永久性肠造口患者化疗期间预期性悲伤现状及影响因素分析
Status Quo of Preparatory Grief in Patients with Permanent Intestinal Stoma Undergoing Chemetherapy and Its Influencing Factors

DOI: 10.12677/NS.2021.105078, PP. 477-484

Keywords: 肠造口，化疗，预期性悲伤，领悟社会支持，自我效能
Intestinal Stoma Patients, Chemotherapy, Preparatory Grief, Perceived Social Support, Self-Efficacy

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Abstract:

目的：了解永久性肠造口患者化疗期间预期性悲伤的现状，并分析其影响因素，为医护人员实施有针对性的干预措施提供参考依据。方法：采取便利抽样法选取青岛市某所三级甲等医院造口门诊就诊的175名化疗期间的肠造口患者作为研究对象，采用一般资料调查表、一般自我效能量表、领悟社会支持量表、癌症患者预期性悲伤量表对其进行调查。结果：肠造口患者化疗期间预期性悲伤得分为(38.20 ± 7.14)分；单因素分析显示，比较不同年龄、文化程度、家庭人均月收入、性格、造口自理程度的肠造口患者化疗期间预期性悲伤的得分，其差异有统计学意义(P < 0.05)；多因素分析显示，年龄、文化程度、性格、造口自理程度、自我效能、领悟社会支持为肠造口患者化疗期间预期性悲伤的主要影响因素(P < 0.05)，共解释总变异量的40.2%。结论：肠造口患者在化疗期间存在较为严重的预期性悲伤，医护人员亟需关注其心理状态，采取有针对性的护理措施，提高患者的心理健康。
Objective: To investigate the status of preparatory grief among intestinal stoma patients undergoing chemotherapy, and to analyze its influencing factors, so as to provide reference for clinical medical staff taking effective interventions. Methods: A total of 175 cases of intestinal stoma patients undergoing chemotherapy were conveniently selected from a hospital in Qingdao. The questionnaire survey was carried out by using a General Information Questionnaire, General Self-Efficacy Scale, Perceived Social Support Scale, the Preparatory Grief in Advanced Cancer Patients Scale. Results: The total PGAC score of the intestinal stoma patients undergoing chemotherapy was (38.20 ± 7.14). The univariate analysis showed that the intestinal stoma patients with different ages, educational backgrounds, personal monthly income, characters, degree of ostomy self-care scored significantly different in PGAC (P < 0.05). Multivariate logistic indicated that ages, educational backgrounds, characters, degree of ostomy self-care, self-efficacy, perceived social support were the major influencing factors of preparatory grief among intestinal stoma patients undergoing chemotherapy (P < 0.05), which explained 40.2% of the total variance. Conclusion: Preparatory grief among intestinal stoma patients undergoing chemotherapy is at a serious level. It is urgent for medical staff to pay attention to their mental state and take targeted nursing measures to improve the mental health of patients.

References

[1]	Chen, W., Zheng, R., Baade, P.D., et al. (2016) Cancer Statistics in China, 2015. CA: A Cancer Journal for Clinicians, 66, 115-132. https://doi.org/10.3322/caac.21338
[2]	国家卫生和计划生育委员会《中国结直肠癌诊疗规范(年版)》专家组. 中国结直肠癌诊疗规范(2017年版) [J]. 中华临床医师杂志, 2018, 12(1): 3-23.
[3]	陈佳琦, 董彩霞, 袁瑛. 2018年结直肠癌治疗研究进展[J]. 实用肿瘤杂志, 2019, 34(1): 1-6.
[4]	郝楠, 张昊, 杨群草, 等. 病耻感对肠造口病人残疾接受度影响的研究[J]. 护理研究, 2018, 32(11): 1703-1706.
[5]	袁珺, 张奇兵, 肖腊梅. 93例结直肠癌患者化疗后骨髓抑制情况分析[J]. 药物流行病学杂志, 2017, 26(9): 631-634.
[6]	辛大君. 晚期癌症患者及其家属悲伤反应研究[D]: [硕士学位论文]. 泸州: 西南医科大学, 2016.
[7]	于文华, 陆宇晗, 路潜, 等. 癌症患者主要照顾者预期性悲伤的研究进展[J]. 中华护理杂志, 2018, 6(53): 730-735.
[8]	Choi, J., Lee, M., Ki, M., et al. (2017) Risk Factors for Feelings of Sadness and Suicide Attempts among Cancer Survivors in South Korea: Find-ings from Nationwide Cross-Sectional Study (KNHANES IV-VI). BMJ Open, 7, e16130. https://doi.org/10.1136/bmjopen-2017-016130
[9]	Kang, Y., Meghani, S.H., Bruner, D.W., et al. (2020) Factors Associated with Depression in African American Patients Being Treated for Cancer Pain. Pain Management Nursing, 21, 410-415. https://doi.org/10.1016/j.pmn.2020.03.006
[10]	王才康, 胡中锋, 刘勇. 一般自我效能感量表的信度和效度研究[J]. 应用心理学, 2001, 7(1): 37-40.
[11]	姜乾金. 领悟社会支持量表[J]. 中国行为医学科学, 2001, 10(10): 41-43.
[12]	叶盈, 辛大君, 鲜莉, 等. 晚期癌症患者预感性悲伤评估量表汉化及信效度评价[J]. 西南医科大学学报, 2018, 41(3): 268-272.
[13]	李建影, 焦杰, 任海玲. 乳腺癌化疗患者预期性悲伤现状及影响因素分析[J]. 护理学杂志, 2020, 35(18): 11-14.
[14]	田原, 邹振亚, 庞国伟. 乳腺癌患者化疗期间预期性悲伤与心理弹性的相关性研究[J]. 中国医药导报, 2019, 16(36): 65-68.
[15]	林琼, 赖雯娟, 林御贤, 等. 直肠癌永久性造口患者的病耻感与适应水平、生活质量的相关性[J]. 护理管理杂志, 2017, 17(10): 727-729.
[16]	Yuan, J.M., Zhang, J.E., Zheng, M.C., et al. (2018) Stigma and Its Influencing Factors among Chinese Patients with Stoma. Psychooncology, 27, 1565-1571. https://doi.org/10.1002/pon.4695
[17]	高兰英, 靳月丽, 王静. 不同造口类型肠造口患者病耻感现状及影响因素分析[J]. 齐鲁护理杂志, 2020, 26(20): 74-76.
[18]	Tomarken, A., Holland, J., Schachter, S., et al. (2008) Factors of Complicated Grief Pre-Death in Caregivers of Cancer Patients. Psycho-Oncology (Chichester, Eng-land), 17, 105-111. https://doi.org/10.1002/pon.1188
[19]	武妍, 赵国艳, 王艺. 局部宫颈癌晚期患者预感性悲伤与心理控制源相关性研究[J]. 护理学报, 2019, 26(23): 71-74.
[20]	Johansson, U.E. and Grimby, A. (2014) An-ticipatory Grief among Close Relatives of Patients with Parkinson’s Disease. Psychology and Behavioral Sciences, 3, 179-184. https://doi.org/10.11648/j.pbs.20140305.15

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