Investigation on psychological and health status and influencing factors of patients with pulmonary nodules

doi:10.3877/cma.j.issn.1674-6902.2021.06.005

Abstract

Abstract:

Objective

To examine the psychological and health status of patients with pulmonary nodules.

Methods

It was administered that a cross-sectional survey to adults with incidental pulmonary nodules.

Results

Through the evaluation of anxiety and depression in 178 patients with pulmonary nodules, It was found that most patients with pulmonary nodules had mild or moderate anxiety. According to the analysis of variance of IES-R score, female patients were more prone to anxiety than male patients (P=0.036). There was no significant difference in IES-R scores among other groups. Univariate logistic regression analysis showed that the larger the diameter of the nodule, the higher the degree of anxiety (P=0.041), "seeing pulmonary nodule on CT" (P=0.001) would increase the level of anxiety, if the doctor explained that "pulmonary nodule is very common" could reduce the degree of anxiety (P=0.006). Multivariate regression analysis showed that younger age (P=0.010), lower monthly income (P=0.014) and larger nodule diameter (P=0.038) were associated with higher anxiety level, "seeing pulmonary nodules on CT" could lead to higher anxiety level (P=0.002). The utility score of EQ-5D-5L was 0.9578±0.0634 The utility of EQ-5D-5L was negatively correlated with the score of IES-R (r=-0.3495, P<0.0001).

Conclusions

Female patients were more anxious than male patients. If patients have seen the pulmonary nodules on CT themselves, this can increase the anxiety levels. If a doctor has told a patient that pulmonary nodules are common before CT imaging, this can reduce the anxiety levels.

Key words: Pulmonary nodules, Anxiety, Communication, EQ-5D-5L, IES-R

Yueyan Lou, Xueling Wu, Bijun Fan, Yongqi Cui, Bin Wu, Yujie Fu, Xiaoming Tan, Yu Zheng. Investigation on psychological and health status and influencing factors of patients with pulmonary nodules[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2021, 14(06): 729-733.

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Figures/Tables 4

References 32

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临床资料		n＝178(%)
性别(%)^a　男/女		43.8/56.2
年龄(岁)(Mean±SD)		51(13.2)
朋友或家人罹患肺癌　是/否		21.3/78.7
吸烟
	否，但曾有吸烟史	14.0
	是	20.8
	无	65.2
教育程度
	未上学	3.4
	小学	12.9
	初中	34.8
	高中	20.8
	大学以上	28.1
月收入
	<3 000 RMB	30.9
	3000~6000 RMB	36.0
	6000~10000 RMB	21.3
	>10 000 RMB	11.8
婚姻
	未婚	4.5
	已婚	93.8
	离婚	1.7
孩子是否入学　是/否		32.6/67.4
发现结节的时间
	<1 day	26.4
	0~3月	11.2
	3~6月	10.1
	6~12月	9.0
	>12月	43.3
结节大小
	<3 mm	29.8
	3~6 mm	50.0
	6~8 mm	15.2
	>8 mm	5.1

临床资料		n＝178(%)
性别(%)^a　男/女		43.8/56.2
年龄(岁)(Mean±SD)		51(13.2)
朋友或家人罹患肺癌　是/否		21.3/78.7
吸烟
	否，但曾有吸烟史	14.0
	是	20.8
	无	65.2
教育程度
	未上学	3.4
	小学	12.9
	初中	34.8
	高中	20.8
	大学以上	28.1
月收入
	<3 000 RMB	30.9
	3000~6000 RMB	36.0
	6000~10000 RMB	21.3
	>10 000 RMB	11.8
婚姻
	未婚	4.5
	已婚	93.8
	离婚	1.7
孩子是否入学　是/否		32.6/67.4
发现结节的时间
	<1 day	26.4
	0~3月	11.2
	3~6月	10.1
	6~12月	9.0
	>12月	43.3
结节大小
	<3 mm	29.8
	3~6 mm	50.0
	6~8 mm	15.2
	>8 mm	5.1

