永久性肠造口患者健康相关行为与生活质量的关系研究

发布时间：2018-01-05 22:06

本文关键词：永久性肠造口患者健康相关行为与生活质量的关系研究　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的本研究通过调查永久性肠造口患者自我表露、反刍思维、孤独感、健康促进行为和生活质量现状及其影响因素,分析自我表露、反刍思维、孤独感、健康促进行为、生活质量间的相关性,探讨自我表露、反刍思维、孤独感、健康促进行为对生活质量的作用路径,以便为患者进行有效的心理行为指导、改善其生活质量提供参考依据。方法本研究属于横断面研究。采用方便抽样法,选取2014年11月至2016年9月在青岛市某三所三级甲等医院复查及参加造口联谊会的225名永久性肠造口患者,采用自我表露指数问卷、反刍思维量表、孤独感中文简版量表、健康促进生活方式量表Ⅱ、造口患者生活质量问卷中文版及患者一般资料调查表,分别调查患者的健康相关行为和生活质量。采用SPSS17.0软件和AMOS21.0软件对数据进行统计分析,主要的统计方法包括:描述性分析、独立样本t检验、单因素方差分析、Pearson相关分析、多元线性回归分析以及结构方程模型等。结果1.永久性肠造口患者自我表露得分为30.35±8.09分;自我表露的影响因素包括每日护理造口时间、年龄、文化程度、造口并发症、性别和居住情况。2.永久性肠造口患者反刍思维得分为2.44±0.46分,各维度得分由高到低依次为症状反刍、强迫思考和反省深思;反刍思维的影响因素包括每日护理造口时间、性别、造口术后时间、是否放化疗、造口并发症以及目前工作状况。3.永久性肠造口患者孤独感得分为19.81±3.77分;孤独感的影响因素包括造口术后时间、婚姻状况、文化程度、性别、目前工作状况、是否放化疗以及造口并发症。4.永久性肠造口患者健康促进行为得分为122.76±25.00分,各维度得分由高到低排序依次是人际关系、营养、运动锻炼、健康职责、自我实现和压力处理;健康促进行为的影响因素包括每日护理造口时间、文化程度和职业。5.永久性肠造口患者生活质量得分为4.84±0.92分,各维度得分由高到低排序依次是心理健康、精神健康、生理健康和社会健康;生活质量的影响因素包括文化程度和每日护理造口时间。6.相关分析结果表明:自我表露与反刍思维和孤独感呈负相关(r=-0.762;r=-0.372,P0.01),自我表露与健康促进行为和生活质量呈正相关(r=0.527;r=0.411,P0.01);反刍思维与孤独感呈正相关(r=0.593,P0.01),反刍思维与健康促进行为和生活质量呈负相关(r=-0.523;r=-0.405,P0.01);孤独感与健康促进行为和生活质量呈负相关(r=-0.525,r=-0.430,P0.01);健康促进行为与生活质量呈正相关(r=0.840,P0.01)。7.结构方程模型显示:自我表露对生活质量具有直接正向预测作用(β=0.124,P0.05);孤独感对生活质量具有直接负向预测作用(β=-0.124,P0.05);健康促进行为对生活质量具有直接正向预测作用(β=0.831,P0.001);反刍思维对生活质量具有直接负向预测作用(β=-0.452,P0.01)。反刍思维、孤独感、健康促进行为在自我表露对生活质量路径中都起到部分中介作用,中介效应值分别占总效应的53.69%、7.06%、19.78%;健康促进行为在孤独感对生活质量路径中起部分中介作用,中介效应值占总效应的48.55%;孤独感和健康促进行为在反刍思维对生活质量路径中起到部分中介作用,中介效应值分别占总效应的7.89%、43.30%。结论1.文化程度、每日护理造口时间、造口术后时间等对永久性肠造口患者自我表露、孤独感、反刍思维、健康促进行为和生活质量有一定的影响。2.自我表露和健康促进行为与生活质量均呈正相关,反刍思维和孤独感与生活质量均呈负相关。3.患者的自我表露可直接影响其生活质量,反刍思维、孤独感和健康促进行为又可作为中介变量调节自我表露对生活质量的影响;孤独感可直接影响患者的生活质量,健康促进行为又可作为中介变量调节两者之间的关系;反刍思维可直接影响患者的生活质量,孤独感和健康促进行为又可作为中介变量调节反刍思维对患者生活质量的影响。
[Abstract]:The purpose of this study is through self disclosure, investigation of permanent colostomy patients of rumination, loneliness, health promotion factors of behavior and quality of life situation and effect analysis, self disclosure, rumination, loneliness, health promoting behavior, the correlation between quality of life and the discussion of self disclosure, rumination, loneliness, health promotion the path to the quality of life for patients with psychological behavior, effective guidance, to provide reference for improving their quality of life. Methods this study was a cross-sectional study. By convenient sampling method, from November 2014 to September 2016 in a three review of three hospitals in Qingdao city and Stoma Association 225 permanent colostomy with the self disclosure index questionnaire, rumination scale, loneliness scale Chinese Jane version, Health Promoting Lifestyle Profile II, made in the quality of life in patients with. The volume Chinese version and the general data of patients were investigated with questionnaire, health behavior and quality of life. The data was analyzed using SPSS17.0 software and AMOS21.0 software, including the main statistical methods: descriptive analysis, independent sample t test, single factor variance analysis, Pearson correlation analysis, regression analysis and structural equation model the results of self disclosure. 