消化道恶性肿瘤患者配偶创伤后成长水平及影响因素分析

发布时间：2018-12-23 10:13

【摘要】：目的:了解消化道恶性肿瘤患者配偶的创伤后成长(Posttraumatic Growth,PTG)现状,深入探讨PTG影响因素,旨在关注、引导消化道恶性肿瘤患者配偶积极应对不良的创伤体验,改变其认知加工过程,提高自我效能,促进临床及社区护士以不同的视角帮助其处于良好的身心状态,提高其照护质量。方法:本研究为横断面研究,采用便利抽样的方法,在2016年7月-12月选择符合纳入、排除标准的山东省某三甲医院消化内科住院的消化道恶性肿瘤患者配偶160人进行问卷调查。问卷内容包括消化道恶性肿瘤患者配偶的一般人口学资料及患者临床疾病资料、创伤后成长评定量表、事件相关反刍问卷和一般自我效能量表。所有数据采用SPSS 21.0软件进行统计分析,统计方法包括描述性统计、t检验、单因素方差分析、Pearson相关分析和多元线性回归分析。结果:1.消化道恶性肿瘤患者配偶PTG水平总分为(52.99±19.88),PTG水平较低。各维度得分由高到低依次是对生活的欣赏(3.07± 1.21)、个人力量(2.59土1.12)、与他人关系(2.46±0.89)、新的可能性(2.42±1.04)、精神改变(2.02±1.15)。2.消化道恶性肿瘤患者配偶反刍性沉思总分为(33.61 土8.13),处于中等水平。各维度得分为目的性反刍(18.13±5.39),侵入性反刍(15.48±4.78)。3.消化道恶性肿瘤患者配偶的自我效能总分为(25.44±6.10),低于全国常模(28.64±5.21 分)。4.独立样本t检验和单因素方差分析显示:在配偶的年龄、职业、家庭平均月收入、照顾时间、家庭关系及患者的自理能力、病理分期方面不同组别的消化道恶性肿瘤患者配偶PTG总分差异有统计学意义(P0.05),消化道恶性肿瘤患者配偶的性别、文化程度、宗教信仰、费用支付方式及患者的入院次数、治疗方式对其PTG总分的影响差异无统计学意义(P0.05)。5.Pearson相关分析显示:消化道肿瘤患者配偶反刍性沉思总分及目的性反刍维度与PTG呈高度正相关(P0.05)。侵入性反刍与PTG呈低度负相关(P0.05),自我效能与PTG呈高度正相关(P0.05)。6.多元线性回归分析显示:影响消化道恶性肿瘤患者配偶PTG水平的因素包括患者的自理能力、病理分期、目的性反刍、侵入性反刍和自我效能。多元相关系数为0.807,共解释变异量65.20%。配偶的PTG水平随着患者的自理能力降低而提高,病理分期处于Ⅱ期的患者配偶成长水平最高。消化道恶性肿瘤患者配偶目的性反刍越多,侵入性反刍越少,自我效能越高,其PTG越高。结论:1.消化道恶性肿瘤患者配偶存在较低水平的创伤后成长。2.影响消化道恶性肿瘤患者配偶创伤后成长水平的人口学因素主要有年龄、职业、家庭平均月收入、照顾时间和家庭关系,患者的肿瘤病理分期及自理能力。3.消化道恶性肿瘤患者配偶的目的性反刍越多,自我效能越高,创伤后成长水平就越高,侵入性反刍越多,创伤后成长水平就越低。4.患者的自理能力、病理分期、目的性反刍、侵入性反刍和自我效能是消化道恶性肿瘤患者配偶创伤后成长的显著影响因素。
[Abstract]:Objective: To study the status of post-traumatic growth (PTG) of the patients with malignant tumor of the digestive tract, and to explore the influence factors of PTG. To promote the clinical and community nurses to help the clinical and community nurses to improve their care quality with different visual angles. Methods: The study was a cross-sectional study. In July-December, 2016, 160 patients with digestive tract malignant tumor who were hospitalized for digestive system of a third-grade hospital in Shandong province were investigated by means of a method of convenient sampling. The contents of the questionnaire included general demographic data of the patient's mate in the digestive tract malignant tumor and the clinical data of the patient, the post-traumatic growth rating scale, the event-related anti-questionnaire and the general self-efficacy scale. All the data were analyzed by SPSS 10.0 software. The statistical methods include descriptive statistics, t-test, single-factor analysis of variance, Pearson correlation analysis and multiple linear regression analysis. Results: 1. The level of PTG in the patients with malignant tumor of the digestive tract was divided into 52. 99 (19. 88) and the PTG level was lower. The scores of each dimension from high to low are the appreciation of life (3.07-1.21), the personal strength (2.59, 1.12), the relationship with others (2.46-0.89), the new possibility (2.42-1.04), and the spiritual change (2.02-1.15). A total of 33. 61 (8.13) of the patients with malignant tumor of the digestive tract were divided into two groups (33.61, 8.13). The dimensions of each dimension are divided into the purpose of the purpose (18.9 to 5.39), and the invasive anti-dumping (15.48, 4.78). The self-efficacy of the spouses in the malignant tumor of the digestive tract is divided into (25. 44 to 6.10), which is lower than that of the national norm (28. 64 to 5.21). the independent sample t-test and the single-factor analysis of variance showed that the age, occupation, average monthly income of the family, the care time, the family relationship, and the self-management of the patient, There was a significant difference in the total score of PTG in the patients with malignant tumor of the digestive tract (P0.05), the sex, the degree of culture, the religious belief, the method of payment and the number of admission to the patient. There was no significant difference in the effect of treatment on the total score of PTG (P0.05). There was a low negative correlation between the invasion and the PTG (P0.05), and the self-efficacy was positively correlated with the PTG (P0.05). The multivariate linear regression analysis showed that the factors that affect the level of PTG in the patients with digestive tract malignant tumor include the self-regulation ability, the pathological stage, the purpose anti-dumping, the invasive anti-interference and the self-efficacy of the patients. The multivariate correlation coefficient was 0.807, and the total amount of variation was 65. 20%. The level of PTG of the spousal was increased with the decrease of the patient's self-regulation, and the level of the partner's growth in the second stage was the highest. The more the patients with malignant tumor of the digestive tract, the more the purpose, the less invasive, the higher the self-efficacy and the higher the PTG. Conclusion: 1. The patients with malignant tumor of the digestive tract have low levels of post-traumatic growth. The demographic factors that affect the post-traumatic growth of the patients with malignant tumor of the digestive tract are mainly age, occupation, average monthly income of the family, the time of care and family, the pathological staging and self-management of the patients. The higher the purpose of the patient's spouse, the higher the self-efficacy, the higher the level of post-traumatic growth, the more invasive anti-cancer, and the lower the level of post-traumatic growth. The patient's self-regulation, the pathological stage, the purpose-back-resistance, the invasive reverse-resistance and the self-efficacy are the significant factors that affect the growth of the partner of the patients with the digestive tract malignant tumor.
【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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