子宫内膜息肉切除术患者复发恐惧现状及其与心理韧性及应对方式的关系

李星星; 王秀梅; 韩燕妮; 陈俊茹

doi:10.16766/j.cnki.issn.1674-4152.004212

子宫内膜息肉切除术患者复发恐惧现状及其与心理韧性及应对方式的关系

doi: 10.16766/j.cnki.issn.1674-4152.004212

空军军医大学第二附属医院妇产科生殖中心，陕西西安 710038

基金项目:

陕西省重点研发计划项目 2023SF-365

详细信息

通讯作者:
韩燕妮，E-mail：761310605@qq.com

中图分类号: R711.74
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出版历程
- 收稿日期: 2024-12-02

Recurrent fear in patients with endometrial polyp resection and its relationship with mental toughness and coping style

Obstetrics and Gynecology Reproductive Center, the Second Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi 710038, China

摘要

摘要: 目的分析子宫内膜息肉切除术患者的复发恐惧现状，并探讨其与心理韧性及应对方式之间的关联。方法采用方便抽样法选取2022年10月—2023年10月空军军医大学第二附属医院妇科128例子宫内膜息肉切除术患者作为研究对象。通过一般资料调查问卷、恐惧疾病进展简化量表(FoP-Q-SF)、心理韧性量表(CD-RISC)和医学应对方式问卷(MCMQ)收集数据，并运用Pearson相关法探讨复发恐惧与心理韧性及应对方式的关系，同时通过多元线性回归分析复发恐惧的相关因素。结果子宫内膜息肉切除术患者恐惧疾病进展总分为(36.53±5.82)分，家庭坚韧力总分为(66.65±18.31)分，应对方式总分为(47.12±6.10)分。子宫内膜息肉切除术患者复发恐惧及各维度与屈服、回避维度呈正相关关系(r=0.352、0.446、0.362, P < 0.05；r=0.412、0.386、0.413, P < 0.05)，与心理韧性总分、面对维度均呈负相关关系(r=-0.681、-0.425、-0.308, P < 0.05；r=-0.410、-0.452、-0.371, P < 0.05)。多元线性回归分析显示，住院次数、文化程度、病程、家庭月收入、心理韧性、应对方式等均是子宫内膜息肉切除术患者复发恐惧的相关影响因素(P < 0.05)。结论子宫内膜息肉切除术患者的复发恐惧程度处于中等水平，心理韧性和应对方式是其主要影响因素。
- 子宫内膜息肉切除术 /
- 复发恐惧 /
- 心理韧性 /
- 应对方式 /
- 相关性
Abstract: Objective To analyze the current status of recurrence fear in patients undergoing endometrial polypectomy and explore its association with psychological resilience and coping styles. Methods A total of 128 patients who underwent endometrial polypectomy in the gynecology department of the Second Affiliated Hospital of Air Force Medical University from October 2022 to October 2023 were selected using convenience sampling. Data were collected through a general information questionnaire, the fear of progression questionnaire-short form (FoP-Q-SF), the Connor-Davidson resilience scale (CD-RISC), and the medical coping modes questionnaire (MCMQ). Pearson correlation analysis was used to explore the relationship between recurrence fear and psychological resilience and coping styles. Multiple linear regression analysis was conducted to identify the factors influencing recurrence fear. Results The total score of fear of progression in patients who underwent endometrial polypectomy was (36.53±5.82) points, the total score of family resilience was (66.65±18.31) points, and the total score of coping styles was (47.12±6.10) points. Pearson correlation analysis revealed that recurrence fear and its dimensions were positively correlated with the dimensions of resignation and avoidance (r=0.352, 0.446, 0.362, P < 0.05; r=0.412, 0.386, 0.413, P < 0.05), and negatively correlated with the total score of psychological resilience and the dimension of confrontation (r=-0.681, -0.425, -0.308, P < 0.05; r=-0.410, -0.452, -0.371, P < 0.05). Multiple linear regression analysis showed that the number of hospitalizations, educational level, disease duration, family monthly income, psychological resilience, and coping styles were all related factors influencing the current status of recurrence fear in patients who underwent endometrial polypectomy (P < 0.05). Conclusion The recurrence fear of patients who underwent endometrial polypectomy is at a moderate level, and psychological resilience and coping styles are the main influencing factors.
- Endometrial polypectomy /
- Fear of relapse /
- Mental toughness /
- Coping style /
- Correlation
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表 1 128例子宫内膜息肉切除术患者一般资料

