消化道肿瘤患者化疗期间不同时间点的心理痛苦水平分析

Objective To explore the changes in psychological distress levels of patients with digestive tract tumors during chemotherapy at different time points and the corresponding nursing strategies. Methods Using the convenience sampling method, 120 patients with digestive tract tumors who were treated in our hospital from August 2023 to July 2024 were selected. The psychological state of the patients was evaluated at the time of their first chemotherapy(T1), 3 months after chemotherapy(T2), 6 months after chemotherapy(T3), and 12 months after chemotherapy(T4) using the Psychological Distress Thermometer(DT), the Generalized Anxiety Disorder Scale(GAD-7), and the Patient Health Questionnaire(PHQ-9). Repeated measures analysis of variance was used to compare the differences in scores at different times, and the generalized estimating equation model was used to analyze the influencing factors of psychological distress levels. Results The rates of moderate to severe psychological distress among the patients were 38.04% at T1, 43.49% at T2, 32.61% at T3, and 27.17% at T4. Among them, the scores of DT, GAD-7, and PHQ-9 reached their peak at T2, and dropped to the lowest at T4. Comparisons of the scores at each time point showed statistically significant differences(P<0.05). The results of the generalized estimating equation analysis indicated that pathological stage Ⅲ-Ⅳ, distant metastasis, having no children, low average monthly income per family member, no medical insurance, introverted personality, being elderly, low educational level, and having a history of chronic diseases were the influencing factors for psychological distress in patients with digestive tract tumors undergoing chemotherapy(P<0.05). Conclusion The psychological distress level of patients with digestive tract tumors undergoing chemotherapy shows dynamic changes, and is influenced by multiple factors. Clinical medical staff need to implement precise psychological intervention for patients at different treatment stages based on the results of periodic assessments.