| Objectives:(1)To identify the status of quality of life and explore the related factors of QOL among patients with gynecologic cancer receiving postoperative chemotherapy;(2)To examine the relationship among level of depression,health locus of control,QOL in patients with gynecologic cancer receiving postoperative chemotherapy;(3)To explore health education and relaxation training's impact on the status of psychology and QOL of gynecologic cancer patients receiving postoperative chemotherapy.Methods:A descriptive design and a quasi-experiment design were used in this study. From June 2007 to January 2008,106 patients received postoperative chemotherapy in the gynecologic ward of Tianjin General Hospital and Tianjin Medical University Cancer Institute and Hospital.All subjects completed the Common Information Questionnaire,Quality of Life Questionnaire-Core 30(QLQ-C30),Self-Rating Depression Scale(SDS),Multidimensional health locus of control(MHLC).At the same time,the value of systolic pressure(SBp),diastolic pressure(DBp),heart rate (HR),body mass index(BMI),lymphocyte(LYMPH),hemoglobin(HGB),serum albumin(ALB)product tested in the same month was collected.All the data collected were evaluated;the status of depression,health locus of control and QOL were described,together with QOL's related factors.The correlation among level of depression,health locus of control,QOL was analyzed.In the part of quasi-experiment,80 subjects admitted were randomly selected into experimental group and control group by the number of rooms.Patients in the experimental group were given health education and relaxation training by the researcher and routine nursing.Patients in control group only received routine nursing.The duration of intervention was 3 courses of chemotherapy.Questionnaires and physiological values were collected again just after intervention.Paired t-test was used in comparing the status of QOL,psychology and physiological values before and after intervention. Independent t-test was used in comparing between experimental group and control group.Statistical analysis was performed with SPSS 13.0. Results:(1)The general level of QOL in gynecologic cancer patients receiving postoperative chemotherapy is at a medium level,lower than reference value.Role function(RF).emotional function(EF),cognitive function(CF),social function (SF)showed lower than reference value,while fatigue(FA),nausea/vomiting(NV), pain(PA),insomnia(SL),appetite(AP),constipation(CO),diarrhea(DI),financial difficulties(FI)showed higher than reference value(P＜0.05).(2)The incidence of depression is 76.42%in gynecologic cancer patients receiving postoperative chemotherapy,in which light degree is 34.91%,middle degree is 31.13%,high degree is 10.38%.The difference of health locus of control between gynecologic cancer patients and model had a statistically significant.The gynecologic cancer patients had a lower internal health locus of control than model;a higher powerful others or chance health locus of control(P＜0.01).(3)One-way ANOVA and Independent t-test revealed that,patients' age,education level,whether work,medical expense paid way,cancer type,chemotherapy times,KPS were related factors of QOL.(4)There was a significantly positive correlative relation between CHLC and depression.(OR=0.323);There was a significantly negative correlative relation between IHLC or PHLC and depression(OR=-0.258,OR=-0.219).There was a significantly positive correlative relation between IHLC and the status of function (QL,PF,RF,SF);There was a significantly negative correlative relation between IHLC and the status of symptom(FA,PA,DY,SL,AP).There was a significantly negative correlative relation between CHLC and the status of function(QL,PF,RF, EF,CF,SF);There was a significantly positive correlative relation between CHLC and the status of symptom(NV,DY).There was a significantly positive correlative relation between PHLC and the status of function(QL,PF,SF);There was a significantly negative correlative relation between PHLC and the status of symptom(FA,NV,AP,CO,DI).There was a significantly negative correlative relation between depression and the status of function(QL,PF,RF,EF,CF,SF); There was a significantly positive correlative relation between depression and the status of symptom(FA,NV,PA,DY,SL,AP).(5)Comparison indexes before and after intervention in experimental group.The score of QL,PF,RF,EF,CF,PHLC significantly increased after intervention.The score of FA,NV,SL,AP,CO,DI, CHLC,depression significantly decreased after intervention.The value of BMI,HGB, ALB significantly increased after intervention.The SBp,DBp and HR significantly decreased after intervention.(6)Comparison indexes between two groups.Compared with control group,the score of QL,RF,EF,CF significantly increased,the score of NV,SL,AP,CO,depression significantly decreased in experimental group.The value of HGB,LYMPH was significantly more than the control group.SBp was significantly lower than the control group.Conclusions:There were associations among some aspects of depression and health locus of control and QOL of gynecologic cancer patients receiving postoperative chemotherapy.Nursing intervention combined health education with relaxation training can re-establish patients' health locus of control,decrease the level of depression,relief symptom by chemistry medicine,and promote their status of QOL.
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