中国妇幼保健

目的 探讨宫颈癌患者化疗期间心理弹性变化轨迹，分析变化轨迹的影响因素。方法 采用便利抽样法选取2021年5月—2024年2月在浙江省中医院接受化疗的198例宫颈癌患者，采用心理弹性量表评估患者基线、化疗早期、化疗中期、化疗后期的心理弹性，采用增长混合模型分析轨迹类别最优数量并且命名，收集宫颈癌患者的临床资料，通过单因素分析与多因素logistic回归模型分析心理弹性变化轨迹的独立影响因素。结果 198例宫颈癌患者化疗期间的心理弹性变化可分为3个潜在类别:低心理弹性降低型60例，中心理弹性持续型86例，高心理弹性降低型52例。婚姻状况、癌症分期、宫颈癌转移、联合放疗、抑郁自评量表评分、焦虑自评量表评分、社会支持评定量表评分、自我效能感量表评分及合并其他慢性疾病均是心理弹性变化轨迹的独立影响因素(均P<0.05)。结论 宫颈癌患者化疗期间心理弹性变化轨迹存在一定异质性，且受婚姻状况、癌症分期、抑郁、焦虑等因素的影响，提示医护人员可根据以上影响因素预测患者心理弹性变化轨迹，并制定个性化干预措施控制心理弹性水平。

Objective To explore change trajectory of psychological resilience of patients with cervical cancer during chemotherapy,and analyze the influencing factors of change trajectory. Methods A total of 198 cervical cancer patients who received chemotherapy in Zhejiang Provincial Hospital of Traditional Chinese Medicine from May 2021 to February 2024 were selected by convenience sampling method.Psychological Resilience Scale was used to evaluate psychological resilience of patients at baseline,early stage of chemotherapy,middle stage of chemotherapy,and late stage of chemotherapy. The optimal number of trajectory categories was analyzed and named by growth mixed model,and the clinical data of the patients with cervical cancer were collected. The independent influencing factors of change trajectory of psychological resilience were analyzed through univariate analysis and multivariate logistic regression models. Results The changes of psychological resilience in 198 patients with cervical cancer during chemotherapy were classified into three potential categories: 60 cases of low psychological resilience reduction type,86 cases of moderate psychological resilience persistence type,and 52 cases of high psychological resilience reduction type. Marital status,cancer stage,cervical cancer metastasis,combined radiotherapy,Self-rating Depression Scale score,Self-Rating Anxiety Scale score,Social Support Rating Scale score,Self-efficacy Scale score,and coexisting other chronic diseases were independent influencing factors for change trajectory of psychological resilience(all P<0. 05). Conclusion Change trajectory of psychological resilience in patients with cervical cancer during chemotherapy shows a certain heterogeneity,which is affected by the factors such as marital status,cancer stage,depression,anxiety,and so on. This suggests that medical staff can predict change trajectory of psychological resilience in patients based on the above influencing factors and formulate personalized intervention measures to control the level of psychological resilience.