头颈部肿瘤放疗患者自我感受负担现状及影响因素分析
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摘要
目的了解头颈部肿瘤放疗患者自我感受负担现状,并分析其影响因素,为减轻患者心理压力,提高患者生存质量提供科学依据。方法选择2016年10月—2017年8月在鄞州人民医院放疗科接受治疗的患者108例。应用自我感受负担量表及自行设计一般量表对研究对象进行调查,采用单因素和多因素分析来确定头颈部肿瘤放疗患者自我感受负担的影响因素。对科研小组成员进行统一培训,确保调查的严谨性、科学性。结果头颈部肿瘤放疗患者中、重度自我感受负担者达61人,占56. 5%,自我感受负担总均分为(33. 35±6. 34)分,处于中度水平,其中位于前3位的分别是担心照顾者花很多钱,担心因照顾我而影响照顾者的健康,担心照顾者因为照顾我负担过重。单因素和多元线性回归分析结果显示,患者性别、婚姻、性格、学历、放疗次数、放疗反应、是否同步化疗为头颈部肿瘤放疗患者自我感受负担的影响因素(均P <0. 05)。结论头颈部肿瘤放疗患者自我感受负担处于中度水平,其中性别、婚姻、性格、学历、放疗次数、放疗反应、是否同步化疗是其主要影响因素,医护人员应关注放疗患者的自我感受负担,根据患者具体情况采取针对性护理干预,降低患者自我感受负担,提高其生存质量。
Objective To describe the status of self-perceived burden and analyze its influencing factors among the patients with head and neck tumor for radiotherapy,providing for a scientific basis to alleviate the psychological pressure and improve patients' quality of life. Methods From October 2016 to August 2017,a total of 108 hospitalized patients with head and neck tumor for radiotherapy were investigated by the Self-Perceived Burden Scale and the self-designed general scale,and analyzed by using univariate and multivariate to determine the influencing factors of patients with head and neck tumor for radiotherapy. To ensure the survey is rigorous and scientific,we took uniform training. Results The total score of the SPB was( 33. 35 ± 6. 34) points,56. 5% of patients were at a moderate level. Among them,the top three were worried that caregivers spend a lot of money worrying about the caregiver' s health due to taking care of me,and worrying that the caregivers were overburdened by taking care of me. Univariate and multiple linear regression analysis showed that gender,marriage,personality,education level,the number of radiotherapy,radiotherapy response,and concurrent with chemotherapy were the factors influencing factors of SPB( P < 0. 05). Conclusion The SPB of head and neck cancer patients with radiotherapy is at a moderate level. To reduce the burden of patients with self-perception and improve their quality of life,we should focus on the SPB of patients with radiation therapy,according to the patient' s gender,marriage,personality,education level,radiotherapy and other related factors to take targeted care intervention.
Objective To describe the status of self-perceived burden and analyze its influencing factors among the patients with head and neck tumor for radiotherapy,providing for a scientific basis to alleviate the psychological pressure and improve patients' quality of life. Methods From October 2016 to August 2017,a total of 108 hospitalized patients with head and neck tumor for radiotherapy were investigated by the Self-Perceived Burden Scale and the self-designed general scale,and analyzed by using univariate and multivariate to determine the influencing factors of patients with head and neck tumor for radiotherapy. To ensure the survey is rigorous and scientific,we took uniform training. Results The total score of the SPB was( 33. 35 ± 6. 34) points,56. 5% of patients were at a moderate level. Among them,the top three were worried that caregivers spend a lot of money worrying about the caregiver' s health due to taking care of me,and worrying that the caregivers were overburdened by taking care of me. Univariate and multiple linear regression analysis showed that gender,marriage,personality,education level,the number of radiotherapy,radiotherapy response,and concurrent with chemotherapy were the factors influencing factors of SPB( P < 0. 05). Conclusion The SPB of head and neck cancer patients with radiotherapy is at a moderate level. To reduce the burden of patients with self-perception and improve their quality of life,we should focus on the SPB of patients with radiation therapy,according to the patient' s gender,marriage,personality,education level,radiotherapy and other related factors to take targeted care intervention.
引文
[1]张成帅.结直肠癌患者自我感受负担与创伤后成长状况的相关性研究[D].长春:吉林大学,2017.
[2]周岩.乳腺癌患者照顾者自我感受负担状况及影响因素研究[J].护理管理杂志,2014,14(7):474-475.
[3]郑晓倩.肿瘤放化疗患者心理弹性与治疗副反应和生存质量的关系研究[D].福州:福建医科大学,2013.
[4]孙彦秋,刘惠珠,吴伟艺,等.鼻咽癌放疗患者生命质量的影响因素分析[J].现代肿瘤医学,2015,23(12):1665-1669.
[5] COUSINEAU N,MCDOWELL I. Measuring chronic patients’feelings of being a burden to their caregivers:development and preliminary validation of a scale[J]. Med Care,2003,41(1):110-118.
[6]张庆娜,李惠萍,王德斌.中文版自我感受负担量表在癌症患者中应用的信效度评价[J].中国实用护理杂志,2013,29(2):1-4.
[7]殷利,梁海鑫,陈世梅,等.鼻咽癌放疗患者自我感受负担及其影响因素的研究[J].中华护理杂志,2016,51(7):793-797.
[8] LIBERT Y,BORGHGRAEF C,BEGUIN Y,et al. Factors associated with self-perceived burden to the primary caregiver in older patients with hematologic malignancies:an exploratory study[J]. Psychooncology,2017,26(1):118-124.
