癌症患者住院放化疗期生存质量与家庭功能的调查研究

发布时间：2018-05-14 06:51

本文选题：癌症 + 住院　；参考：《第四军医大学》2015年硕士论文

【摘要】：研究目的:本研究通过调查西安市两所医院癌症患者住院放化疗期生存质量及家庭功能状况,了解癌症患的生存质量与家庭功能情况,以及两者之间的相关性,分析影响患者生存质量的影响因素,为癌症照护人员制定个性化医疗服务及护理措施提供理论指导,并为下一步制定癌症患者住院放化疗期的生存质量及家庭功能干预措施提供理论依据。研究方法:1.现况研究采用流行病学横断面研究方法,选取西安市两所有代表性的三甲医院进行放化疗的住院癌症患者为研究对象。查阅相关资料自编一般情况调查表,选用世界卫生组织生存质量测定量表(WHOQOL-100)和家庭功能指数问卷(Family APGAR Index,APGAR)作为调查工具。调查方式采用调查员下科获得患者知情同意,调查对象自填问卷形式取得问卷结果。按照WHOQOL-100、APGAR提供的计算方法与评分标准,对结果进行整理。2.统计学方法使用Epidata3.1建立数据库,双人录入调查数据,采用SPSS17.0统计软件进行数据分析,所用的统计方法有:对患者一般资料进行描述性分析,单因素分析采用单样本t检验、独立样本t检验、方差分析、pearson相关分析,多因素分析采用多元线性逐步回归,p0.05差异具有统计学意义。研究结果:1患者的生存质量情况1.1不同情况患者生存质量比较1.1.1不同性别患者在生存质量的6个领域得分差异无统计学意义(p0.05);在生存质量各方面之间比较,男性患者在精神支柱和休闲娱乐活动的参与机会与参与程度2个方面满意度均低于女性患者(p0.05)。1.1.2不同年龄段患者[1]在生存质量的6个领域得分差异均无统计学意义,在生存质量各方面之间比较,经济来源方面,45~59岁中年患者得分最低(p0.05),60岁及以上老年患者得分最高(p0.05),对总的健康状况与生存感受和家庭摩擦对患者的影响两个条目得分进行比较,18~44岁青年患者得分最低,60岁及以上老年患者得分最高(p0.05)。1.1.3不同学历患者在心理领域及精神支柱领域得分差异有统计学意义(p0.05);对生存质量各方面得分比较,积极感受、工作能力、经济压力和精神支柱4个方面得分差异有统计学意义(p0.05),呈现出学历越低,平均分越低的趋势。1.1.4在婚患者社会关系领域及性生活方面满意度高于非再婚患者,其他方面生存质量差异无统计学差异(p0.05)。1.1.5不同职业患者在心理领域、环境领域、精神支柱领域得分差异有统计学意义(p0.05);生存质量各方面比较,患者在积极感受、思想学习记忆和注意力、对药物及医疗手段的依赖性、工作能力、经济来源、获取新信息知识技能的机会、休闲娱乐活动的参与、环境条件8方面的得分差异有统计学意义(p0.05);家庭摩擦对患者的影响条目得分差异有统计学意义;农民及从事服务业患者以上得分较低。1.1.6不同癌症类型的患者生存质量得分无统计学差异(p0.05)。1.1.7不同治疗方式的患者在生理领域、社会关系领域及精神支柱领域得分差异有统计学意义(p0.05);对生存质量各方面得分进行比较,患者的疼痛与不适、对药物及医疗手段的依赖、个人关系、所需社会支持的满意度、交通条件、精神支柱等6个方面得分差异有统计学意义(p0.05),在总的健康状况与生存感受和家庭摩擦对患者的影响2个条目得分差异有统计学意义(p0.05);同步放化疗的患者以上得分低于单独进行放疗的患者(p0.05)。1.1.8患者住院期间不同照顾者分组比较,配偶照顾的患者社会关系领域得分高于其他人员照顾的患者得分(p0.05);生存质量各方面进行比较,睡眠与休息、思想学习记忆和注意力、个人关系、所需社会支持的满意程度4个方面的得分差异有统计学意义(p0.05),配偶照顾的患者睡眠与休息、个人关系、所需社会支持的满意程度得分高于其他人员照顾的患者得分(p0.05);家庭摩擦对患者的影响条目,配偶照顾的患者影响小于其他人员照顾的患者(p0.05)。1.2患者生存质量与常模比较癌症患者住院放化疗期生存质量在生理领域、心理领域、独立性领域、精神支柱领域得分与常模相比,差异有统计学意义(p0.000),社会关系领域和环境领域得分与常模相比,差异无统计学意义(p0.05);在生存质量的24个方面中,研究对象除在积极感受,个人关系,社会安全保障,获取新信息、知识、技能机会,交通条件等5个方面的感受得分与常模相比差异无统计学意义外(p0.05),其他19个方面得分与常模相比差异有统计学意义(p0.05);调查对象总的健康状况和生存质量的感受得分与常模相比差异有统计学意义(p0.000)。2.患者家庭功能情况分析青年患者家庭功能低于中年患者,不在婚患者家庭功能低于在婚患者,农民患者家庭功低于工人、行政工作者、专业技术从业者,同步放化疗患者家庭功能低于单独放疗或化疗的患者,得分差异有统计学意义(p0.05)。家庭功能各纬度得分比较,青年患者感知的家庭合作度和成长度低于中年患者,并且也低于60岁及以上年龄的老年患者感知的家庭成长度(p0.05);男性患者感知的家庭适应度低于女性患者(p0.05);同时进行放化疗的患者感知的家庭功能除亲密度外,其他维度家庭功能低于单独放疗或化疗的患者(p0.05);行政工作者感知的家庭合作度高于工人、农民、服务业从业者,知识分子、行政工作者、工人感知的情感度和亲密度高于农民和服务业从业者(p0.05)。3.患者生存质量与家庭功能的相关性患者家庭适应度得分与心理领域、社会关系领域、环境领域、精神支柱领域得分正相关(P0.05);合作度得分除和独立性领域外其余领域得分均正相关(P0.05);成长度得分和生存质量的所有领域及总的健康状况与生存质量感受得分正向关(P0.05);情感度得分与社会关系领域、环境领域得分正相关(P0.05);亲密度得分与心理领域、社会关系领域、精神支柱领域得分正相关(P0.05);家庭功能总得分与除独立性领域外其他领域得分均正相关(P0.05)。4.癌症患者住院放化疗期生存质量的多因素分析家庭功能是患者心理领域、社会关系、环境、精神支柱、总的健康状况和生存质量感受、家庭摩擦的影响因素,年龄和婚姻状况是总的健康状况和生存质量感受、家庭摩擦的影响因素,性别是环境领域的影响因素,住院照顾者是家庭摩擦的影响因素。研究结论:1.癌症患者在住院放化疗期生存质量显著下降2.患者生存质量受多种因素影响,主要影响因素为家庭功能3.不同情况患者感知的家庭功能有差别,青年患者、非在婚患者、农民患者、联合放化疗患者家庭功能较低
[Abstract]:The purpose of this study was to investigate the quality of life and family function of cancer patients in hospital in Xi'an, and to understand the quality of life and family function of cancer patients and the relationship between them, and to analyze the influencing factors of the quality of life of the patients, and to make personalized medical services for the cancer care workers and to make personalized medical services for the cancer care workers. The nursing measures provide theoretical guidance, and provide a theoretical basis for the next step of formulating the quality of life and family function intervention during the stage of chemotherapy for cancer patients. Research methods: 1. the epidemiological cross-sectional study method was used to select all the representative three a hospital of Xi'an for chemotherapy and chemotherapy in hospital. The research object is to consult the relevant information for the general situation questionnaire, select the WHO quality of life scale (WHOQOL-100) and the family function index questionnaire (Family APGAR Index, APGAR) as the investigation tool. The investigation method uses the investigator's lower department to obtain the informed consent of the patient, and the questionnaire results are obtained by the questionnaire. According to the calculation method and grading standard provided by WHOQOL-100 and APGAR, the results are collated and.2. statistics method is used to establish the database