临床资料	单因素回归分析OR(95%CI)，P值		多因素回归分析OR(95%CI)，P值
临床资料	中　度	重　度	中　度	重　度
性　别	1.704(0.912~3.181) 0.095	2.378(0.755~7.495) 0.139	1.990(0.996~3.977) 0.051	3.014(0.805~11.283) 0.101
年龄	1.003(0.980~1.027) 0.786	0.973 (0.934~1.014) 0.197	0.990 (0.961~1.020) 0.498	0.930 (0.880~0.983) 0.010
朋友或家人罹患肺癌	0.636 (0.299~1.355) 0.241	1.556 (0.317~7.634) 0.586
吸烟	1.147 (0.755~1.744) 0.519	1.648 (0.692~3.920) 0.259
教育程度	0.994 (0.755~1.307) 0.964	0.936 (0.581~1.507) 0.785
月收入	0.793 (0.579~1.086) 0.147	0.642 (0.356~1.158) 0.141	0.791 (0.531~1.179) 0.250	0.374 (0.171~0.818) 0.014
婚姻状态	1.042 (0.293~3.701) 0.949	0.583 (0.080~4.264) 0.595
孩子是否入学	1.091 (0.562~2.118) 0.797	0.618 (0.206~1.851) 0.390
发现结节时间	1.092 (0.911~1.310) 0.342	1.098 (0.797~1.511) 0.569
结节大小	0.845 (0.568~1.257) 0.405	1.914 (1.027~3.567) 0.041	0.869 (0.567~1.333) 0.521	2.081 (1.042~4.159) 0.038
医师是否指出结节大小	0.900 (0.454~1.785) 0.763	1.125 (0.326~3.879) 0.852
是否在CT上看到结节	3.070 (1.594~5.912) 0.001	1.139 (0.388~3.345) 0.813	3.091 (1.515~6.305) 0.002	1.319 (0.390~4.467) 0.656
医师是否阐述肺癌的可能性	0.774 (0.267~2.245) 0.637	1.232 (0.236~6.432) 0.804
医师是否说明结节的不确定性	0.771 (0.389~1.529) 0.457	2.839 (0.946~8.523) 0.063	1.187 (0.555~2.541) 0.659	3.149 (0.912~10.871) 0.070
医师是否解释结节的常见性	0.404 (0.211~0.774) 0.006	1.320 (0.446~3.901) 0.616	0.514 (0.252~1.045) 0.066	0.979 (0.290~3.297) 0.972

临床资料	单因素回归分析OR(95%CI)，P值		多因素回归分析OR(95%CI)，P值
临床资料	中　度	重　度	中　度	重　度
性　别	1.704(0.912~3.181) 0.095	2.378(0.755~7.495) 0.139	1.990(0.996~3.977) 0.051	3.014(0.805~11.283) 0.101
年龄	1.003(0.980~1.027) 0.786	0.973 (0.934~1.014) 0.197	0.990 (0.961~1.020) 0.498	0.930 (0.880~0.983) 0.010
朋友或家人罹患肺癌	0.636 (0.299~1.355) 0.241	1.556 (0.317~7.634) 0.586
吸烟	1.147 (0.755~1.744) 0.519	1.648 (0.692~3.920) 0.259
教育程度	0.994 (0.755~1.307) 0.964	0.936 (0.581~1.507) 0.785
月收入	0.793 (0.579~1.086) 0.147	0.642 (0.356~1.158) 0.141	0.791 (0.531~1.179) 0.250	0.374 (0.171~0.818) 0.014
婚姻状态	1.042 (0.293~3.701) 0.949	0.583 (0.080~4.264) 0.595
孩子是否入学	1.091 (0.562~2.118) 0.797	0.618 (0.206~1.851) 0.390
发现结节时间	1.092 (0.911~1.310) 0.342	1.098 (0.797~1.511) 0.569
结节大小	0.845 (0.568~1.257) 0.405	1.914 (1.027~3.567) 0.041	0.869 (0.567~1.333) 0.521	2.081 (1.042~4.159) 0.038
医师是否指出结节大小	0.900 (0.454~1.785) 0.763	1.125 (0.326~3.879) 0.852
是否在CT上看到结节	3.070 (1.594~5.912) 0.001	1.139 (0.388~3.345) 0.813	3.091 (1.515~6.305) 0.002	1.319 (0.390~4.467) 0.656
医师是否阐述肺癌的可能性	0.774 (0.267~2.245) 0.637	1.232 (0.236~6.432) 0.804
医师是否说明结节的不确定性	0.771 (0.389~1.529) 0.457	2.839 (0.946~8.523) 0.063	1.187 (0.555~2.541) 0.659	3.149 (0.912~10.871) 0.070
医师是否解释结节的常见性	0.404 (0.211~0.774) 0.006	1.320 (0.446~3.901) 0.616	0.514 (0.252~1.045) 0.066	0.979 (0.290~3.297) 0.972

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