| Cancer, as a kind of common disease, has already be a disease which seriouslyinfluences human health. In mostcountries, the morbidity and mortality of cancer has been raised year by year, even hasbecome the most common reason of death taking the place of heart disease. Head and neckcancer is a kind of serious and commonly happened cancer, which will seriously influencepatients’ life way and quality of living. What’s more, there has a risen trend of the mortalityof head and neck cancer. As the biological-psychological-social medical model has beenpresented, psychological and social elements have been more and more emphasized incancer. The most commonly happened emotional response of cancer patients is depression.Depression is a kind of dysthymic disorder which often represents as down emotion, slowthinking and inhibition behavior. The suicide ratio of depression was as high as12%-14%,which was the highest disease among all kinds of mental diseases.Previous studies demonstrated that depressed mood had very close relationship withcancer. Depression can lead to decline of immune system function, and make the originaldisease worse and more complicated. Depression with different kinds of degree andcharacter needs to be treated differently. In that reason, psychological problems of cancerpatients with depression had been widely concerned by researchers.Physical self-concept is the first part which grows in individual consciousness and abasic and important part in the whole self-concept. Whole self-concept refers to individuals’vision to figure, character, physical ability, etc. It is not only the power of personal activity,but also the promotion of individuals’ mental health. Because of special anatomical positionof head and neck cancer, surgical detectomy would not only destroy patients’ speaking and swallow function, but also destroy their face in different degrees. These all will generatepsychological and social stress; disturb patients’ understanding of physical self-concept,which will bring emotion disorder such as depression, anxiety and so on.On that purpose, this research aimed to explore mental health status and physicalself-concept characters of head and neck cancer patients with depression. This research willhelp to recognize correctly and use right way to do psychological intervention for head andneck cancer patients with depression.Methods：We screened out the study subjects from the patients who were diagnosed as malignanttumor by pathology or cytology and under treated in No.252military hospital and BaodingNo.2hospital in the period of May,2009-Sep,2012. We screened324patients inaccordance with the following standards:1. higher than primary school education;2. nodrug and alcohol addiction or dependence;3. no mental disease and melancholia history;4.the patients and their family members inform and consent to be study objects;5. throughself-rating depression scale (SDS) test and clinical structured psychiatric interviews, thescores of depression≥50. Finally, we screened out128head and neck cancer patients withdepression as our study subjects totally. In those patients,96of them were males and32were females, and the age of them were between33and72. All questionnaires of this studywere handed out and collected on the spot, and each questionnaire consisted of one generalsituation questionnaire and four scales. General situation questionnaire included patients’social demographical characters (such as gender, age, education level, career, marital status,medical expense category, social support) and disease information (such as family historyof tumor, tumor staging, operation and radiotherapy and chemotherapy situation, course ofdisease, cancer informed situation, and other physical disease) and so on. Four scales weredepression self-rating scale, symptom self-rating scale, physical self-concept scale, andnegative physical self-concept scale. All data were analyzed by SPSS18.0, and the methodsmainly were: t test, variance analysis, correlation analysis and regression analysis.The main findings were as follows：1. The study found that patients with different degree of depression had significant differences in the total score of physical self-concept. Patients with mild depression had thehighest evaluation of physical self-concept, and patients with major depression had thelowest evaluation of the body. On the physical features, the satisfaction evaluation ofpatients with mild depression was significantly higher than that of patients with majordepression; On the body movement characteristics, mild depression patients weresignificantly higher than that of patients with moderate depression and major depression;There were no significant differences on evaluation of figure, sexual characteristics andnegative body among patients with different degree of depression. On the general overallsatisfaction and physiognomy factor, there were significant differences among patients withdifferent depression. The mild depression patients had the highest evaluation, while patientswith major depression had the lowest evaluation. And there were significant differences onother factors. In addition, there were significant gender differences in the dimensions ofphysical self concept. Specifically, the scores of females on each dimension wassignificantly lower than that of male patients, and females had lower scores on eachdimension of negative physical self. There were significant differences in different incomelevels on the evaluation of physical self-concept. Among them, the physical appearancescores of the patients with the income level more than3000yuan were significantly higherthan that of monthly income under1000yuan. There were no significant differences on thedifferent degree in all aspects of the characteristics of physical self-concept and negativephysical self. In addition, this study found there were significant differences in patients withdifferent age on the evaluation of physical self-concept. Specifically, the patients with theage under45years were most satisfied with their body, while the patients with the age of46-59were most dissatisfied with their body.2. The SCL-90scores of head and neck cancer patients with depression were92.80-278.96, and the average score was167.55±51.56. There were60patients whosetotal score were more than160, which accounting for about46.87%of the total number.Each factor score of SCL-90was significantly higher than that of the Chinese norm(P<0.05). There were no gender difference on all symptom subscales of head and neckcancer patients (P>0.05). In the factors of the scale, the patients with the ages of46-59scored the highest, and the patients below the age of45scored the lowest. There weresignificant income level differences in somatization, interpersonal sensitivity, depression, anxiety, terror, and paranoid dimensions. The scores of the patients with the monthlyincome level under1000yuan was significantly higher than that of the patients with1000-3000and3000yuan (P<0.05).3. Physical characteristics had significant negative correlations with each factor ofsymptom self-rating scale, and the former could predict the latter variables. In additionally,the negative evaluations on short height, appearance and fatness had significant positivecorrelations with each factor of symptoms self-assessment, and the former could predicteffectively to the latter variables.In conclusion, this study concluded that：1. The evaluation of their self body for the head and neck cancer patients withdepression was generally low, and they tended to give negative evaluation. The physicalself of male patients was higher than that of female patients, the body self evaluation ofpatients with higher income level were significantly higher than those of lower incomelevels, and middle-aged patients about their physical satisfaction was the lowest. Therefore,we should pay attention to patients’ cognitive bias of physical self, change their negativecognitive characteristics of self, and help them to better integrate into the community andmaintain the socialization degree of patients.2. The mental health status of head and neck cancer patients with depressive patientswas generally poor, psychological problems were significantly higher than those of Chinesenorm; there were significant differences on all symptoms of SCL-90among patients withdifferent degree of depression (P <0.05). On all symptoms of SCL-90, patients with majordepression group had the highest score, and patients with mild depression group scoredlowest. There were no gender differences of mental health among head and neck cancerpatients with depression, but there was significant difference in age and income level.Specifically, the mental health problems of middle aged head and neck cancer patients withdepression were the most serious, and the mental health status of patients with lowerincome was worse.3. Characteristics of body appearance, short and fat of head and neck cancer patientswith depressive had an important effect on their mental health. Therefore, we shouldunderstand the physical self evaluation characteristics of head and neck cancer patients with depression, and focus on the impact of these characteristics on the psychological health ofpatients, which had great significance on the psychological intervention in the treatment ofcancer. |
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