using Epidata3.1. Two people are entered into the survey data and the SPSS17.0 statistics software is used to analyze the data. The statistical methods used are: the descriptive analysis of the general materials for the patients and the single factor analysis using the single sample t. Test, independent sample t test, variance analysis, Pearson correlation analysis, multi factor analysis using multiple linear stepwise regression, P0.05 difference had statistical significance. The results of the study: 1 patients' quality of life 1.1 different cases of patients' quality of life comparison of 1.1.1 different sex patients in the 6 areas of quality of life score difference is not statistically significant Meaning (P0.05); in comparison of all aspects of quality of life, the satisfaction of male patients in the 2 aspects of the opportunity and participation of spiritual support and recreational activities was lower than that of women (P0.05) and there was no significant difference in the score of [1] in the quality of life of the patients with different age groups of.1.1.2, and the ratio of the quality of life to all aspects was compared. In terms of economic origin, middle-aged patients aged 45~59 was the lowest (P0.05), and the scores of 60 years old and older were the highest (P0.05). Compared with the total health status and the impact of two items on the survival experience and family friction, the 18~44 year old patients scored the lowest score, and the 60 years old and older patients had the highest score (P0.05).1.1.3 difference. There were significant differences in scores in psychological and spiritual pillar areas (P0.05), and there were significant differences in scores of scores in all aspects of life quality, positive feeling, work ability, economic pressure and spiritual support (P0.05), which showed that the lower the learning calendar and the lower average score, the trend.1.1.4 was in the social customs of the married patients. The degree of satisfaction in the field and sexual life was higher than that of non remarried patients, and there was no statistical difference in other aspects of quality of life (P0.05).1.1.5 different occupational patients had statistical significance (P0.05) in the psychological, environmental and spiritual pillar areas (P0.05); the quality of life in all aspects, the patients were positive, thought, learning, memory and attention. Strength, dependence on drugs and medical means, work ability, economic sources, opportunities to acquire new information knowledge and skills, the participation of leisure and entertainment activities, and the 8 aspects of the environmental conditions are statistically significant (P0.05); family friction has a statistically significant difference in the score of the impact items on the patients; the peasants and the patients engaged in the service industry are above. There was no statistical difference in the score of quality of life of the patients with different types of.1.1.6 with different types of cancer (P0.05). The scores of the patients in different ways of.1.1.7 treatment were statistically significant (P0.05) in the field of physiology, social relations and spiritual pillar areas (P0.05); the scores of the quality of life were compared, the pain and discomfort of the patients, and the medicine and medical treatment There were statistically significant differences in the scores of 6 aspects, such as the dependence of means, personal relationship, the satisfaction of social support, traffic conditions, and spiritual support (P0.05). There were statistically significant differences in the scores of 2 items in the total health status and survival feelings and family friction (P0.05); the scores of patients with synchronous radiotherapy and chemotherapy were lower than those of the single group. The patients (P0.05).1.1.8 alone were compared with the different caregivers during the period of hospitalization, and the social relationships in the field of spouse care were higher than those of the other patients (P0.05); the quality of life was compared, sleep and rest, thought, memory and attention, personal relationship, and the satisfaction of social support required. There were significant differences in scores between 4 aspects (P0.05). The scores of sleep and rest, personal relationship, and social support needed by spouses were higher than those of other patients (P0.05); the impact items of family friction on patients, the effect of the spouse taking care of the patients were less than those of other patients (P0.05).1.2 The quality of survival of the patients was compared with the normal model. Compared with the norm, the difference was statistically significant (p0.000), compared with the norm in the field of social relations and the environment (P0.05), and 2 in the quality of life. In the 4 aspects, the subjects had no statistically significant difference (P0.05) in 5 aspects, such as positive feelings, personal relations, social security, access to new information, knowledge, skill opportunities and traffic conditions (P0.05), and the other 19 aspects were statistically significant (P0.05); the total health of the subjects was in general health. The difference in the feeling score of the condition and the quality of life compared with the norm (p0.000) the family function of.2. patients was lower than that of the middle-aged patients, and the family function of the married patients was lower than that of the married patients. The family work of the farmers was lower than the workers, the administrative workers, the professional technical practitioners, and the concurrent chemoradiotherapy patients. The difference in score of family function was lower than that of radiotherapy alone or chemotherapy (P0.05). Compared with the score of family function, the degree of family cooperation and growth of young patients was lower than that of middle-aged patients, and the perceived family growth (P0.05) was lower than the age of 60 years and older. The degree of adaptation was lower than that of female patients (P0.05); the perceived family function of patients undergoing chemotherapy was lower than intimacy, and other dimensions of family function were lower than those of individual radiotherapy or chemotherapy (P0.05); the degree of family cooperation perceived by administrative workers was higher than that of workers, farmers, service practitioners, intellectuals, administrative workers, and workers. The degree and intimacy higher than the farmers and service industry practitioners (P0.05).3. patients with the quality of life and family function of the family fitness score and the psychological field, social relations, the environment, the spiritual pillar field score positive correlation (P0.05); the degree of cooperation is not only positively related to the other areas outside the field of independence (P0.05); The score of the length score and the quality of life, the overall health status and the score of the quality of life were positively correlated (P0.05); the score of emotion was positively related to the field of social relations, the score of the environment (P0.05); the score of intimacy was positively correlated with the field of psychology, social relations, and the spiritual pillar field (P0.05); the total score of family function and the elimination of the score were positive. Multiple factors of positive correlation in other fields outside the field of independence (P0.05) a multifactor analysis of the quality of life in patients with cancer in.4. cancer patients; family function is the psychological field, social relations, environment, mental support, overall health status and quality of life, the factors affecting family friction, age and marital status are the overall health conditions and the overall health status. The quality of life, the influencing factors of family friction, sex are the influencing factors in the environmental field, the hospitalized caregivers are the influencing factors of family friction. 1. the study conclusions: the quality of life of the cancer patients in the hospitalized stage of chemotherapy and chemotherapy is significantly decreased by 2., the main influence factors are the family function 3. different cases. The family function of perception is different. Young patients, non married patients, farmer patients, family members with combined chemoradiotherapy have lower family function.

【学位授予单位】：第四军医大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R473.73

【参考文献】