術前がん患者の反すう傾向と抑うつ・ソーシャルサポートとの関係に関する研究

Correlation of Rumination Patterns with Depression and Social Support among Preoperative Cancer Patients

要旨

　目的：術前がん患者の反すう傾向と抑うつ，ソーシャルサポートとの関係を明らかにする．

　方法：A県がん診療拠点病院で，呼吸器・消化器外科の24〜64歳の術前患者を対象に，反すうに関する尺度，ソーシャルサポート尺度，抑うつ（CES-D）と個人属性からなる自記式質問紙を用いた横断的調査を実施した．

　結果：101名が研究に参加した（回収率90.2％・有効回答率100％）．反すうのネガティブな内省と抑うつには正の相関が認められた．問題への直面化とCES-D得点には有意な相関はみられなかったが，ソーシャルサポートと有意な相関が認められた．反すう傾向が認められない場合には，アドバイス・助言がCES-D得点と関連する．しかし，ネガティブな内省ではソーシャルサポートはCES-D得点の軽減に効果的ではなく，診断早期からの専門家のサポートが必要である．

　結論：術前がん患者において，反すうのネガティブな内省はCES-Dと関連がある．2つの反すう傾向により抑うつ感情に対するサポートは異なる．

　Purpose: This study aimed to assess the rumination patterns of preoperative cancer patients and the correlation with depression and social support.

　Methods: This cross-sectional study included 101 preoperative cancer patients diagnosed with digestive or thoracic cancer, aged 20 to 64 years, who were hospitalized in cancer cooperation hospitals (Hospital A). We assessed rumination patterns (Expanded Response Styles Questionnaire), social support (Social Support Scale by Fukuoka, 2000), depression (CES-D), and basic attributions using paper-pen surveys. We calculated two rumination patterns, t-tests between each scale, and Pearson's correlation coefficient. We also performed a t-test on the relationship between rumination and depression for social support and its sub-items.

　Results: The study had a 90.2% survey recovery rate and 100% valid response rate. A correlation was found between negative ruminative introspection and CES-D, but the correlation between facing the fact of rumination and CES-D was not significant. A significant correlation was found between facing the fact of rumination and having social support. When no rumination was observed, social support in the form of advice was associated with CES-D reduction. However, when facing the fact of rumination was recognized, the score of depression was increased by concrete actions. Additionally, in negative ruminative introspection, social support is not effective in reducing CES-D and requires mental support at the early stage of diagnosis.

　Conclusion: In preoperative cancer patients, a correlation was shown between negative ruminative introspection and depressive symptom. Regarding the patterns of each ruminant, need for support varied.