| Objectives:The incidence of Cancer, an important factor to induce patients death in the world, had been increasing gradually. According to WHO data, It was showed that there were 140 million new tumor patients in the world in 2012, 8.2million died of cancer, accounting for 14.6% of the total deaths. In China, as the National Cancer Registry Center showed, the number of cancer accounted for almost half of the world. There were 3.5 million new tumor patients each year, and 2.5 million die of it. The incidence of gastric cancer,esophageal cancer, pancreatic cancer, liver cancer,colon cancer and other digestive system malignant tumor increased in recent years, accounting for 60% ~70% of all tumors, ranking first on the death list, the age of cancer patients also decreased. The digestive system cancer is the most common malignancy in China. Most patients who have been diagnosed in middle or end stage of the cancer lost operation chances. So the chemotherapy play more and more important roles in cancer treatment. In the process of chemotherapy not only tumor cells will be killed, but also the physical functions will decline, the effect to mental status of patients has gradually attracted more and more attentions. As the change of medical model and the improvement of people understanding to disease, the psychological impact of depression to both benign and malignant tumor patients had highlighted gradually.The clinical phenomenon of depressive emotion and negative automatic thoughts of digestive cancer patients before and after chemotherapy were described in this study, and the changes of depressive emotion were analyzed, and the role of chemotherapy were investigated. The result may provide the theoretical basis for psychological care and treatment.Methods: Questionnaire survey was conducted among 115 digestive cancer patients who were hospitalized in Department of Gastroenterology of the Second Affiliated Hospital of Hebei North University from January 2014 to February 2015. The questionnaire includes three parts: the general information of the patients, questionnaire of Hamilton Depression Scale(HAMD) and questionnaire of Automatic Thoughts Questionnaire(ATQ). The time of investigation was one week before the first chemotherapy was conducted and two cycles after chemotherapy has been conducted. SPSS17.0 was used for statistical analysis.Results:1 In this study, 115 patients were enrolled and we got 110 questionnaires, and 103 questionnaires were valid. 5 of 7 questionnaires were filled in by the family members of the patients,so they can not reflect the real emotional state of patients,2 questionnaires of them were not completed,we see them as invalid questionnaire.There were 58 males and 45 females, and the ratio of male to female was 1.2:1. The age of the patients was 36 to 88, and the mean age was 68.07±11.52. There were 33 patients younger than 60, and 70 patients older than 60. There were 26 cases of colorectal cancer, 23 cases of hepatic carcinoma, 18 cases of gastric cancer, 12 cases of pancreatic cancer, 11 cases of cholangiocarcinoma, 7 cases of esophageal cancer, 6 cases of gastric cardia cancer. There were 7 workers, 59 retirees, 30 farmers and 7 were unemployed.2 There were 34 patients that have depression before chemotherapy, the rate of depression was 33.0%. There were 37 patients that have depression after chemotherapy has been conducted for two cycles, the rate of depression was 35.9%. The incidence of depression and HAMD scores(9.25 ±6.13)of patients after chemotherapy was increased significantly compared to the patients without chemotherapy(7.65±5.58)(P<0.05).3 There was no significant difference between HAMD score and clinical characteristics, such as gender, profession,tumor types. As for age, the older the patients, the lower the HAMD score. The HAMD score were 20.40±12.97 and 6.00±1.64 when patients younger than 60 and older than 60 years old.4 According to HAMD score, the patients were divided into two groups, depression group(HAMD>7points) and non-depression group(HAMD≦7 points).Before chemotherapy, ATQ total score of depression group was 56.29 ± 6.60,which was higher than non-depression group(43.42±4.21),after two cycles of chemotherapy, ATQ total score of depression group was 63.49±4.13,which was also higher than non-depression group(49.70±2.82). ATQ total score in two cycles of chemotherapy(54.65±7.44) was higher than pre chemotherapy(47.67±7.93).Conclusions:1 Depressive emotion was common among digestive tumor patients befo- re and after chemotherapy. Before chemotherapy the incidence of depression was 33%; after Chemotherapy the incidence of depression was 35.9%. After two cycles of chemotherapy, both the incidence of depression and HAMD scores were increased significantly compared to those pre chemotherapy.2 Depressive emotion of digestive cancer patients in chemotherapy was related with ages and there was no significant difference on gender, occupation and tumor types.3 ATQ total scores of digestive cancer patients after chemotherapy were significantly higher than before chemotherapy,which indicated that negative automatic thoughts played important roles in generation of depression of digestive cancer patients in chemotherapy. |
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