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北京大学学报（医学版） ›› 2022, Vol. 54 ›› Issue (4): 727-734. doi: 10.19723/j.issn.1671-167X.2022.04.023

• 论著 • 上一篇    下一篇

口腔颌面部恶性肿瘤患者术后正念水平调查及影响因素分析

马芮,宣岩,段瑶,帅婷*()   

  1. 北京大学口腔医学院·口腔医院第二门诊部，国家口腔医学中心，国家口腔疾病临床医学研究中心，口腔生物材料和数字诊疗装备国家工程研究中心，口腔数字医学北京市重点实验室，国家卫生健康委员会口腔医学计算机应用工程技术研究中心，国家药品监督管理局口腔生物材料重点实验室，北京 100020
  • 收稿日期:2021-07-28 出版日期:2022-08-18 发布日期:2022-08-11
  • 通讯作者: 帅婷 E-mail:shuai13921832260@126.com
  • 基金资助:
    北京大学红瑞护理青年学者发展科研基金(HRHL19MS04)

Investigation on mindfulness level of patients with oral and maxillofacial malignant tumor after operation and analysis of its influencing factors

Rui MA,Yan XUAN,Yao DUAN,Ting SHUAI*()   

  1. Second Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100020, China
  • Received:2021-07-28 Online:2022-08-18 Published:2022-08-11
  • Contact: Ting SHUAI E-mail:shuai13921832260@126.com
  • Supported by:
    the Hongrui Nursing Young Scholars Development Research Fund Project of Peking University(HRHL19MS04)

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摘要：

目的: 了解口腔颌面部恶性肿瘤患者术后正念水平现状并分析其影响因素，为患者提供有针对性的支持和帮助，对临床提供证据支持。方法: 采用便利抽样法选取2021年1—6月于北京大学口腔医院接受口腔颌面部恶性肿瘤手术的术后患者452例进行术后随访，通过一般资料调查表、五因素正念量表、压力知觉量表、自尊量表进行调查，采用t检验及方差分析比较不同人口学特征的口腔颌面部恶性肿瘤患者术后的正念得分情况，通过Z检验比较口腔颌面部恶性肿瘤术后患者与正常人群正念水平的差异，采用Spearman相关性分析对正念得分与知觉压力、自尊得分进行相关性分析，运用多重线性回归分析正念水平的影响因素。结果: 共回收有效问卷439份，口腔颌面部恶性肿瘤患者术后正念水平的平均得分为(120.28±13.86)分，各维度得分从高到低依次为有觉知的行动、不判断、描述、观察、不反应。口腔颌面部恶性肿瘤患者术后正念总分及各个维度得分与正常人群相比均有差异。t检验及单因素方差分析表明，不同患病时长、年龄、居住地、教育程度、婚姻状况、人均月收入、职业、医药支付方式对于口腔颌面部恶性肿瘤术后患者的正念水平有影响(P < 0.10)。Spearman相关性分析表明，正念水平与知觉压力水平呈负相关，与自尊水平呈正相关。其中，患病时长、婚姻状况、压力知觉、自尊纳入回归方程，提示对口腔颌面部恶性肿瘤患者术后正念水平有重要影响。结论: 口腔颌面部恶性肿瘤患者术后正念水平较低，与患病时长、婚姻状况、压力知觉相关，医护人员应尽早识别此类人群，进行有效心理干预，为提升正念水平提供帮助，努力提高患者的心理健康水平。

关键词: 口腔颌面部恶性肿瘤, 正念, 情感症状

Abstract:

Objective: To investigate the status quo of postoperative mindfulness level in patients with oral and maxillofacial malignant tumors, to analyze its influencing factors, and to provide targeted support for the patients, in order to provide evidence for clinical support. Methods: A total of 452 patients with oral and maxillofacial malignant tumor who were admitted to the Peking University School of Stomatology from January 2021 to June 2021 were followed up by convenience sampling method, the general information questionnaire, the Five Facet Mindfulness Questionnaire, the 10-item perceived stress scale, and the self-esteem scale were used. The t test and analysis of variance were used to compare the scores of mindfulness of the patients with different demographic characteristics after oral and maxillofacial malignant tumors, and the differences of mindfulness levels between the patients with oral and maxillofacial malignant tumors and the normal population were compared by the Z test, Spearman correlation analysis was used to analyze the correlation between the scores of mindfulness and perceived stress and self-esteem. Multiple linear regression was used to analyze the influencing factors of mindfulness levels. Results: A total of 439 valid questionnaires were collected. The average score of postoperative mindfulness of the patients with oral and maxillofacial malignant tumor was 120.28±13.86. The scores of each dimension from high to low were as follows: act with awareness, non-judging, describing, observing, and non-reacting. Compared with the normal population, the patients with oral and maxillofacial malignant tumor showed significant differences in the total scores and scores of various dimensions after surgery. The t test and ANOVA showed that different duration of disease, age, residence, education, marital status, per capita monthly income, occupation, and medical payment methods had influences on postoperative mindfulness level of the patients with oral and maxillofacial malignant tumor (P < 0.10). Spearman correlation analysis showed that the level of mindfulness was negatively correlated with the level of perceived stress, and positively correlated with the level of self-esteem. The duration of illness, marital status, stress perception and self-esteem were included in the regression equation, suggesting that postoperative mindfulness levels of the patients with oral and maxillofacial malignant tumor had an important effect. Conclusion: Patients with oral and maxillofacial malignant tumors have low postoperative mindfulness, which is related to duration of disease, marital status, and the level of perceived stress. Medical staff should identify this group as soon as possible, provide effective psychological intervention, help to improve the level of mindfulness, and strive to improve the patients'mental health.

