乳腺癌患者健康行为及健康行为改变的临床调查研究

发布时间：2018-04-30 06:12

本文选题：乳腺癌 + 健康行为　；参考：《广州中医药大学》2015年硕士论文

【摘要】：目的：采用临床流行病学调查方法,对乳腺癌患者健康行为状况进行调查,了解乳腺癌患者健康行为现状,分析被调查者健康行为改变情况及意愿,探讨可能影响乳腺癌患者健康行为改变的因素,为制定乳腺癌患者科学合理的健康行为改变方案提供初步参考；同时希望问卷能够得到认可,为下一步研究提供参考。方法：采用前瞻性方便样本调查方法,定性研究和定量研究相结合的调查方法进行现场问卷调查,将收集到的308例乳腺癌患者健康行为状况调查问卷建立数据库,应用χ2检验、t检验、秩和检验和非条件逐步Logistic回归分析等统计方法,了解乳腺癌患者的健康行为现状及其健康行为改变情况及意愿,探讨影响乳腺癌患者健康行为改变的可能因素；采用可靠性分析及因子分析对乳腺癌患者健康行为状况调查表进行信度、效度的评价。结果：1.乳腺癌患者健康行为调查研究乳腺癌患者较重视自身健康,患病后对乳腺癌相关知识的了解程度较前明显提高,超过96%的患者计划今后去了解乳腺癌相关知识；多数患者的健康意识较高,能较好的遵从医生的建议和指导,遵医服药、定期复查；调查的308例乳腺癌患者中有健康行为改变者296例(占96.1%),当前还没有纠正的不良习惯大部分患者计划今后进行改变。对影响乳腺癌患者健康行为改变因素的研究分析,结果提示：乳腺癌患者在实际年龄,累积哺乳时间,患病后对乳腺癌相关知识的了解情况,是否知道未哺乳/少哺乳、喜食烟熏/腌制品、含雌激素的保健品或护肤品、胸罩的佩戴或使用不当及恶性肿瘤家族史可能导致乳腺癌发生,对健康重视程度,是否规律用餐,是否主动调控饮食类型,有无多吃新鲜果蔬、少吃红肉、减少高脂肪/高热量饮食及少吃烟熏/腌制食物饮食调控的具体表现、是否增加体育锻炼、是否需要控制体重、是否保持生活起居规律等方面差异均有统计学意义(P0.05)。进一步进行非条件逐步Logistic回归分析,结果显示：知道恶性肿瘤家族史可能导致乳腺癌发生者比不知道者其行为改变率相对更高；患病后主动调控饮食者比不调控者其行为改变率相对较高；患病后有增加体育锻炼者比不增加者其行为改变率相对较高。2.乳腺癌健康行为状况调查表信度、效度评价①信度分析：本问卷总条目的克朗巴赫系数α=0.67(标准化α=0.70),经检验F=235.12,P=0.0001(P0.01),差异有统计学意义；故本问卷信度尚可。②效度分析：采用主成分因子分析法对乳腺癌患者健康行为问卷的条目进行因子分析,结果显示KMO值=0.67,Bartlett球形检验其概率P=0.0001(P0.01),提示该数据抽样随机性满足因子分析；进一步分析提取9个公因子,累计贡献率为71.8%,本问卷效度较好,基本符合问卷的理论框架,但仍有个别条目存在不易解释的情况,有待今后继续优化完善。结论：1.乳腺癌患者健康行为改变状况：乳腺癌患者基本都有健康行为改变(96.1%)提示乳腺癌患者重视自身的健康行为改变。影响乳腺癌患者健康行为改变的因素有：是否知道恶性肿瘤家族史可能导致乳腺癌发生、患病后是否经常主动调控饮食类型；患病后有无增加体育锻炼。2.乳腺癌患者健康行为状况调查表的信度尚可、效度较好,具有一定的临床应用价值,但仍需进一步优化、完善该问卷,提高其信度和效度,提升其推广应用价值。
[Abstract]:Objective: To investigate the health behavior of breast cancer patients by clinical epidemiological investigation, to understand the status of healthy behavior of breast cancer patients, to analyze the changes in health behavior of the patients and to discuss the factors that may affect the health behavior changes of the breast cancer patients and to formulate scientific and rational behavior of breast cancer patients. At the same time, we hope that the questionnaire can be approved to provide reference for the next step. Methods: a prospective and convenient sample survey method, a survey method combining qualitative and quantitative research, and a questionnaire on the health behavior of 308 cases of breast cancer patients were established. The database, using the statistical methods such as chi 2 test, t test, rank sum test and unconditional Logistic regression analysis to understand the status of health behavior of breast cancer patients and their health behavior changes and wishes, and discuss the possible factors affecting the change of healthy behavior of breast cancer patients, and use reliability analysis and factor analysis to treat the patients with breast cancer. The reliability and validity of the health behavior questionnaire. Results: 1. the investigation of the health behavior of the breast cancer patients was more important to the breast cancer patients. The knowledge of breast cancer related knowledge was improved significantly after the illness. More than 96% of the patients planned to understand the breast cancer related knowledge in the future; the health of the majority of the patients was healthy. Higher awareness, better compliance with doctors' advice and guidance, compliance with medicine and periodic review; 296 of the 308 cases of breast cancer patients investigated were healthy behavioural changes (96.1%), and most of the patients who had not corrected the bad habits were planned to change in the future. Fruit hints: breast cancer patients in the actual age, the accumulation of lactation time, the understanding of the knowledge related to breast cancer after the illness, whether they know not lactation / less lactation, smoked / pickled products, estrogen containing health care products or skin care products, brassiere wear or use improper and the family history of malignant tumor may lead to breast cancer, to health. Whether or not to have regular meals, whether or not to regulate the diet actively, whether to eat more fresh fruits and vegetables, eat less red meat, reduce high fat / high calorie diet and eat less smoked / pickled food and diet regulation, whether to increase physical exercise, or not to control weight, or not to keep the living rules and other aspects of the difference are statistically significant P0.05. Further unconditional Logistic regression analysis was carried out. The results showed that the family history of malignant tumor may lead to a higher rate of behavior change than those who did not know the breast cancer. The rate of behavior change was relatively high in.2. breast cancer health behavior questionnaire reliability and reliability analysis: the Krone Bach coefficient alpha =0.67 (standardized alpha =0.70) of this questionnaire, F=235.12, P=0.0001 (P0.01), was statistically significant; therefore, the reliability of this questionnaire was still available. Factor analysis was used to analyze the items of the health behavior questionnaire for breast cancer patients. The results showed that the KMO value was =0.67 and the probability of Bartlett spherical test was P=0.0001 (P0.01), suggesting that the data were sampled randomly to satisfy the factor analysis, and the 9 public factors were extracted and the cumulative Tribute rate was 71.8%. The validity of the questionnaire was better, basically conformed to the questionnaire. The theoretical framework, but there are still some items that are not easy to explain, and need to be optimized in the future. Conclusion: 1. the health behavior changes of breast cancer patients: breast cancer patients basically have healthy behavior changes (96.1%) suggest that breast cancer patients pay attention to their own health changes. Factors are: whether or not the family history of malignant tumor may lead to the occurrence of breast cancer and whether the diet type is regularly regulated after the disease; the reliability of the health behavior questionnaire of.2. breast cancer patients after the illness is still available, the validity is good, and it has certain clinical application value, but it still needs to be further optimized to improve this question. It can improve its reliability and validity and enhance its application value.

【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R737.9

【参考文献】