Investigation And Analysis Of Anxiety And Depression Inpatients With Early Gastrointestinal Cancer Before Endoscopic Submucosal Dissection

BackgroundThe latest national cancer report in 2018 points out that the incidence of malignant tumors in digestive tract is second only to lung cancer,which seriously threatens the health of people.In recent years,with the improvement of living standards and the rapid development of endoscopy technology,more and more digestive tract tumors have been detected early.ESD(endoscopic submucosal dissection)as a new treatment of early gastrointestinal cancer,provides a new treatment for patients with early gastrointestinal cancer,avoiding surgery.ESD has many advantages over surgery,such as less trauma,faster recovery,lower cost and fewer complications.However,ESD as a new treatment,is rarely known bypatients and their families,which coupled with the fear of the disease itself,arousing patients’negative emotions such as anxiety and depression before surgery.The purpose of this study is to study the anxiety and depression status of patients with early gastrointestinal cancer before ESD and its possible influencing factors.On this basis,we hope to propose corresponding treatment and nursing measures to help patients build up confidence to overcome the disease and promote rapid recovery of patients.ObjectiveThrough questionnaires in patients with early gastrointestinal cancer before ESD,the occurrence and influencing factors of anxiety and depression were analyzed.It is hoped that on this basis,positive psychological intervention and health education can be provided to patients,so as to help them cooperate with treatment actively and improve their quality of life.Data and Methods226 patients with early gastrointestinal cancer before operation in Qilu Hospital of Shandong University were selected to fill in the general situation questionnaire,SAS,SDS scale and social support rating scale(SSRS)the day before operation.T test,variance analysis,multiple regression analysis and Pearson correlation coefficient were used in the analysis.ResultsMain Results:In this study,226 questionnaires were distributed and 226 were recovered,with an effective recovery rate of 100%.Among the 226 patients investigated,74 were early esophageal cancer,116 were early gastric cancer,36 were early colorectal cancer,137 were male and 89 were female;average age57.73± 11.00.The anxiety score of 226 patients with early gastrointestinal cancer before ESD was 40.38± 6.29 and the depression score was 39.98± 6.55,both of them are higher than the domestic norm,the difference is statistically significant(p<0.01);22 of them had positive anxiety score,accounting for 9.7%of the total,including 21 patients with mild anxiety and 1 patient with moderate anxiety;10 patients had positive depression score,accounting for 4.4%of the total,including 9 patients with mild depression and 1 patient with moderate depression.The results of univariate analysis were as follows:(1)Different gender,education levels,income,occupations,place of residence,type of medical insurance,location of lesions,and whether having chronic diseases had different anxiety levels,while age,marital status,hospitalization history,admission route had no statistical significance on the anxiety of patients;women,high education level,retirement,living in cities and towns,workers’health insurance,early colorectal cancer,patients with chronic diseases,low social support had higher anxiety scores.(2)Depression level is different in patients with different age,sex,monthly income,occupation,type of medical insurance,location of lesion,and whether they have chronic diseases or not.But there is no significant difference in depression level among patients with different marital status,education level,residence,admission route and hospitalization history;depression scores were higher in patients older than 60,female,retired,early colorectal cancer,chronic diseases and low social support.The results of multivariate analysis were as follows:(1)Sex,education level,chronic diseases and total scores of social support had significant effects on preoperative anxiety.(2)Age,sex,education level,subjective support and total social support scores have significant effects on the depressive state of patients before operation;although there is no statistical significance on the depressive score of patients with chronic diseases,but it is marginally significant(P=0.052),we should also pay attention to it.Relevance analysis:Anxiety and depression in patients with early gastrointestinal cancer before ESD were negatively correlated with subjective support,objective support,support utilization and total scores of social support.Conclusion and SuggestionAnxiety and depression are prevalent in patients with early gastrointestinal cancer before ESD,and the degree of anxiety and depression varies with different influencing factors.In clinical work,we should give patients the necessary psychological nursing and health education and improve the level of social support,as a result to help patients eliminate negative psychology,actively cooperate with treatment,and promote patients’ quality of life.It is of great practical significance to provide individualized psychological intervention,health education and good social support for these patients.