Table 1. Baseline data of a total of 128 patients who underwent endometrial polyp resection

项目	类别	例(%)
年龄(岁)	23~40	36(28.13)
	41~68	92(71.87)
婚姻状况	已婚	61(47.66)
	未婚	18(14.06)
	离异	32(25.00)
	丧偶	17(13.28)
文化程度	小学	20(15.63)
	初中	32(25.00)
	中专/高中	36(28.13)
	本科	40(31.24)
职业	公务员	31(24.22)
	企业、事业单位人员	43(33.59)
	自由职业	21(16.41)
	无业	33(25.78)
家庭月收入(元)	＜3 000	39(30.47)
	3 000~6 000	42(32.81)
	＞6 000	47(36.72)
病程(月)	＜6	8(6.25)
	6~12	51(39.84)
	＞12	69(53.91)
医疗费用支付方式	医保	78(60.94)
	自费	50(39.06)
住院次数(次)	≤3	62(48.44)
	＞3	66(51.56)

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表 2 子宫内膜息肉切除术患者复发恐惧与心理韧性、应对方式的相关性

Table 2. Relationships between fear of recurrence, psychological resilience, and coping styles in patients following endometrial polyp resection

项目	恐惧疾病进展总分		生理健康		社会支持
项目	r值	P值	r值	P值	r值	P值
心理韧性	-0.681	< 0.001	-0.425	< 0.001	-0.308	0.001
面对	-0.410	< 0.001	-0.452	< 0.001	-0.371	< 0.001
屈服	0.352	< 0.001	0.446	< 0.001	0.362	< 0.001
回避	0.412	< 0.001	0.386	< 0.001	0.413	< 0.001

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表 3 子宫内膜息肉切除术患者复发恐惧影响因素的单因素分析

Table 3. Univariate analysis of the factors influencing the recurrence fear in patients undergoing endometrial polyp resection

项目	例数	恐惧疾病进展(x±s，分)	统计量	P值
住院次数
≤3	62	29.36±1.25	12.074^a	< 0.001
＞3	66	35.20±3.61
年龄(岁)
23~40	36	32.31±2.40	0.521^a	0.208
41~68	92	30.58±2.63
文化程度
小学	20	37.61±4.32	157.316^b	< 0.001
初中	32	32.05±3.57
中专/高中	36	29.66±2.10
本科	40	23.61±0.28
病程(月)
＜6	8	22.38±0.25	59.659^b	< 0.001
6~12	51	29.41±1.22
＞12	69	33.69±2.94
家庭月收入(元)
< 3 000	39	36.98±4.10	59.275^b	< 0.001
3 000~6 000	42	31.42±2.47
>6 000	47	28.33±1.14
医疗费用支付形式
自费	50	30.58±2.54	0.022^a	0.983
医保	78	30.57±2.55
婚姻状况
已婚	61	29.36±2.33	0.683^b	0.871
未婚	18	28.58±2.39
离异	32	29.10±2.18
丧偶	17	29.66±2.60
职业
公务员	31	30.21±2.85	1.156^b	0.763
企业、事业单位人员	43	28.63±3.10
自由职业	21	31.20±2.51
无业	33	29.11±2.93
注：^a为t值，^b为F值。

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表 4 子宫内膜息肉切除术患者复发恐惧影响因素的多元线性回归分析

Table 4. Multiple linear regression analysis to identify factors associated with fear of recurrence in patients undergoing endometrial polyp resection

自变量	B	SE	β	t值	P值
住院次数	0.154	0.071	-0.134	2.264	< 0.001
文化程度	1.326	0.569	0.144	2.152	< 0.001
病程	0.232	0.158	0.117	2.394	< 0.001
家庭月收入	0.512	0.231	0.123	2.241	< 0.001
心理韧性	3.531	1.124	0.142	-2.245	< 0.001
应对方式	-2.431	1.210	-0.152	2.362	< 0.001

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参考文献(20)

