196例乳腺癌化疗患者尊严现状及影响因素分析

doi:10.16460/j.issn1008-9969.2020.12.033

摘要/Abstract

摘要： 目的了解乳腺癌化疗患者的尊严现状,分析其影响因素。方法采用方便抽样法,2019年4—6月抽取北京市7所三级甲等医院的乳腺癌化疗患者作为研究对象。采用一般资料调查问卷、患者尊严量表、心理痛苦温度计及领悟社会支持量表,对其进行调查。采用多元线性回归分析乳腺癌化疗患者尊严的影响因素。结果本组乳腺癌化疗患者尊严得分为（38.21±12.98）分;多元线性回归分析结果显示,治疗方案、心理痛苦、社会支持进入回归方程（P<0.01）,共解释乳腺癌化疗患者尊严总变异的41.6%。结论本组乳腺癌化疗患者的尊严处于轻度受损水平,建议医护人员重点关注有乳腺切除术史、心理痛苦评分较高及社会支持得分较低的乳腺癌化疗患者,根据其情况进行个性化指导,鼓励乳腺癌化疗患者之间多交流,鼓励亲友多向患者表达关心和爱,从而提高患者的尊严水平。

关键词: 乳腺癌患者, 化疗, 尊严, 生命质量, 社会支持

Abstract: Objective To investigate the status quo of dignity in breast cancer women receiving chemotherapy and explore its influence factors. Methods With cross-sectional survey method, breast cancer women receiving chemotherapy from 7 tertiary grade-A hospitals were investigated by demographic questionnaire, Patients Dignity Inventory, Distress Thermometer and Perceived Social Support Scale from April to June 2019. Multiple linear regression was used to predict the influencing factors of patient dignity. Results The total score of dignity was 38.21±12.98. Multiple linear regression showed that three variables, including treatment plan, psychological distress and social support entered into the regression equation (P<0.01), which could explain 41.6% of the total variance of dignity. Conclusion The dignity of breast cancer women receiving chemotherapy is at a slightly low level. Medical staff should pay more attention to patients with history of mastectomy, those psychological distress and those without more social support and take continuous intervention to encourage family members and friends to extend care and love to the patients, thus to improve their dignity.

Key words: breast cancer patient, chemotherapy, dignity, quality of life, social support

中图分类号:

R473.73

朱一凡, 陈芷谦, 郭巧红, 苏娅丽. 196例乳腺癌化疗患者尊严现状及影响因素分析[J]. 护理学报, 2020, 27(12): 33-37.

ZHU Yi-fan, CHEN Zhi-qian, GUO Qiao-hong, SU Ya-li. Current Status of Dignity of 196 Breast Cancer Women Receiving Chemotherapy and Its Influence Factors[J]. Journal of Nursing, 2020, 27(12): 33-37.