1. permanent colostomy patients score was 30.35 + 8.09; influence factors of self disclosure including the daily nursing stoma time, age, culture degree, stoma complications, sex and living conditions of.2. permanent colostomy patients rumination score was 2.44 + 0.46 points, the scores from high to low in order for the symptoms of rumination, brooding and reflection; influencing factors of rumination including the daily nursing stoma time, gender, time after colostomy, whether chemotherapy, stoma The complications and the current working condition of.3. permanent colostomy patients loneliness score was 19.81 + 3.77; influencing factors of loneliness after colostomy include time, marital status, education level, gender, current working conditions, whether chemotherapy and complication of.4. permanent colostomy patients health promoting behavior score was 122.76 + 25, the scores from high to low rank is the interpersonal relationship, nutrition, exercise, health responsibility, self realization and pressure treatment; health promoting behavior factors include the effect of daily nursing of colostomy time, education level and occupation.5. the quality of life in patients with permanent colostomy score was 4.84 + 0.92 points, the scores from high to low rank is mental health, mental health, physical health and social health; the factors affecting the quality of life including education and daily nursing stoma time.6. correlation analysis The results show that the self disclosure and rumination and loneliness were negatively correlated (r=-0.762; r=-0.372, P0.01), self disclosure and health promoting behaviors and quality of life were positively correlated (r=0.527; r=0.411, P0.01); rumination and loneliness was positively correlated (r=0.593, P0.01), rumination and health promotion behavior and quality of life is negative correlation (r=-0.523; r=-0.405, P0.01); loneliness and health promoting behaviors and quality of life were negatively correlated (r=-0.525, r=-0.430, P0.01); promote health related behavior and quality of life was positively (r=0.840, P0.01).7. structural equation model: self disclosure has a direct positive effect on the quality of life (beta =0.124, P0.05); loneliness has a direct negative effect on the quality of life (beta =-0.124, P0.05); the behavior has a direct positive prediction on the quality of life for health promotion (beta =0.831, P0.001); rumination directly with the quality of life Negative predictive effect (beta =-0.452, P0.01). Rumination, loneliness, health promoting behavior in self disclosure on the quality of life path plays a part intermediary role mediating effect of total effect values were 53.69%, 7.06%, 19.78%; health promoting behavior in the loneliness of the mediating effect of the quality of life path in the intermediary effect value of the total effect in 48.55%; promote the behavior of rumination to play the part of the intermediary role of quality of life in the path of loneliness and health, the mediating effect of total effect values were 7.89%, 1. 43.30%. conclusion education, daily nursing time after colostomy stoma, the time of self disclosure, permanent colostomy patients loneliness, rumination, health promoting behaviors and quality of life have certain effect of.2. self disclosure and health promoting behavior and quality of life were positively correlated, rumination and loneliness and life quality were Negative correlation with.3. self disclosure can directly affect the quality of life, rumination, loneliness and health promotion behavior as a mediating variable self disclosure regulation effect on quality of life; loneliness can directly affect the quality of life of patients, health promoting behaviors and can be used as an intermediary variable regulating the relationship between rumination; can directly affect the quality of life of patients, loneliness and health promotion behavior as a mediating variable regulation of rumination effects on the quality of life of patients.

【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.73

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