膀胱癌患者生命质量与希望水平的相关性研究

发布时间：2018-04-02 03:26

本文选题：膀胱癌　切入点：生命质量　出处：《山东大学》2017年硕士论文

【摘要】：目的本研究旨在了解住院膀胱癌患者手术后生命质量及希望水平的现状,分析患者生命质量与希望水平的相关性,探讨患者一般人口学资料、疾病特性、希望水平等因素对生命质量的影响,为临床医护人员采取干预措施提供理论依据。方法采用方便抽样的方法,选取在山东省某三甲医院住院的118例膀胱癌患者为研究对象,用一般资料调查表、癌症患者生命质量测定量表体系中的膀胱癌量表QLICP-BL(V2.0)、Herth希望量表进行横断面调查。由被试者自行完成问卷,通过两个量表来评估患者的生命质量及希望水平的现状,分析影响膀胱癌患者生命质量的主要因素。用SPSS17.0软件进行数据录入,使用描述性分析、独立样本t检验、单因素方差分析、Pearson相关分析、多元线性回归进行统计分析。结果1.膀胱癌患者一般资料和疾病相关信息118例膀胱癌患者中,男93例,女25例,年龄27～86岁,平均62.56+13.04岁;教师和干部职业者占21%,工人24.6%,农民42%;专科以下学历的患者占75.5%,专科及以上学历的患者24.5%;家庭经济状况中等以上的患者占78%;95.8%的患者有医疗保险;79.7%的患者有吸烟史,其中17.8%的患者已经戒烟;饮食习惯中均衡饮食的患者占69.5%;经常活动的患者占45%。临床资料中,治疗方式均为手术治疗,83.9%的患者经尿道膀胱肿瘤电切术,10.2%的患者膀胱肿瘤全切手术,79.7%的患者病理分期集中在Ta和T1期。2.膀胱癌患者生命质量得分情况及不同人口学变量和临床特征患者生命质量现状膀胱癌患者术后生命质量总分为74.70± 11.51分,特异模块得分高于共性模块。共性模块四个领域中得分由低到高依次为:躯体功能、心理功能、社会功能、共性症状与副作用;特异模块得分由低到高依次为性功能问题、特异心理作用、尿路症状、尿袋问题、特异躯体症状。不同职业、文化程度、家庭经济状况的膀胱癌患者术后生命质量不同,职业是工人、农民的生命质量得分明显低于干部、教师、个体和其他职业患者,本科及以上学历患者高于其他患者,家庭经济条件好的患者生命质量高。3.膀胱癌患者希望水平得分膀胱癌患者术后总体希望水平得分为37.81 ±3.32分,处于高等水平。在希望水平三个维度中,采取积极行动得分最高,对现实和未来积极态度得分最低。4.膀胱癌患者生命质量与希望水平的相关分析相关分析显示,膀胱癌患者生命质量总分与希望水平总分(r=0.190,P0.05)及各维度(对现实和未来积极态度除外)呈正相关;采取积极行动与生命质量总分(r=0.240,P0.05)及共性模块中的躯体功能(r=0.210,P0.05)、心理功能(r=0.340,P0.05)、社会功能(r=0.244,P0.05)呈正相关;与他人保持亲密关系与生命质量总分(r=0.184,P0.05)及共性模块中的心理功能(r=0.221,P0.05)、社会功能(r=0.202,P0.05)呈正相关;对现实和未来的积极态度与生命质量总分及各维度均不相关。5.膀胱癌患者生命质量多元回归分析首先,以生命质量总分为因变量,以一般人口学资料和临床特征的各项指标,如性别、年龄、文化程度、家庭经济状况、肿瘤分期、手术方式等指标为自变量,进行多元线性回归分析,筛选出影响因素。结果表明,家庭经济状况是患者生命质量的影响因素。其次,以生命质量为因变量,加入希望水平量表各维度及总分作为自变量,对生命质量总分进行影响因素分析,结果表明,家庭经济状况、希望水平总分、对现实和未来积极态度是膀胱癌患者生命质量的影响因素。两个回归方程显示,家庭经济情况越好,生命质量总分越高。同时,加入希望水平各领域及总分后,对现实和未来积极态度和希望水平得分越高,生命质量得分越高。结论1.住院膀胱癌患者整体生命质量较好,处于中等偏上水平。2.职业、文化程度、家庭经济状况不同的膀胱癌患者手术后生命质量不同,工人、农民的生命质量低于干部、教师、个体和其他职业者,本科及以上学历患者生命质量高于其他学历者,家庭经济条件好的患者生命质量高。3.住院膀胱癌患者总体希望水平处于高等水平。4.住院膀胱癌患者生命质量与希望水平呈正相关,希望水平越高,生命质量越高。5.家庭经济状况、希望水平、对现实和未来积极态度是生命质量的显著影响因素。建议在临床上,重视这些影响因素,采取积极的应对措施。
[Abstract]:Objective the purpose of this study is to understand the current status of hospitalized patients with bladder cancer after surgery, quality of life and hope level, correlation analysis of quality of life in patients with the level of hope, to explore the general demographic data, disease characteristics, influence factors such as the level of quality of life, and provide a theoretical basis for the clinical medical staff to take intervention measures. Methods by convenient sampling the selection method in 118 cases of bladder cancer patients in a tertiary hospital in Shandong Province as the research object, with the general information questionnaire, scale system in QLICP-BL scale quality of life for patients with cancer of bladder cancer (V2.0), Herth Hope Scale for cross-sectional survey. The subjects completed the questionnaire, through two scale to assess status of the patient's quality of life and hope level, analysis of main factors affecting the quality of life of patients with bladder cancer. Data entry with SPSS17.0 software, Using descriptive analysis, independent samples t test, one-way ANOVA, Pearson correlation analysis, multiple linear regression statistical analysis. Results the general information and the disease of 1. patients with bladder cancer related information of 118 cases of bladder cancer patients, male 93 cases, female 25 cases, age 27~86 years old, the average age of 62.56+13.04 teachers and cadres' occupation; the workers accounted for 21%, 24.6%, and 42% farmers; specialist qualifications accounted for 75.5%, college degree or above with 24.5%; the economic situation of the family of intermediate or above accounted for 78% of patients; 95.8% patients had medical insurance; 79.7% of the patients had a history of smoking, of which 17.8% of the patients had quit; 69.5% for a balanced diet diet in the regular activities; patients accounted for 45%. clinical data, treatment for surgical treatment, postoperative transurethral resection of bladder tumor in 83.9% patients, 10.2% patients with bladder tumor total resection surgery, 79.7% patients with pathological staging Focused on the Ta and T1.2. in bladder cancer patients and the quality of life scores of different demographic variables and clinical features of quality of life of patients with bladder cancer patients with postoperative quality of life score