Related Investigation On Post Traumatic Stress Disorder, Mental Health, Resilience, Personality And Coping Style Of Gynecologic Cancer Patients

With the transforming of medical model from the biological medical model to thebiopsychosocial model, the life quality of patients suffering from cancer has increasinglydrawn general attention. More and more people think that when modern medicine is inpursuit of the life extension, it should pay more attention to improve the quality of life. Thenumber of long-term survivor of cancer patients (survival time after diagnosis≥5years)increases year by year, but the researches of long-term survivors were mainly limited bybiology factors such as type of tumor, stages, and complication or not, so there was fewresearches on psychological status of the patients.Mental health is not only an important part of the quality of life, but is also animportant factor affecting life quality. Epidemiological investigation showed that, themorbidity of post-traumatic stress disorder (PTSD) in high-risk groups suffered greattrauma was3%~58%, the proportion of psychological problems is far higher than that ingeneral population. However, most people will recover gradually and adapt well to stress.The ability that response effectively to and adapt well when facing loss, difficulty,adversity or disasters was called psychological resilience. This research shows that thepsychological resilience could predict individuals’ mental health after stress, which is animportant evaluation indicator for mental health. Exploring the relationships amongpost-traumatic stress disorder, resilience characteristics, personality and coping styles ofcancer patients have significant meaning for improving their mental health.In recent years, the incidence of gynecologic cancer increasing year after year, and hasa trend of rejuvenation. The diagnosis of cancer has great hit to patients. The change offemale body image and the sex character caused by operation, and the side effects ofradiation and chemotherapy all make the patient in chronic stress state, finally lead to negative emotions and accelerate the deterioration of the cancer. The gynecologic cancerpatient as a special group has multiple identities, which is the nucleus of family and work,and they face more and more stress situation. Former studies showed that the incidence ofpost-traumatic stress disorder of patients with cancer is higher, which mainly manifest thetraumatic memories of the flashbacks and flashbacks, dodge and high alert. Once thesesymptoms occur relatively stable, it will seriously influence the quality of the patients’ life.With the transformation of medical model, offering comprehensive treatment togynecological cancer patients had significant meaning to improve the quality life of thepatients.Everyone has resilience, but the level of resilience is different because of theinteraction of people and the environment. Through studying the relationships among thecancer patients’ post-traumatic stress disorder, psychological resilience characteristics, theirpersonality and coping styles, we can target psychological intervention, improve mentalhealth level and increase treatment adherence, hence improve the quality life of the patients.There have been some researches about the resilience characteristics of the cancerpatients at home and abroad, and also have the researches about the mechanism ofresilience. These researches mainly aimed at teenagers and the community people, but theclinical patients especially cancer patients are less involved. The researches about theirPTSD and resilience were relatively less. However, the patients play an important role infamily and sociality. Therefore, their health has great influence on stability of family andsociety, which have important research value.Methods1. ParticipantsUsing the cluster sampling method, Select a total of200patients from3three level offirst-class hospital of Chongqing from August2010to June2011, and the patients firstreceive hospitalization because of suffering from ovarian cancer, cervical cancerendometrial cancer or flocking carcinoma. All participants’ cancer is in early or middleperiod, and they fully understand their condition and are willing to participate in the study.In addition, the patients have clear consciousness, normal expression and have no otherbody disease and mental illness. Finally, we collected181complicated questionnaire, of which,150cases married,20cases unmarried,11cases divorced and widowed. Theparticipants’ age range from20-68years old (41.15±11.58).2. MeasuresEach questionnaire of the study is composed by basic information and five scales.Because the test amount is too large, so we arrange3times of3days to complete the fullquestionnaire. The five scales were:(1) the Post-Traumatic Stress Disorder SymptomsList-Civilian Version (PTSD, Checklist-Civilian Version, PCL-C);(2) theConnor-Davidson resilience scale (CD-RISC);(3) Symptoms Rating Scale (Self-ReportSymptom Checklist90, SCL-90);(4)Eysenck Personality Questionnaire,(EPQ);(5)CopingStyle Questionnaire(CSQ).3. Statistical MethodsAll the data were analyzed by SPSS17.0statistics software. The main methods are: ttest, correlation analysis, variance analysis and regression analysis.Results1. PTSD scores of Gynecological cancer patients:The total PTSD scores of gynecologic cancer patients range from17to72points, andthe total mean score is30.75±11.28. The patients who scored over38points took up22.65%. There are20cases that scored over45points (11.05%), which was higher than thatof the American Psychiatric Association’s statistics (median8%). It means that theincidence of PTSD of gynecological cancer is far greater than the general population.2. Resilience condition of gynecological cancer patients(1) The resilience status of the gynecological cancer patients is much worse in thisstudy and is less than that in the Chinese community crowd and American communitycrowd. The score range from25to93points, and the total mean score is60.09±19.38.(2)Resilience differed from different medical insurance. The score of resilience from high tolow in turn is: commercial insurance, worker medical insurance, rural insurance and noinsurance.(3) Resilience differed from different cultural degree. The patients with collegedegree are significant higher than that with the primary school.(4) Resilience differed fromdifferent economic income, occupation and pathological part, but there was no significantdifference on the age of patients. 3. The comparison of personality, psychological health and coping style between thehigh resilience group and low resilience groupThe scores of extraversion, rationalization of high resilience group is significantlyhigher than the low group, while the scores of neuroticism is significantly lower than thelow group. At the same time, the results of correlation analysis showed that resiliencepositively related with extraversion and rationalization, but negatively related with mentalhealth, neuroticism and retreat.4. The comparison of resilience, coping style and personality between positive andnegative group of SCL-90.The resilience score of positive group was significantly lower than the negative group(P <0.01). The neuroticism score of positive group was significantly higher than thenegative group (P <0.01), but there is no significant difference on extraversion. On thefactor of coping style, the score of positive group on self-accusation, retreat andrationalization was significantly higher than the negative group (P <0.05).5. The correlation and regression analysis of PTSD, resilience, personality and copingstyles of Gynecological cancer patients.PTSD had positive correlations with SCL-90, self-accusation and retreat, and hadnegative correlations with resilience, problem solving and rationalization. SCL-90hadpositive correlations with PTSD, self-accusation, help seeking，illusion and retreat, and hadnegative correlations with resilience, extraversion and rationalization. Regression analysisshowed that, SCL-90, extraversion and neuroticism explained26.2%of resilience;optimism and rationalization explained29.00%of SCL-90.ConclusionThe resilience and mental health level of gynecologic cancer patients is generally low,and the incidence of PTSD is far greater than the general population. The resilience differedfrom different demographic variable (medical insurance status, educational level, economicincome, professional background, the lesion site). Extraversion, rationalization andneuroticism had significant predictive power to resilience. PTSD had positive correlationswith SCL-90, self-accusation and retreat, and had negative correlations with resilience,problem solving, seeking help and rationalization. Resilience could well predict mental health level of gynecological cancer patients. The patients’ resilience, mental health level,the personality characteristics and coping style could predict PTSD. It means that weshould provide personalized psychological counseling and health education to thegynecological cancer patients. Promote patients’ resilience and mental health, and henceimprove their treatment compliance, the treatment effect, the quality of life, etc.