Key words: Oral and maxillofacial malignant tumor, Mindfulness, Affective symptoms

中图分类号: 

  • R739.8

表1

口腔颌面部恶性肿瘤患者五因素正念量表各维度得分"

Dimension Quantity terms Scores of dimension Average score of Dimension, $\bar x \pm s$ Average score of mindfulness, $\bar x \pm s$
Observing 8 40 22.25±7.00
Describing 8 40 24.86±5.78
Act with awareness 8 40 33.69±13.09 120.28±13.86
Non-judging 8 40 25.29±5.83
Non-reacting 7 35 20.14±4.99

表2

口腔颌面部恶性肿瘤患者术后正念得分单因素分析"

Items n Constituent ratio/% Score of mindfulness, $\bar x \pm s$ Statistic (F/t) P
Neoplasms histologic type 0.687 0.601
    SCC 307 69.63 120.43±13.46
    ACC 38 8.66 119.03±13.12
    MEC 38 8.66 119.58±14.35
    Osteosarcoma 22 5.01 117.32±15.13
    Others 34 7.74 123.00±16.83
Chemotherapy 0.274 0.230
    Yes 148 33.71 119.16±14.83
    No 291 66.29 120.84±13.33
Radiotherapy 6.540 0.757
    Yes 30 6.83 119.23±19.30
    No 409 93.17 120.35±13.40
Metastasis 2.055 0.251
    Yes 381 86.79 120.57±13.42
    No 58 13.21 118.33±16.48
Duration of illness/months 2.166 0.091
    ≤6 156 35.54 122.34±12.58
    7-12 87 19.82 118.16±13.39
    13-48 139 31.66 120.00±14.32
    ≥49 57 12.98 118.53±16.17
Gender 0.142 0.706
    Female 179 40.77 120.17±14.47
    Male 260 59.23 120.35±13.45
Age/years 3.779 0.024
    1-30 32 7.29 125.00±13.02
    31-55 193 43.96 118.56±13.58
    56-88 214 48.75 121.12±14.05
Residence 3.664 0.012
    City 229 52.16 122.33±14.95
    County 82 18.68 118.63±13.69
    Town 45 10.25 117.51±12.03
    Country 83 18.91 117.72±10.81
Education 3.430 0.017
    Junior high school 145 33.03 118.35±10.49
    Senior high school 118 26.88 120.08±15.35
    University 156 35.54 121.19±15.32
    Postgraduate 20 4.56 128.25±11.29
Marital status 2.190 0.089
    Married 383 87.24 119.96±13.86
    Unmarried 29 6.61 126.31±13.60
    Divorced 10 2.28 119.90±9.24
    Widowed 17 3.87 117.24±14.86
Monthly income/yuan 7.437 0.007
     < 3 000 73 16.63 117.63±10.42
    ≥3 000 366 83.37 120.80±14.40
Job 3.322 0.037
    Farmer 92 20.96 117.09±11.21
    Worker 108 24.60 121.83±13.22
    Intellectual 239 54.44 120.80±14.89
Payment 2.601 0.036
    Self-supporting 136 30.98 119.32±13.74
    Medical insurance 227 51.71 120.85±14.26
    NCMS 64 14.58 118.17±11.72
    Free medicare 8 1.82 132.25±11.5
    Others 4 0.91 129.50±19.69
Other disease 0.016 0.590
    Yes 74 16.86 121.07±14.24
    No 365 83.14 120.12±13.80
Religion 0.103 0.349
    Yes 25 5.69 122.80±15.8
    No 414 94.31 120.12±13.74

表3

口腔颌面部恶性肿瘤患者术后正念水平影响因素的多重线性回归分析"

Factor B SE β t P
Constant 117.878 11.471 10.276 < 0.001
Age 0.105 0.058 0.106 1.793 0.074
Duration of illness -1.416 0.606 -0.109 -2.339 0.020
Residence
    City 0.868 2.484 0.031 0.349 0.727
    County -1.100 2.536 -0.031 -0.434 0.665
    Town -2.232 2.875 -0.049 -0.776 0.438
Education
    Junior high school -6.626 3.788 -0.225 -1.749 0.081
    Senior high school -6.865 3.605 -0.220 -1.904 0.058
    University -5.527 3.257 -0.191 -1.697 0.090
Marital
    Married 4.662 3.384 0.112 1.378 0.169
    Unmarried 13.609 4.649 0.244 2.927 0.004
    Divorced 4.734 5.469 0.051 0.866 0.387
Monthly income 0.603 2.244 0.016 0.269 0.788
Job
    Farmer -1.012 2.702 -0.030 -0.374 0.708
    Worker 2.682 1.816 0.083 1.477 0.140
Payment
    Self-supporting -4.461 6.805 -0.149 -0.656 0.512
    Medical insurance -5.491 6.728 -0.198 -0.816 0.415
    NCMS -3.399 7.073 -0.087 -0.481 0.631
    Free medicare 3.859 8.240 0.037 0.468 0.640
Stress perception level -0.409 0.105 -0.200 -3.880 < 0.001
Self-esteem 0.356 0.194 0.095 1.832 0.068
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