护理学报 ›› 2023, Vol. 30 ›› Issue (13): 18-23.doi: 10.16460/j.issn1008-9969.2023.13.018
173例晚期癌症患者家庭回避癌症沟通现状及影响因素分析
乔悦a, 段培蓓b, 王晓庆a, 杨丽华c, 邹炎铃c, 费超男c
- 南京中医药大学附属医院 a.消化肿瘤外科; b.护理部; c.肿瘤内科 江苏 南京 210004
摘要： 目的 探讨晚期癌症患者家庭回避癌症沟通现状,为家庭沟通实践方案提供依据。方法 采用方便抽样法选取173例晚期癌症患者,以一般资料问卷、家庭回避癌症沟通量表、家庭功能评估量表及恐惧疾病进展简化量表对其进行调查。结果 家庭回避癌症沟通标准分为60.00（30.00,90.00）分。多重线性回归分析显示,家庭功能、被照护时长、教育程度、当前阶段治疗方式是家庭回避癌症沟通程度的影响因素（P<0.001）,共解释总变异的42.1%。结论 晚期癌症患者家庭回避癌症沟通程度处于中等偏上水平,护理人员需重点关注家庭功能障碍、被照护时长短、教育程度较低、家庭人均月收入水平低及接受化疗等其他治疗的晚期癌症患者,提供针对性沟通策略,促进积极沟通。
中图分类号:
- R473.73
| [1] Feng RM, Zong YN, Cao SM, et al.Current cancer situation in China: good or bad news from the 2018 global cancer statistics[J]. Cancer Commun (Lond),2019,39(1):22. DOI:10.1186/s40880-019-0368-6. [2] Forbat L.The role and value of family therapy for people living with cancer: a rapid review of recent evidence[J]. Curr Opin Support Palliat Care,2020,14(3):263-269. DOI:10.1097/SPC.0000000000000504. [3] Chawak S, Chittem M, Dhillon H, et al.Treatment-related communication experiences and expectations among Indian cancer patients receiving radiation therapy and their family members: a qualitative study[J]. Patient Educ Couns,2022,105(9):2913-2922. DOI:10.1016/j.pec.2022.05.003. [4] Haase JE, Kintner EK, Monahan PO, et al.The resilience in illness model, part 1: exploratory evaluation in adolescents and young adults with cancer[J]. Cancer Nurs,2014,37(3): E1-E12. DOI:10.1097/NCC.0b013e31828941bb. [5] Wittenberg E, Kravits K, Goldsmith J, et al.Validation of a model of family caregiver communication types and related caregiver outcomes[J]. Palliat Support Care,2017,15(1):3-11. DOI:10.1017/S1478951516000109. [6] Fisher CL, Wolf BM, Fowler C, et al.Experiences of "openness" between mothers and daughters during breast cancer: implications for coping and healthy outcomes[J]. Psychooncology,2017,26(11):1872-1880. DOI:10.1002/pon.4253. [7] Jeong A, Shin DW, Kim SY, et al.Avoidance of cancer communication, perceived social support, and anxiety and depression among patients with cancer[J]. Psychooncology, 2016,25(11):1301-1307. DOI:10.1002/pon.4060. [8] Waldrop DP, Meeker MA, Kerr C, et al.The nature and timing of family-provider communication in late-stage cancer: a qualitative study of caregivers' experiences[J].J Pain Symptom Manage,2012, 43(2):182-194. DOI:10.1016/j.jpainsymman.2011.04.017. [9] Waddell G.A Fear-avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability[J]. Pain,1993, 52(2):157-168. DOI:10.1016/0304-3959(93)90127-B. [10] Lebel S, Ozakinci G, Humphris G, et al.Current state and future prospects of research on fear of cancer recurrence[J].Psychooncology,2017,26(4):424-427.DOI:10.1002/pon.4103. [11] Lim