[1]	陈果, 应杰, 田璐, 等. 宫腔镜刨削系统治疗多发性子宫内膜息肉的临床效果评价[J]. 中华全科医学, 2023, 21(6): 985-988, 1029. doi: 10.16766/j.cnki.issn.1674-4152.003031 CHEN G, YING J, TIAN L, et al. Evaluation of the clinical effect of hysteroscopic dissection system in the treatment of multiple endometrial polyps[J]. Chinese Journal of General Practice, 2023, 21(6): 985-988, 1029. doi: 10.16766/j.cnki.issn.1674-4152.003031
[2]	唐菲, 曹福娣, 单华伟, 等. 左炔诺孕酮缓释系统应用于宫腔镜下子宫内膜息肉切除术后患者的临床疗效[J]. 现代医学与健康研究电子杂志, 2024, 8(21): 84-86. TANG F, CAO F D, SHAN H W, et al. The clinical efficacy of levonorgestrel sustained-release system in patients after hysteroscopic resection of endometrial polyps[J]. Electronic Journal of Modern Medicine and Health Research, 2024, 8(21): 84-86.
[3]	HUI P. Endometrial polyp in postmenopausal women: an epicenter for the development of endometrial serous carcinoma[J]. Arch Pathol Lab Med, 2023, 147(4): 413-417. doi: 10.5858/arpa.2021-0557-RA
[4]	余平芝, 李菲菲. 子宫内膜息肉行宫腔镜联合天然孕激素治疗的效果观察[J]. 中华全科医学, 2022, 20(2): 267-269. doi: 10.16766/j.cnki.issn.1674-4152.002329 YU P Z, LI F F. Observation on the effect of hysteroscopy combined with natural progesterone treatment for endometrial polyps[J]. Chinese Journal of General Practice, 2022, 20(2): 267-269. doi: 10.16766/j.cnki.issn.1674-4152.002329
[5]	SHARIF NIA H, SHE L, FROELICHER E S, et al. Psychometric evaluation of the Connor-Davidson resilience scale among Iranian population[J]. BMC Psychiatry, 2023, 23(1): 92. doi: 10.1186/s12888-023-04580-8
[6]	王春苗, 饶婷. 生活希望计划干预对妇科肿瘤患者希望水平、负面情绪及应对方式的影响[J]. 中国健康心理学杂志, 2023, 31(3): 342-346. WANG C M, RAO T. The influence of the Life Hope Program intervention on the hope level, negative emotions and coping styles of gynecological tumor patients[J]. Chinese Journal of Health Psychology, 2023, 31(3): 342-346.
[7]	郭艳, 杨玲玲, 夏恩兰, 等. 宫腔镜子宫内膜息肉切除术后影响息肉复发的多因素分析: 手术时机的研究[J]. 中国微创外科杂志, 2023, 23(10): 726-730. GUO Y, YANG L L, XIA E L, et al. Multivariate analysis of factors influencing polyp recurrence after hysteroscopic endometrial polyp resection: A study on the timing of surgery[J]. Chinese Journal of Minimally Invasive Surgery, 2023, 23(10): 726-730.
[8]	张湘香, 彭乙聆, 胡天琼. 家庭支持和家庭韧性对妇科肿瘤术后复发恐惧的影响分析[J]. 肿瘤代谢与营养电子杂志, 2022, 9(5): 609-615. ZHANG X X, PENG Y L, HU T Q. Analysis of the Impact of Family Support and Family Resilience on the Fear of Postoperative Recurrence of Gynecological Tumors[J]. Electronic Journal of Tumor Metabolism and Nutrition, 2022, 9(5): 609-615.
[9]	PRETORIUS T B, PADMANABHANUNNI A. Validation of the connor-davidson resilience scale-10 in South Africa: item response theory and classical test theory[J]. Psychol Res Behav Manag, 2022, 15: 1235-1245. doi: 10.2147/PRBM.S365112
[10]	孙宇, 卢凌, 李颖. 妇科肿瘤患者化疗所致周围神经病变的症状体验与应对方式[J]. 生殖医学杂志, 2023, 32(10): 1496-1502. SUN Y, LU L, LI Y. Symptom experience and Coping styles of peripheral neuropathy caused by chemotherapy in patients with gynecological tumors[J]. Journal of Reproductive Medicine, 2023, 32(10): 1496-1502.
