急性白血病患者生存质量现状及影响因素的研究

发布时间：2018-02-10 14:29

本文关键词： 急性白血病生存质量焦虑抑郁社会支持应对方式　出处：《山东大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究目的:了解白血病患者生存质量现状,分析一般资料、焦虑抑郁、应对方式、社会支持对生存质量的影响,探讨急性白血病患者生存质量相关影响因素,从而为提高白血病患者生存质量提供理论依据,对改善白血病患者的生存质量具有重要意义。研究方法:本研究为横断面描述性研究。采用便利抽样的方法选取2016年4月～2016年7月入住山东省济南市4所三甲医院,并符合纳入排除标准的急性白血病患者294例。采用一般资料调查表问卷,医院焦虑抑郁量表(hospitalanxiety and depression scale,HADS),医学应对问卷(medical coping modes questionnaire,MCMQ),生存质量测定量表(quality of life questionnaires-core 30,QLQ-C30),社会支持评定量表(social support revalued scale,SSRS)对患者进行问卷调查。采用SPSS 20.0软件进行数据的统计分析,主要应用描述性分析、独立样本t检验、单因素方差分析、Pearson相关分析、多元线性回归分析等统计学分析方法。研究结果:1.本次调查共发放300份问卷,回收300份,回收率100%。回收问卷中有效问卷294份,问卷有效率98%。2.急性白血病患者的总体健康水平得分为64.14±27.28,明显低于Norwegian常模;功能领域中得分最高的条目为认知功能,80.68±21.70;症状领域中得分最高的条目为疲乏,40.27±24.72;单条项目中得分最高的条目为经济困难,63.26±36.75。3.急性白血病患者的焦虑得分7.01±4.35,抑郁得分5.78±4.48,处于较低水平。4.急性白血病患者医学应对方式的总得分为46.34±4.97,各维度得分分别为:面对(20.43±4.06),回避(17.40±2.70),屈服(8.52±2.84)。除屈服应对外,面对与回避得分均明显高于常模。5.急性白血病患者社会支持状况,社会支持总分得分为38.97±8.35,明显高于肖水源的社会总支持常模,其中客观支持得分9.94±3.82,主观支持得分21.85±5.26,对支持的利用度为7.14±1.92,。6.单因素分析结果表明,急性白血病患者生存质量各维度的影响因素很多,其中病程、患病期间主要的照顾者、入院次数、有无子女对总体健康水平的差异有统计学意义,即P0.05;其它变量对总体健康水平的差异无统计学意义,即P0.05。7.Pearso 相关分析表明,患者焦虑、抑郁得分与患者的总体健康水平及功能维度呈现明显的负相关,与症状维度呈现正相关;回避应对与总体健康水平呈现正相关,屈服应对与总体健康状况及功能领域呈负相关;患者的客观支持与总体健康水平及与多数功能领域呈现正相关,与多数症状领域呈现负相关,对支持的利用度与总体健康水平及情绪功能呈现正相关,社会总支持与总体健康水平及多数功能领域呈正相关,主观支持与生存质量基本无相关性。8.多元线性回归分析显示,急性白血病患者的生存质量受多种因素的影响,不同人口学资料和疾病相关特征对急性白血病患者生存质量各维度均有不同程度的影响,焦虑、抑郁、应对方式、社会支持对急性白血病患者的生存质量有一定的影响。研究结论:1.急性白血病患者的生存质量处于较低水平。改善白血病患者的临床症状,对提高患者的生存质量有显著意义。2.急性白血病患者的焦虑、抑郁与总体健康水平及功能领域各维度呈现明显负相关,与其它领域呈现明显的正相关。降低患者的焦虑抑郁水平有助于提高白血病患者的生存质量。3.回避作为一种积极的应对方式对患者的总体健康水平起着重要的作用。医护人员可根据患者的具体情况帮助患者建立有益于健康的应对方式,以提高患者的生存质量。4.急性白血病患者的社会支持较好。提高患者的社会支持,有助于提高患者的生存质量。
[Abstract]:Objective: To investigate the quality of life of patients with leukemia and analyze the general information, anxiety and depression, coping style, social support's influence on the quality of life, to explore the related factors of quality of life in patients with acute leukemia, so as to improve the life quality of patients with leukemia and provide a theoretical basis, and has important significance to improve the quality of life of patients with leukemia. Methods: This study study is a cross-sectional descriptive study. Using the convenience sampling method to select 4 hospitals in Shandong Province in July 2016 to April 2016 in Ji'nan City, and 294 acute leukemia patients met the inclusion exclusion criteria. The general information questionnaire, hospital anxiety and Depression Scale (hospitalanxiety and depression scale, HADS), Medical Coping Questionnaire (medical coping modes questionnaire, MCMQ), scale for measurement of quality of life (quality of life questionnaires-core 30, QLQ- C30), social support rating scale (social support revalued scale, SSRS) the patients were investigated with a questionnaire. Data were analysed by SPSS 20 software, mainly used descriptive analysis, independent samples t test, one-way ANOVA, Pearson correlation analysis, multiple linear regression analysis and other statistical methods. The results of the study: 1. in this survey, 300 questionnaires were distributed, 300 were recovered, the recovery rate of 100%. were effective questionnaires of 294 questionnaires, the efficiency of 98%.2. in acute leukemia patients overall health score was 64.14 + 27.28, significantly lower than the norm of Norwegian entry; the highest score function in the field of cognitive function, 80.68 + 21.70; the highest score items in the field of fatigue symptoms, 