Qualitative Research For The Ture Psychological Experience Of Patients With Rectal Carcinoma

Background:Recent years, the incidence of rectal carcinoma increased rapidly. After underwent colostomy, patients face not only the physiological changes brought by surgery, but also loss of adaptations to society and families. Compared with patients of common patients, they need face more serious and more complicated physiological stresses. Factors including worries about supporting kids and parents, marriage life, and anxiety of losing job and adaptation to society after surgery directly impact on psychological status of these patients.As the high incidence of rectal carcinoma, the development of modern medical mode, deepened research on psycho-neuroimmunology, the effect of psycho-social factors and of problems of psycho-health on immune system are more and more under attention. A great many studies proved that sebum-itol has immune suppression effect, reduces lymphocytes in blood, reduces activity of T lymphocytes and monocytes, lowers activity of natural killer cells, and reduces production of cytokines, respectively. Negative social-psychological factors act on human body for a long term which leads functional disorder of central nerve system, endocrine system, and immune system. As the end production of hypothalamic-pituitary-adrenal axis (HPAA), por can be an index of weigh of stress level.At present, qualitative research on patients with rectal carcinoma is becoming hot issue. Many alien scholars perform qualitative research on the psychological status of the patients with rectal carcinoma. Notter J and Burnard P studied qualitatively on pre-operative preparation of patients with ileum fillet neostomy, which showed that surgery is a big event of patient life, and along with operation, their hope of completely recovery destroyed. Most of patients with ileostomy has psychic trauma, anguished memory and bodily changes, even affect normal life. In our country, the number of qualitative researches on psychological experience increased day by day. Chen su-hong et al studied qualitatively on life experience of patients with rectal carcinoma, which shows patients suffer greatly mental pressure during life, mainly focus on control of defecation, ability of self-care, economic pressure, worries on reoccurrence of cancer, and couple life, and so on. However, few researches attach importance to patients with rectal carcinoma. Moreover, qualitative research that takes quantitative research as complement has not been reported.Objective: Depth exploration of patients with rectal carcinoma colostomy experience the real psychological and mental stress on the cortisol (Cor) and interleukin--2 (IL-2) levels, as well as psychological stress and immune function related to each other. Understand the social and psychological factors on rectal carcinoma patients the impact of colostomy, for individual differences and psychological pressure on comprehensive and in-depth analysis and interpretation of rectal cancer in patients with colostomy of the psychological stress response and cognitive-behavioral methods for clinical human psychological intervention and psychological education provide a theoretical basis. To determine the qualitative and quantitative research method is effective and feasible.Methods: In this study, qualitative research methods of phenomenology as a guide, selected from 60 cases of abdominal surgery in Jilin Province Tumor Hospital, confirmed by pathology in the lower segment of rectal cancer patients. Interview with the text material will be to collate, analyze and summarize the theme. As a supplement to quantitative research,60 cases of rectal carcinoma patients colostomy SCL (SCL-90) to assess psychological state and the 1st day in hospital to take blood 4ml serum cortisol (Cor) and interleukin--2 (IL-2) level.Results:1. Qualitative interviews into four themes: emotional disorders perioperative; colostomy life changes for the future; from disease and economic pressure; of health care needs of the community.2. Rectal carcinomapatients with SCL-90 (somatization depression and anxiety) factor score and the norm of comparison, significant differences (all P <0.05).3. Rectal cancer in patients with SCL-90 scale factor, and immune parameters of the correlation analysis shows that SCL-90 score with Cor level was positively correlated with IL-2 level was significantly negatively correlated (all P <0.0001).4. Low level of education, widowed, divorced unmarried cancer factor SCL-90 score was significantly higher than the high education level and married (P <0.0001).5. Laid-off workers, retirees and low-income patients with cancer of the SCL-90 score was significantly higher than the factor-service and high income (P <0.0001).Conclusions:1. Rectal carcinoma patients with colostomy perioperative emotional disorders to show anxiety, depression, escape and evade, anger, fear, low self-esteem, loss of self-confidence and anxiety.2. The performance of an integrated stress response to mental fatigue, not hopeless, nervous, and so on with people do not want to.3. The uncertainty of disease and concern about their future.4. Lead to psychological stress colostomy were decreased immune function.5. Nurses should take the initiative to carry out a positive psychological education and psychological intervention, so as to enhance the patients quality of life and survival.