| Background:In recent years, the morbidity of breast cancer in youthful women increased rapidly. Being identified as breast caner patients brings these women not only the damages of surgery but also loss of adaptations to society and families. Compared with patients of other diseases, they need to face more serious and complicated stresses. They may face problems of educating children and bring up parents, worries about the marriage bond and anxiety of losing job and adaptation to society. All the above factors influence the psychological situation of these patients directly. Thus it can be seen that damages to youthful patients of breast cancer are more serious than those to mid-life patients or aged patients of breast cancer.The results of the researches in the past show that in large extent the psychological stresses of patients come from the period of diagnosis. The diagnosis of cancer would bring serious psychological crisis and create excitable expressions and body syndrome in different extents. Faced with the kinds of side effects of surgery, radiotherapy, chemotherapy and endocrine, the majority of patients have the uncertainty to the knowledge related to this cancer and the life after surgery.As the incidence of breast cancer increasing and modern medical mode developing, psychoneuroimmunology has being deepened and the influence of psychological social factors and patients'problems has being thought more highly of. Many researches prove that the arising and developments of breast cancer relate to elemental, psychological and social factors. These factors cause psychological and behavior changes by immune factors which are released by immune cells and effect central nerve system and influence the taking place, recrudescence and transplanting of cancers through nerve-endocrine-immune network, then immune system. As excitable sources, these complicated problems may influence immune system, then the process and recovery of diseases.At present, qualitative research on breast cancer has been the focus of the present research. Many researchers perform the qualitative research on the psychological situation of the patients with breast cancer. Most of these researches attach importance to discussing the psychological countermeasures to the disease. In our country, the number of qualitative researches on psychological experience increased day by day. However, few researches attach importance to youthful patients and the period of diagnosis. Moreover, qualitative research that takes quantitative research as complement has not been reported.Objectives:The aim of this paper is to explore the true psychological experience of youthful patients with breast cancer in the period of diagnosis, analyze psychological problems of these patients comprehensively and deeply concerning emotions such as anxiety and depress and personal characteristics and know about the influence on endocrine system of the patients with breast cancer in the period of diagnosis comprehensively and deeply. By the above effort, this paper wish to identify the availability and efficiency of performing the clinical researches that combine qualitative methods with quantitative methods and provide the new thoughts for the system of nursing knowledge.Methods:This paper employed phenomenological methods. This paper is a prospective research that employed qualitative methods mainly aided by quantitative methods investigating 60 youthful patients with breast cancer by use of questionnaires and taking deep talks with 12 individuals. This paper took three 3-A hospitals as investigating units and investigated included patients by use of questionnaires. The questionnaires include ordinary investigating questionnaires, SCL-90 (Symptom Checklist 90) questionnaires and LES (Life Event Scale)questionnaires. At the same time, this paper took deep talk with 12 individuals of the included patients. The semi-structural outlines were developed to record, rectify and analyze the content of the talk. The levels of AD (adrenaline) and NE (Noradrenaline) in the serum of the included patients were detected before surgery.Results:1,Five subjects were summarized in the qualitative research: change of self identification, serious uncertainty, change of self role, change of adaptation and obligation to society and shortage of knowledge and ability for early diagnosis.2,The scores of body symptom, depress and anxiety of youthful patients with breast cancer are higher than that of normal population (P<0.05).3,The results of the comparisons of the above three factors in the these patients showed there is no magnificent diversity in the score of body symptom whether the patient receive a senior high school education or not (p=>0.05). The scores of depress factors and anxiety factors in the patients who haven't received senior high school education are higher than that of the ones who have received this education (P<0.05). The scores of the above three factors in the patients who haven't spouses are higher than that of the patients who are in marriages (P<0.05). The scores of the depress factor and anxiety factor of the patients who haven't jobs are higher magnificently than that of the patients who have a job (P<0.05). There is no magnificent diversity in the score of body symptom (P>0.05). The scores of the depress factor and anxiety factor of the patients whose salaries are less income will be obviously than that of the patients whose salaries are more income (P<0.05). There is no magnificent diversity in the score of body symptom (P>0.05). There are mutual effects between the scores of depress factor and anxiety factor and A, B, C personal characteristics (P<0.001; P=0.029). There is no mutual effect in the score of body symptom.4,The correlative analysis on how body and emotional factors influence immunne functions showed the levels of AD and NE correlate positively to the depress (P<0.05) mood and the anxiety mood (P<0.05) in the patients with breast cancer in the period of diagnosis, and independablity to the body symptoms (P>0.05).5,The correlative analysis on negative life events influence body symptoms, depress mood and anxiety mood showed the excitable dose of negative life events correlates to these factors positively (P<0.05). The results showed that the excitable dose of all life events correlates to body symptoms independablity (P>0.05), to depress factors and anxiety factors positively (P<0.05). All the above factors correlate to the positive excitable life dose independablity (P>0.05).Conclusions:1,The youthful patients with breast cancer who receive lower education are easier to express the depress and anxiety than the patients who receive higher education.2,The patients who haven't spouses, job or low salaries are in more serious depress and anxiety moods.3,There are mutual effects between the scores of depress factor and anxiety factor and A, B, C personal characteristics.4,In the period of diagnosis, the youthful patients who suffered negative life events express more serious depress and anxiety moods.5,In the period of diagnosis, when the patient has higher scores of depress factors and anxiety factors, the levels of AD and NE in his serum are higher and his immune function are inferior.6,In the period of diagnosis, it is common that there is uncertainty in the youthful patients with breast cancer and shortage of conceptions and knowledge of self checking breast.
|
PDF Full Text Request