参考文献

[1] 师金,梁迪,李道娟,等.全球女性乳腺癌流行情况研究[J].中国肿瘤,2017, 26(9):683-690.DOI:10.11735/j.issn.1004-0242.2017.09.A006.
[2] 陈万青,郑荣寿.中国女性乳腺癌发病死亡和生存状况[J].中国肿瘤临床,2015,42(13):668-674.DOI:10.3969/j.issn.1000-8179.20150571.
[3] Guo Q,Jacelon CS.An Integrative Review of Dignity in End-of-life Care[J]. Palliat Med, 2014, 28(7):931-940.DOI:10.1177/0269216314528399.
[4] Hall S, Davies JM, Gao W,et al.Patterns of Dignity-related Distress at The End of Life: A Cross-sectional Study of Patients with Advanced Cancer and Care Home Residents[J].Palliat Med, 2014, 28(9):1118-1127.DOI:10.1177/0269216314533740.
[5] 蔡建平,郭冰洁,江子芳.乳腺癌患者复发恐惧现状及影响因素分析[J].护理学报,2018,25(21):5-8.DOI:10.16460/j.issn1008-9969.2018.21.005.
[6] 薛翠翠,刘均娥.乳腺癌患者体像及心理干预的研究进展[J].中华护理杂志,2015, 50(6):728-732.DOI:10.3761/j.issn.0254-1769.2015.06.019.
[7] Chochinov HM,Hack T, Hassard T,et al.Dignity in The Terminally Ill: A Cross-sectional, Cohort Study[J].Lancet,2002,360(9350):2026-2030.DOI:10.1016 /S0140-6736(02)12022-8.
[8] Oechsle K, Wais MC, Vehling S, et al.Relationship Between Symptom Burden, Distress, and Sense of Dignity in Terminally Ill Cancer Patients[J]. J Pain Symptom Manage,2014,48(3):313-321. DOI:10.1016/j.jpainsymman.2013.10.022.
[9] 曹艳梅,薛云珍,葛国靖,等.晚期癌症患者尊严现状及影响因素研究[J].护理学报,2017,24(7):30-34.DOI:10.16460/j.issn1008-9969.2017.07.030.
[10] Wang L,Wei L,Xue L,et al.Dignity and Its Influencing Factors in Patients with Cancer in North China: A Cross-sectional Study[J].Curr Oncol,2019, 26(2):188-193.DOI:10.3747/ co.26.4679.
[11] 宋立业,宋琪,刘霞.青岛市某医院肺癌患者尊严感现状及影响因素[J].医学与社会,2018,31(9):69-71.DOI:10.13723/j.yxysh.2018.09.021.
[12] 魏亚红. 中晚期癌症患者的尊严受损水平及其影响因素的研究[D].石家庄:河北医科大学,2017.
[13] 薛卫成. 介绍乳腺癌TNM分期系统[J].7版.诊断病理学杂志,2010,17(4):241-244. DOI:1007-8096(2010)04-0241-04.
[14] Chochinov HM, Hassard T, McClement S, et al.The Patient Dignity Inventory: A Novel Way of Measuring Dignity-related Distress in Palliative Care[J]. J Pain Symptom Manage, 2008,36(6):559-571.DOI:10.1016/j.jpainsymman.2007.12.018.
[15] 葛国靖,曹艳梅,刘捷,等.中文版患者尊严量表初步修订及信、效度评价[J].中国公共卫生,2016,32(8):1088-1091.DOI:10.11847/zgggws2016-32-08-21.
[16] 宋颖,田畅,阎玲.208例肿瘤晚期患者尊严状况与病情进展知晓度相关性分析[J].护理学报,2018,25(16):60-63.DOI:10.16460/j.issn1008-9969.2018.16.060.
[17] Roth AJ,Kornblith AB,Batel-Copel L,et al.Rapid Screening for Psychologic Distress in Men with Prostate Carcinoma: A Pilot Study[J].Cancer, 1998, 82(10):1904-1908.
[18] 张叶宁,张海伟,宋丽莉,等.心理痛苦温度计在中国癌症患者心理痛苦筛查中的应用[J].中国心理卫生杂志,2010, 24(12):897-902.DOI:1000-6729(2010)012-0897-06.
[19] 沈颖,张静,卜庆云,等.乳腺癌患者心理痛苦水平及其影响因素的纵向研究[J].中国护理管理,2018,18(5):617-622.DOI:10.3969/j.issn.1672-1756.2018.05.009.
[20] Blumenthal JA, Burg MM, Barefoot J, et al.Social Support,Type a Behavior,and Coronary Artery Disease[J].Psychosom Med,1987,49(4):331-340.DOI:10.1097/00006842-198707000-00002.
[21] 汪向东,王希林,马弘.心理卫生评定量表手册 (增订版)[M].北京:中国心理卫生杂志社, 1999:117.
[22] 张帆,朱树贞,邓平基.领悟社会支持量表在国内住院病人社会支持研究中的应用评价[J].护理研究, 2018,32(13):2048-2052.DOI:10.12102/j.issn.1009-6493.2018.13.015.
[23] 江笑笑. 基于保护性因素的乳腺癌患者心理韧性干预方案初步构建[D].合肥:安徽医科大学,2019.
[24] Shahhoseini S,Borhani F,Atashzadeh Shoorideh F,et al.Different Sources of Dignity-related Distress in Women Receiving Chemotherapy for Breast Cancer[J]. Asian Pac J Cancer Prev,2017,18(11):2953-2958.DOI:10.22034/APJCP.2017.18.11.2953.
[25] Chochinov HM, Hack T, McClement S,et al.Dignity in The Terminally Ill: A Developing Empirical Model[J]. Soc Sci Med, 2002, 54(3):433-443.DOI:10.1016/s0277-9536(01)00084-3.
[26] 杨荣益. 农村女性乳腺癌患者就医行为研究[D].昆明:云南大学,2016.
[27] 时华,薛萍,薛桂凤,等.早期护理干预对乳腺癌根治术后并发症的效果观察[J].实用临床医药杂志,2014,18(22):151-152.DOI:10.7619/jcmp.201422055.
[28] Hughes KL, Sargeant H, Hawkes AL.Acceptability of the Distress Thermometer and Problem List to Community-based Telephone Cancer Helpline Operators, and to Cancer Patients and Carers[J]. BMC Cancer, 2011,11(1):46.DOI:10.1186/1471-2407-11-46.
[29] 陈思涓,谭慧,谌永毅,等.美国癌症患者心理痛苦五步骤管理及其对我国的启示[J].中国护理管理,2018,18(1):118-121.DOI:10.3969/j.issn.1672-1756.2018.01.028.
[30] 薛翠翠,刘均娥. 乳腺癌患者体像及心理干预的研究进展[J].中华护理杂志,2015,50(6):728-732.DOI:10.3761/j.issn.0254-1769.2015.06.019.
[31] 邓珍珍,刘化侠,田靖,宿婷.中晚期癌症病人尊严丧失与社会支持的相关性研究[J].护理研究, 2017,31(16):2031-2034.DOI:10.3969/j.issn.1009-6493.2017.16.034.
[32] Chochinov HM, Krisjanson LJ, Hack TF, et al.Dignity in the Terminally Ill: Revisited[J]. J Palliat Med, 2006, 9(3):666-672.DOI:10.1089/jpm.2006.9.666.
[33] Henry M, Habib L A,Morrison M,et al.Head and Neck Cancer Patients Want Us to Support Them Psychologically in the Posttreatment Period:Survey Results[J]. Palliat Support Care,2014,12(6):48l-493.DOI:10.1017/S1478951513000771.
[34] O’Brien KM, Timmons A, Butow P, et al.Associations Between Neighbourhood Support and Financial Burden with Unmet Needs of Head and Neck Cancer Survivors[J]. Oral Oncol,2017,65(5):57-64.DOI:10.1016/j.oraloncology.2016.12.019.
[35] Barber B,Dergousoff J,Nesbitt M,et al.Depression as a Predictor of Postoperative Functional Performance Status (PFPS) and Treatment Adherence in Head and Neck Cancer Patients: A Prospective Study[J].J Otolaryngol Head NeckSurg,2015,44(1):1-8.DOI:10.1186/s40463-015-0092-4.
[36] 肖婷,李惠萍,张婷,等.乳腺癌患者社会支持对心理韧性的影响:有调节的中介模型[J].现代预防医学,2017,44(21):3974-3977.

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