+/CD8+ ratio and NK cell). Then the 77 tumor patients were randomly divided into intervention group (n=38) and non-intervention group (n=39), the former received psychological intervention during radiotherapy, while the latter only received standard nursing. They were tested the psychological rating scales and the immune function after radiotherapy, as well.Results: 1. The tumor patients group had significantly higher level than the healthy controls on SCL-90 total scores , total equipartition ,positive items, positive item equipartition and all factors scores(P<0.05 or P<0.01), distinctly in somatization, depression, anxiety and psycho- disposition.2. The patient showed apparently higher scores than controls in SAS, SDS and abnormal feeling ratio (P<0.05 or P<0.01); the SAS scores of patient were positively related with the SCL-90 total scores, total equipartition, positive items, positive item equipartition and all factors scores (P<0.05 or P<0.01), while the SDS scores were obviously positively with those of SCL-90 (P<0.05 or P<0.01).3. There was no significant difference between tumor patients and healthy groups in positive coping style scores (P>0.05), while the tumor patients group had obviously higher negative coping style scores than controls (P<0.005). There were negative correlations between positive coping style and psychological status (P<0.05 or P<0.01), but positive correlations between negative coping style and psychological status(P<0.05 or P<0.01) in patients.4. The cancer patients group had significantly higher scores than control group in EPQ Neuroticism (N) and Lie (L) (P<0.05), while no significant difference in Extraversion (E) and Psychoticism (P) (P<0.05).5. The intervention group after radiotherapy had significantly decreased scores in SCL-90 total scores, total equipartition, positive items, positive item equipartition, all factors scores and SAS, SDS compared to that before radiotherapy and the non-intervention group (P<0.05 or P<0.01), while the non-intervention group after radio therapy had obviously high scores in those of SCL-90 and SAS, SDS compared to that before radiotherapy (P<0.05 or P<0.01). In further study we found that the intervention group patients after radiotherapy had a obviously lower level in depression, anxiety and attack rate than that before radiotherapy and non-intervention group (P<0.05, respectively ).6. The intervention group after radiotherapy had obviously lower score in negative coping style than that of non-intervention group and before radiotherapy respectively (P<0.05 or P<0.001), while scores of positive coping style were higher than those (P<0.001).7. The CD3+, CD4+ cells percentage and CD4+/CD8+ ratio of tumor patients before radiotherapy were all significantly lower than the controls (all P<0.01). Before radiotherapy there was no difference in the immune function (CD3+, CD4+, CD8+ cells percentage, CD4+/CD8+ ratio and NK cell) between intervention group and non-intervention group(P>0.05). In the non-intervention group CD3+, CD4+, CD8+ cells percentage, CD4+/CD8+ ratio and NK cell were lower after radiotherapy than that before radiotherapy; which CD3+, CD4+ cells percentage were significantly lower (P<0.001, P<0.05). In the intervention group the level of CD8+ and NK cell after radiotherapy is higher than that before radiotherapy, in which the increase of NK cell was the most obvious (P<0.01), while CD3+, CD4+ cells percentage and CD4+/CD8+ ratio lower after radiotherapy than that before radiotherapy. After radiotherapy CD3+,CD4+,CD8+,CD4+/CD8+ and NK cell of intervention patients were all higher than the non-intervention group, especially the CD4+and NK cell (P<0.05, respectively).8. Related analysis showed that the CD3+ cells percentage of patients was obviously negatively related with the depression score of SCL-90, SAS, SDS (P<0.05 or P<0.01); and CD8+ level also negatively with the SCL-90 total scores , total equipartition positive items, anancastia, depression, anxiety, hostility, phobophobia, mental disorder factor and SDS (P<0.05 or P<0.01), while CD4+/CD8+ ratio only significantly positively with the anancastia and hostility scores of the SCL-90 (all P<0.05). The negative coping style of tumor was obviously negatively related with CD3+, CD8+ cells percentage (P<0.05 or P<0.01), obviously positively with CD4+/CD8+ ratio (P<0.01), while tumor group's positive confrontation scores were only positively with CD8+ (P<0.05).Conclusion: The malignant tumor patients treated by radiotherapy have the personality feature of psychoticism, emotional instability, low cell immune function and serious somatic symptom. They also have anxious and depressed emotion, and most of them are negative coping style, which aggravate after radiotherapy. Related analysis showed that there is dependability among emotion, somatic symptom, coping style and immune function. The psychological intervention has positive effect on emotional disorder and immune function in tumor patients treated with radiotherapy.