JW, Ashing-Giwa KT.Is family functioning and communication associated with health-related quality of life for Chinese- and Korean-American breast cancer survivors[J]. Qual Life Res,2013,22(6):1319-1329.DOI:10.1007/s11136-012-0247-y. [12] Shin DW, Shin J, Kim SY, et al.Family avoidance of communication about cancer: a dyadic examination[J]. Cancer Res Treat,2016,48(1):384-392. DOI:10.4143/crt.2014.280. [13] 张云雪,解子惠,李媛媛,等.家庭回避癌症沟通量表汉化及信效度评价[J].护理学杂志,2022,37(7):9-12. DOI:10.3870/j.issn.1001-4152.2022.07.009. [14] American Cancer Society. Understanding advanced cancer, metastatic cancer,bone metastasis [EB/OL]. (2020-09-10) [2022-09-28]. https://www.cancer.org/treatment/understanding-your-diagnosis/advanced-cancer/what-is.html. [15] 孙彩云,林征,周美景,等.炎症性肠病患者疾病获益感现状及影响因素分析[J].护理学报,2022,29(6):1-6. DOI:10.16460/j.issn1008-9969.2022.06.001. [16] Mallinger JB, Griggs JJ, Shields CG.Family communication and mental health after breast cancer[J].Eur J Cancer Care (Engl),2006,15(4):355-361.DOI:10.1111/j.1365-2354.2006.00666.x. [17] Smilkstein G.The family APGAR: a proposal for a family function test and its use by physicians[J]. J Fam Pract,1978,6(6):1231-1239. [18] 吕繁,曾光,刘松暖,等.家庭关怀度指数问卷测量脑血管病病人家庭功能的信度和效度研究[J].中国公共卫生,1999(11):27-28. [19] Liu H, Liu X, Liu Z, et al.Death anxiety and its relationship with family function and meaning in life in patients with advanced cancer-a cross-sectional survey in China[J].Asia Pac J Oncol Nurs, 2022,9(10):100134. DOI:10.1016/j.apjon.2022.100134. [20] 张作记. 行为医学量表手册[M].北京:中华医学电子音像出版社,2005:156-227. [21] Mehnert A, Herschbach P, Berg P, et al.Fear of progression in breast cancer patients-validation of the short form of the Fear of Progression Questionnaire (FOP-Q-SF)[J]. Z Psychosom Med Psychother,2006,52(3):274-288. DOI:10.13109/zptm.2006.52.3.274. [22] 吴奇云,叶志霞,李丽,等.癌症患者恐惧疾病进展简化量表的汉化及信效度分析[J].中华护理杂志, 2015, 50(12):1515-1519. DOI:10.3761/j.issn.0254-1769.2015.12.021. [23] Herschbach P, Berg P, Waadt S, et al.Group psychotherapy of dysfunctional fear of progression in patients with chronic arthritis or cancer[J]. Psychother Psychosom,2010,79(1):31-38. DOI:10.1159/000254903. [24] 高启胜. 护理科研统计方法与软件操作实战[M].上海:上海交通大学出版社,2019:175. [25] Lim JW, Shon EJ.The dyadic effects of family cohesion and communication on health-related quality of life: the moderating role of sex[J]. Cancer Nurs,2018,41(2):156-165. DOI:10.1097/NCC.0000000000000468. [26] George LS, Breitbart W, Prigerson HG."My family wants something different": discordance in perceived personal and family treatment preference and its association with do-not-resuscitate order placement[J]. J Oncol Pract,2019,15(11):e942-e947.DOI:10.1200/JOP.19.00250. [27] Wittenberg