Study Of Depression And Influencing Factors In Young Patients With Breast Cancer Undergoing Chemotherapy After Operation

Objective: To investigate the status of depression in young patients with breast cancer during chemotherapy after operation,analyzing the influencing factors of depression and the correlation between depression and the change of sex hormone level.Risk factors were assessed in the early stage,help to design effective psychological intervention programs and drug treatment intervention to help patients adjust the mood,and actively cooperate with the treatment.Methods A total of 205 postoperative patients with breast cancer undergoing chemotherapy were investigated by a self-designed general information questionnaires ?the M.D.Anderson Symptom Inventory-Chinese(MDASI-C)and the Self-rating Depression Scale(SDS)in the department of Breast Cancer surgery of Tumor Hospital affiliated to Guangxi Medical University from June 2015 to December 2016,at the same time,serum samples were collected to measure the levels of sex hormones.Inclusion criteria: 18~44years old,Premenopausal before chemotherapy,levels of Estradiol ? Follicle stimulating hormone ? Luteinizing hormone all in premenopausal level,no castration treatment of ovarian function;not use any endocrine drugs;able to complete the survey independently;without any mental illness or mentaldisorder,so on.Exclusion criteria: male,serious condition or severe side effects of chemotherapy,unable to participate in the study;metastatic or recurrent breast cancer patients;taking antidepressants or receiving psychological treatment.Results Statistical analysis of the data,the results are as follows:1.60% of patients have depressive disorder in various levels.total score of depression(55.44±10.07),were higher than the domestic norm(33.46±8.55,t=20.14,p<0.001).2.Multiple regression analysis showed that family relationship,subjective feeling to the disease,economic burden caused by disease,clinical stages were the main influencing factors of depression,Statistically significant(F=191.78,p=0.000).Its decision coefficient R2=0.764.These four factors explain the 76.4% variance of the patient's depression,is a significant predictor of depression in patients.In chemotherapy side effects,13 symptoms incidence rate 75.6%~94.6%,The higher incidence taking place in a series was fatigue(94.6%)?poor appetite(93.2%)?nausea(93.2%)?vomiting(90.2%)?sleep disturbed(88.3%),higher score in a series was poor appetite(4.44±2.45)?vomiting(4.29±2.67)?nausea(4.26±2.16)?sleep disturbed(3.76±2.56)?fatigue(3.72±1.69).Univariate analysis of patient symptoms showed that there were significantly differences in pain,poor appetite,numbness,sleep disturbances,vomiting,forgetful-ness,drowsiness,nausea,fatigue,sadness and distress scores between the depression group and the non-depression group(p<0.001),suggesting that the symptoms' scores in the depression group were slightly higher than those in the non-depression group,shortness of breath,dry mouth were not statistically significant(p=0.122,0.152).Logistic multivariate analysis showed that scoresof pain,poor appetite,sadness,distress increased,leading to score of depression increased,are risk factors of depression.3.Detection of sex hormone levels in patients during chemotherapy,the results showed that different levels of depression were differently in estradiol(F=64.43,p=0.000)?follicle stimulating(F=92.21,p=0.000)?luteinizing hormone(F=34.05,p=0.000)? testosterone(F=9.54,p=0.000)levels.the different was statistically significant.Estradiol levels(23.28±9.10)?testosterone levels(0.19±0.04)were lowest in severe depressive patients,and follicle stimulating(38.32±13.55)? luteinizing hormone(42.96±7.14)in severe depressive patients were highest.4.The score of depression was negatively correlated with estradiol levels(r=-0.65,p < 0.05),positive correlation with follicle stimulating levels(r=0.61,p < 0.05),positive correlation with luteinizing hormone levels(r=0.64,p<0.05),negatively correlated with testosterone levels(r=-0.33,p<0.05)?Conclusion: 1.Young patients with breast cancer have different degrees of depression during chemotherapy period.2.family relationship,subjective feeling to the disease,economic burden caused by disease,clinical stages are the main influencing factors of depression.3.the scores of pain,poor appetite,sadness,affliction increase are the risk factors of depression.4.The occurrence of depression is closely related to the changes of sex hormone levels.Nurses should be based on hormone levels and the corresponding factors to develop targeted interventions.