40.27 + 24.72; the highest score in a single item project for the economic difficulties, 63.26 + 36.75.3. in acute leukemia patients anxiety depression score of 7.01 + 4.35. Score 5.78 + 4.48, a total score of low levels of.4. in acute leukemia patients medical coping style was 46.34 + 4.97, the scores were: in the face of (20.43 + 4.06), (17.40 + 2.70) avoidance, yield (8.52 + 2.84). The yield of foreign, face and avoidance scores were significantly higher than those in ordinary die.5. acute leukemia patients with the status of social support, the total score of social support score was 38.97 + 8.35, significantly higher than Xiao total social support norm, the objective support score of 9.94 + 3.82, 21.85 + 5.26, the score of subjective support, utilization of support for 7.14 + 1.92,.6. single factor analysis results show that many factors. Effect of acute leukemia patients with various dimensions of quality of life among the course, during the prevalence of primary caregivers, frequency of hospitalization have no difference on the overall health of the children was statistically significant, P0.05; differences in other variables on the overall health of the system without In terms of meaning, namely the P0.05.7.Pearso correlation analysis showed that patients with anxiety, showed significant negative correlation and the overall health of patients with depression scores and functional dimensions, are positively correlated with symptom dimensions; avoidant coping and overall health level are positively correlated, negatively related to health status and function of yield response and total body areas; patients with objective support and overall health level and most functional areas have positive correlation, negative correlation with the majority of symptoms, utilization of support and the level of health and emotional function is a positive correlation, and the level of health and social spending to the overall field most functions positively related to subjective support and quality of life had no correlation.8. multiple linear regression the analysis shows that the quality of life of patients with acute leukemia is influenced by many factors, different demographic and disease characteristics of acute leukemia The quality of life of patients with different extent and dimensions are anxiety, depression, coping style, social support has a certain impact on the quality of life of patients with acute leukemia. Conclusion: the quality of life of patients with acute leukemia in 1. at a low level. To improve the clinical symptoms of patients with leukemia, with significant anxiety on.2. in patients with acute leukemia to improve the quality of life of patients, the dimensions of depression and the overall level of health and functional areas showed significant negative correlation, showed significant positive correlation with other areas. Lower levels of anxiety and depression of patients is helpful to improve the quality of life of patients with leukemia.3. avoidance as a positive coping style on the overall health level of patients plays an important the role of medical staff. According to the specific circumstances of the patients to help patients establish healthy coping style, to improve the patient's quality of life.4. The social support of the patients with acute leukemia is better. It is helpful to improve the patient's social support and improve the quality of life of the patients.

【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R733.71

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