E, Borneman T, Koczywas M, et al.Cancer communication and family caregiver quality of life[J]. Behav Sci (Basel),2017,7(1):12. DOI:10.3390/bs7010012. [28] Malhotra C, Kanesvaran R, Krishna L, et al.Oncologists' responses to patient and caregiver negative emotions and patient perception of quality of communication: results from a multi-ethnic Asian setting[J]. Support Care Cancer,2018,26(3):957-965.DOI:10.1007/s00520-017-3916-0. [29] 范廷婷,钟梦诗,罗彩凤,等.乳腺癌术后患者心理弹性和积极应对方式对自我形象的影响研究[J]. 护士进修杂志,2019,34(2):122-125.DOI:10.16821/j.cnki.hsjx.2019.02.006. [30] 李思. 青年女性癌症病人夫妻疾病沟通及自我倡权现状[J]. 护理研究,2022,36(19):3522-3527. DOI:10.12102/j.issn.1009-6493.2022.19.028. [31] 洪丹,徐艳,李飞燕,等. 文盲患者参加抗肿瘤药物临床试验的若干伦理问题[J]. 中国肿瘤,2015,24(10):838-840. DOI:10.11735/j.issn.1004-0242.2015.10.A008. [32] 邾萍,付菊芳,王波,等.243例乳腺癌患者配偶照顾负担及影响因素研究[J].中华护理杂志, 2013,48(8):718-721. DOI:10.3761/j.issn.0254-1769.2013.08.014. [33] Alfano CM, Leach CR, Smith TG,et al.Equitably improving outcomes for cancer survivors and supporting caregivers: a blueprint for care delivery, research, education, and policy[J]. CA Cancer J Clin,2019, 69(1):35-49. DOI:10.3322/caac.21548. [34] 吴丹,高丽华,田逸秀. 前列腺癌手术患者术后希望水平与社会支持、焦虑抑郁情绪的关系分析[J]. 中国性科学,2022,31(9):28-31. DOI:10.3969/j.issn.1672-1993.2022.09.008. [35] 唐涵,刘维,肖涵,等. 中青年乳腺癌患者手术方式决策困境及影响因素研究[J]. 护理学杂志,2020,35(20):14-17. DOI:10.3870/j.issn.1001-4152.2020.20.014. |
| [1] | 钱湛, 杨晓婷, 林觐民. 癌症患者生育忧虑体验的Meta整合[J]. 护理学报, 2023, 30(4): 55-60. |
| [2] | 相军爱, 闫荣, 丁敏, 孟祥敏, 林雨婷, 柳文慧, 姜凯. 癌症患者临终关怀偏好的研究进展[J]. 护理学报, 2023, 30(14): 37-41. |
| [3] | 孙梦晨, 冯芳茗, 何佳倩, 范思雨, 杨颖, 季佳妮. 癌症患者自杀风险评估量表的编制及信效度检验[J]. 护理学报, 2023, 30(13): 13-17. |
| [4] | 谭兰惠, 房培, 喻惠丹, 冯翎, 余立平. 231例女性癌症患者自我倡权现状及影响因素分析[J]. 护理学报, 2023, 30(12): 62-66. |
| [5] | 唐涵, 尚磊. 青少年癌症患者家庭照护者健康素养的研究进展[J]. 护理学报, 2023, 30(10): 31-34. |
| [6] | 张涌静, 申华平, 郭庆峰, 王娟. 置入PICC并带管出院癌症患者基于mHealth技术延续护理的效果观察[J]. 护理学报, 2022, 29(9): 68-72. |
| [7] | 孙海燕, 秦阳, 徐益荣, 陈文艳. 癌症患者及其配偶二元应对与心理弹性的主体-客体互倚模型研究[J]. 护理学报, 2022, 29(6): 60-64. |
| [8] | 张营, 孟英涛, 尚美美, 杨德艳, 朱玉方, 王倩. 癌症相关认知功能障碍评估和管理的证据总结[J]. 护理学报, 2022, 29(3): 52-56. |
| [9] | 冯宪凌, 白杨, 古钰君. 《儿童、青少年和年轻成人癌症幸存者癌因性疲乏监测》解读[J]. 护理学报, 2022, 29(24): 64-67. |
| [10] | 刘文崇, 葛洪霞, 程方方, 沈婷婷, 林欢. 220名癌症患儿父母养育内疚感现状及影响因素分析[J]. 护理学报, 2022, 29(23): 1-6. |
| [11] | 柳云, 田敏, 王亚菲, 刘峰, 李新, 潘宁. 护士促进癌症幸存者体力活动知信行问卷的编制及信效度检验[J]. 护理学报, 2022, 29(23): 7-12. |
| [12] | 李佳欣, 刘子薇, 尚娅萌, 王莹莹, 张亚娟, 栗跃歌, 刘芳丽. 癌症患者久坐行为的研究进展[J]. 护理学报, 2022, 29(23): 22-27. |
| [13] | 杨晓霞, 吕利明, 陈美旭, 任燕语. 癌症幸存者社会比较及相关研究进展[J]. 护理学报, 2022, 29(23): 28-32. |
| [14] | 严雪, 刘倩倩, 魏思琪. 妇科癌症患者社会疏离影响因素的质性研究Meta整合[J]. 护理学报, 2022, 29(20): 39-43. |
| [15] | 张会敏, 孙晓晨, 马红梅. 年轻癌症患者生育忧虑心理体验质性研究的Meta整合[J]. 护理学报, 2022, 29(2): 51-56. |
|