was 74.70 + 11.51 points, scored higher than the general module. The specific module score four field general module in order from low to high: physical function, psychological function, social function, common symptoms and side effects; the specific module scores from low to high order function, specific psychological effect, urinary tract symptoms, urine bag, body symptom specific. Different occupation, education level, bladder cancer patients quality of life after the family economic situation is different, occupation workers score the quality of life of farmers is significantly lower than that of the individual cadres, teachers, and other occupation with bachelor degree were higher than that in other patients, family economic conditions of the quality of life of patients with high.3. bladder cancer patients Researchers hope to score after resection of bladder cancer and the overall level of hope score was 37.81 + 3.32 points, at the higher level. The level of hope in three dimensions, to take positive action to score the highest level of correlation analysis correlation analysis of the reality and the future positive attitude of the lowest score of.4. in bladder cancer patients' quality of life and hope, bladder cancer the quality of life of patients with total score and total score of hope level (r=0.190, P0.05) and dimensions (except for reality and future positive attitude) were positively correlated; take positive action and the quality of life score (r=0.240, P0.05) and common module in physical function (r=0.210, P0.05), psychological function (r=0.340, P0.05), social function (r=0.244, P0.05) were positively correlated; keep close relationship with the quality of life score with others (r=0.184, P0.05) and the common psychological function in the module (r=0.221, P0.05), social function (r=0.202, P0.05) were positively related to this; Real and positive attitude and quality of life score in future and the dimensions are not related quality of life of patients with bladder cancer.5. multivariate regression analysis first, quality of life score as the dependent variable, with the index, and the clinical features of demographic information such as gender, age, educational level, family economic status, tumor stage, operation index as independent variables, multivariate linear regression analysis, find out the influence factors. The results show that the economic situation of the family are the factors influencing the life quality of the patients. Secondly, due to the quality of life variables, adding hope level scale of each dimension and the total score as independent variables, analyzes the influencing factors on the quality of life score results show that family the state of the economy, the level of hope to score, the reality and the future positive attitude is the factors influencing the life quality of patients with bladder cancer. Two regression equations, the family economic situation better, The quality of life score higher. At the same time, the hope of joining field level and total, the reality and the future positive attitude and hope level the higher the score, life quality score is high. The conclusion of the 1. hospitalized patients with bladder cancer better overall quality of life, in the middle level.2. occupation, education level, family economic operation in patients with bladder carcinoma different quality of life, quality of life of peasant workers, lower cadres, teachers, individual and other occupation, bachelor degree or above in the quality of life of patients is higher than other levels of education, family economic conditions of the high quality of life in patients with.3. hospitalized patients with bladder cancer overall level of hope at the higher level of.4. in the quality of life of patients with bladder cancer with the level of hope was positively correlated to the higher the level, the higher the quality of life of.5. family economic conditions, the level of hope, is the quality of life of the reality and the future positive attitude It is suggested that we should pay attention to these factors and take positive measures in clinical practice.

【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】：R473.73

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