[11]	周冬梅, 臧丽, 李苗苗, 等. 炎症性肠病患者心理韧性与自我管理行为、疾病进展恐惧的相关性分析[J]. 中华现代护理杂志, 2022, 28(27): 3751-3755. ZHOU D M, ZANG L, LI M M, et al. Correlation analysis of psychological resilience, self-management behavior and fear of disease progression in patients with inflammatory bowel disease[J]. Chinese Journal of Modern Nursing, 2022, 28(27): 3751-3755.
[12]	张旭, 孙迪, 李小寒, 等. 癌症患者复发恐惧的潜在剖面分析[J]. 中华护理杂志, 2023, 58(6): 662-669. ZHANG X, SUN D, LI X H, et al. Potential profile analysis of fear of recurrence in Cancer patients[J]. Chin J of Nurs, 2023, 58(6): 662-669.
[13]	胡君霞, 吴丽芳. 宫颈癌患者复发恐惧与生活质量的关系及心理弹性的中介效应分析[J]. 检验医学与临床, 2022, 19(16): 2276-2279. HU J X, WU L F. Analysis of the Relationship between Fear of Recurrence and Quality of Life in Patients with Cervical Cancer and the mediating effect of Psychological resilience[J]. Lab Medi Clin, 2022, 19(16): 2276-2279.
[14]	占云燕, 林燕, 吴珊珊. 以家属为主导的赋能心理护理对宫颈癌患者创伤后应激及复发恐惧的影响[J]. 中国性科学, 2023, 32(11): 104-108. ZHAN Y Y, LIN Y, WU S S. The influence of family-led enabling psychological care on post-traumatic stress and fear of recurrence in patients with cervical cancer[J]. Chinese Sex Science, 2023, 32(11): 104-108.
[15]	姚敏. PERMA模式下的积极心理干预对妇科肿瘤患者心理弹性及癌症复发恐惧的影响[J]. 实用妇科内分泌电子杂志, 2021, 8(22): 114-116. YAO M. The influence of positive psychological intervention under the PERMA model on the psychological resilience and fear of cancer recurrence of gynecological tumor patients[J]. Practical Gynecological Endocrinology Electronic Magazine, 2021, 8(22): 114-116.
[16]	商玉妹, 罗小婉, 方方. 配偶同步赋能教育对卵巢癌化疗患者情绪抑制及癌症复发恐惧的影响[J]. 实用妇科内分泌电子杂志, 2022, 9(19): 108-110. SHANG Y M, LUO X W, FANG F. The influence of spousal synchronous empowerment education on emotional suppression and fear of cancer recurrence in patients with ovarian cancer undergoing chemotherapy[J]. Practical Gynecological Endocrinology Electronic Magazine, 2022, 9(19): 108-110.
[17]	曾小红, 陶琳, 杨颖, 等. 乳腺癌术后患者自我效能感与应对方式对癌症复发恐惧的影响研究[J]. 肿瘤预防与治疗, 2023, 36(8): 688-696. ZENG X H, TAO L, YANG Y, et al. A Study on the Impact of Self-efficacy and Coping Styles on the Fear of Cancer Recurrence in Postoperative Breast Cancer Patients[J]. Cancer Prevention and Treatment, 2023, 36(8): 688-696.
[18]	严沁清, 姚欣, 刘泳材, 等. 应对方式在前列腺癌术后患者疾病感知与癌症复发恐惧间的中介效应研究[J]. 中华男科学杂志, 2023, 29(6): 511-517. YAN Q Q, YAO X, LIU Y C, et al. A Study on the mediating Effect of Coping Styles between Disease Perception and Fear of Cancer Recurrence in Patients after Prostate Cancer Surgery[J]. Chinese Journal of Andrology, 2023, 29(6): 511-517.
[19]	何亚林, 吴强. 妇科恶性肿瘤患者化疗相关性味觉改变对营养、恶心呕吐及应对方式的影响[J]. 四川医学, 2022, 43(9): 857-861. HE Y L, WU Q. The influence of chemotherapy-related taste changes in patients with gynecological malignant tumors on nutrition, nausea and vomiting, and coping styles[J]. Sichuan Medicine, 2022, 43(9): 857-861.
[20]	赵婷, 祖木热提·乌斯曼, 吴梅, 等. 突发性耳聋心理应激与应对方式的关系: 心理弹性的中介作用[J]. 中国健康心理学杂志, 2023, 31(10): 1504-1509. ZHAO T, Zumureti Usman, WU M, et al. The Relationship between Psychological Stress and Coping Styles in Sudden deafness: The Mediating Role of psychological Resilience[J]. Chinese Journal of Health Psychology, 2023, 31(10): 1504-1509.