[9]陈静华,钟碧芳,刘慧茹,等.鼻咽癌病人放射治疗期间反射性口腔黏膜损伤的护理干预效果观察[J].全科护理,2015,13(7):636-638.
[10] XIAO W,CHAN C W H,FAN Y,et al. Symptom clusters in patients with nasopharyngeal carcinoma during radiotherapy[J]. Eur J Oncol Nurs,2017,28:7-13.
[11] LEE J E,SHIN D W,CHO J,et al. Caregiver burden,patients’selfperceived burden,and preference for palliative care among cancer patients and caregivers[J]. Psychooncology,2015,24(11):1545-1551.
[12]李娟.女性乳腺癌患者自我感受负担及影响因素的研究[D].衡阳:南华大学,2013.
[13]王大遒,王爱平.乳腺癌患者自我感受负担现状及其影响因素调查[J].护理学杂志,2015,30(14):87-89.
[14]钱涵,周郁秋,刘莹,等.癌症患者自我感受负担状况及其影响因素分析[J].中国护理管理,2013,13(4):42-45.
[15]张蒙,李颂兵,陈茜.老年常见慢性病患者自我感受负担及其影响因素研究[J].中国护理管理,2017,17(1):63-68.
[16] UNAL D,ORHAN O,OZSOY S D,et al. Effect of radiotherapy on psychiatric disorder in patients with head and neck cancer[J]. Indian J Cancer,2016,53(1):162-165.
[17]赵雯雯,郑珊红,张爱华.癌症患者心理弹性水平及其影响因素研究[J].护理学杂志,2015,30(3):22-25.
[18]智晓旭,孟爱凤,茅昌敏,等.癌症患者住院化疗期间负担感的调查研究[J].中华护理教育,2015,12(3):220-223.
[19]张明洁.品管圈对鼻咽癌放疗患者干预效果评价研究[D].济南:山东大学,2016.
[20]张春琦.鼻咽癌患者放疗期间创伤后成长特点与影响因素及心理干预的研究[D].南宁:广西医科大学,2017.
[2]周岩.乳腺癌患者照顾者自我感受负担状况及影响因素研究[J].护理管理杂志,2014,14(7):474-475.
[3]郑晓倩.肿瘤放化疗患者心理弹性与治疗副反应和生存质量的关系研究[D].福州:福建医科大学,2013.
[4]孙彦秋,刘惠珠,吴伟艺,等.鼻咽癌放疗患者生命质量的影响因素分析[J].现代肿瘤医学,2015,23(12):1665-1669.
[5] COUSINEAU N,MCDOWELL I. Measuring chronic patients’feelings of being a burden to their caregivers:development and preliminary validation of a scale[J]. Med Care,2003,41(1):110-118.
[6]张庆娜,李惠萍,王德斌.中文版自我感受负担量表在癌症患者中应用的信效度评价[J].中国实用护理杂志,2013,29(2):1-4.
[7]殷利,梁海鑫,陈世梅,等.鼻咽癌放疗患者自我感受负担及其影响因素的研究[J].中华护理杂志,2016,51(7):793-797.
[8] LIBERT Y,BORGHGRAEF C,BEGUIN Y,et al. Factors associated with self-perceived burden to the primary caregiver in older patients with hematologic malignancies:an exploratory study[J]. Psychooncology,2017,26(1):118-124.
[9]陈静华,钟碧芳,刘慧茹,等.鼻咽癌病人放射治疗期间反射性口腔黏膜损伤的护理干预效果观察[J].全科护理,2015,13(7):636-638.
[10] XIAO W,CHAN C W H,FAN Y,et al. Symptom clusters in patients with nasopharyngeal carcinoma during radiotherapy[J]. Eur J Oncol Nurs,2017,28:7-13.
[11] LEE J E,SHIN D W,CHO J,et al. Caregiver burden,patients’selfperceived burden,and preference for palliative care among cancer patients and caregivers[J]. Psychooncology,2015,24(11):1545-1551.
[12]李娟.女性乳腺癌患者自我感受负担及影响因素的研究[D].衡阳:南华大学,2013.
[13]王大遒,王爱平.乳腺癌患者自我感受负担现状及其影响因素调查[J].护理学杂志,2015,30(14):87-89.
[14]钱涵,周郁秋,刘莹,等.癌症患者自我感受负担状况及其影响因素分析[J].中国护理管理,2013,13(4):42-45.
[15]张蒙,李颂兵,陈茜.老年常见慢性病患者自我感受负担及其影响因素研究[J].中国护理管理,2017,17(1):63-68.
[16] UNAL D,ORHAN O,OZSOY S D,et al. Effect of radiotherapy on psychiatric disorder in patients with head and neck cancer[J]. Indian J Cancer,2016,53(1):162-165.
[17]赵雯雯,郑珊红,张爱华.癌症患者心理弹性水平及其影响因素研究[J].护理学杂志,2015,30(3):22-25.
[18]智晓旭,孟爱凤,茅昌敏,等.癌症患者住院化疗期间负担感的调查研究[J].中华护理教育,2015,12(3):220-223.
[19]张明洁.品管圈对鼻咽癌放疗患者干预效果评价研究[D].济南:山东大学,2016.
[20]张春琦.鼻咽癌患者放疗期间创伤后成长特点与影响因素及心理干预的研究[D].南宁:广西医科大学,2017.
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