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造口患者适应水平调查及其影响因素研究

发布时间:2019-01-12 12:04  文章来源:笔耕文化传播
【摘要】:[目的]通过评估造口患者一般人口学及疾病相关情况、适应水平、应对方式、自我效能、社会支持总体状况,全面分析探索造口患者适应水平的影响因素,旨在为制定及实施有效的护理干预方案提供理论依据。[方法]通过文献回顾、理论研究等方法确定研究变量和测量工具。采用造口患者一般人口学及疾病相关资料调查表、中文版造口者社会心理适应量表、中文版医学应对问卷、造口患者自我效能量表、社会支持评定量表对南京地区两所医院的320例造口患者进行调查。采用单因素分析、相关分析以及多元逐步线性回归分析影响造口患者适应水平的因素。[结果]本次研究中造口患者的适应水平总分为(47.02±7.42)分,三个维度的得分为(14.47±2.49)分、(12.84±2.00)分、(19.72±4.10)分,总体处于中低水平。单因素分析显示:不同性别、年龄、婚姻状况、文化程度、医疗费用支付方式、造口术后时间、造口位置合适与否、造口相关并发症、每月购买造口用品费用、主动与医护人员交流情况、参加造口联谊会或其他相关活动情况、自护程度、自我接受程度的造口患者适应水平之间存在统计学差异(P0.05);面对应对方式维度、自我效能及各维度、社会支持及各维度均与造口患者适应水平呈显著正相关(P0.01),回避、屈服应对方式维度与造口患者适应水平呈显著负相关(P0.01);多元逐步线性回归分析显示:自我效能,造口术后时间,面对,主观社会支持,造口自我接受程度,支持利用度,造口自我护理程度,屈服8个影响适应水平的变量先后进入回归方程。由标准化偏回归系数可看出影响作用的大小依次是:面对,造口术后时间,主观社会支持,自我效能,造口自我接受程度,屈服,支持利用度,造口自我护理程度。[结论]本研究中样本人群的适应状况总体处于中低水平。自我效能、面对应对方式、主观社会支持、社会支持利用度得分越高,造口患者的适应水平越高;造口自我接受程度、造口自护程度越高,适应水平越高;造口术后6年以上的患者适应水平高于6年以内的;屈服应对方式得分越低,患者适应水平越高。本课题研究结果可帮助评估筛选目标人群,通过构建针对影响因素的干预模式,以改善造口患者的适应状况及长期生存质量。
[Abstract]:[objective] to evaluate the general demographics and disease related status of patients with stomatosis, the level of adaptation, coping style, self-efficacy, and the overall situation of social support, and to analyze comprehensively the factors affecting the level of adaptation of patients with stomstomy. The aim is to provide theoretical basis for the formulation and implementation of effective nursing intervention programs. [methods] study variables and measurement tools were determined by literature review, theoretical research and other methods. The questionnaire of general demography and disease-related information of patients with stomatostomy, the Chinese version of social-psychological adaptation scale, the Chinese version of medical coping questionnaire, the self-efficacy scale of patients with stomatostomy were used. The Social support rating scale (SSS) was used to investigate 320 patients with stoma in two hospitals in Nanjing. Univariate analysis, correlation analysis and multiple stepwise linear regression analysis were used to analyze the factors affecting the level of adaptation. [results] in this study, the total score of adaptation level was (47.02 卤7.42), the score of three dimensions was (14.47 卤2.49), (12.84 卤2.00), (19.72 卤4.10), the total score was in the middle and low level, the total score was (47.02 卤7.42), (14.47 卤2.49), (12.84 卤2.00), (19.72 卤4.10). Univariate analysis showed that: sex, age, marital status, educational level, medical expenses payment, time after ostomy, appropriate location of stomy, complications associated with stomatostomy, cost of purchasing ostomy articles per month, There was statistical difference between the patients who took the initiative to communicate with the medical staff, participated in the oral association or other related activities, the degree of self-care, the degree of self-acceptance of the patients with the level of adaptation (P0.05); The coping style dimensions, self-efficacy and each dimension, social support and each dimension were significantly positive correlation with the level of adaptation of patients with ostomy (P0.01), avoidance; There was a significant negative correlation between the dimension of yield coping style and the level of adaptation (P0.01). Multiple stepwise linear regression analysis showed that: Self-efficacy, time after ostomy, face, subjective social support, degree of self-acceptance, degree of utilization of support, degree of self-nursing of stomatostomy, The eight variables that affect the adaptation level entered the regression equation successively. From the standardized partial regression coefficient, we can see that the order of influence is: face, postorostomy time, subjective social support, self-efficacy, ostomy self-acceptance degree, yield, support utilization degree, ostomy self-nursing degree. [conclusion] the adaptation status of the sample population in this study is in low and middle level. Self-efficacy, facing coping style, subjective social support, the higher the score of the utilization of social support, the higher the adaptation level of the patients, the higher the degree of self-acceptance, the higher the degree of self-care, the higher the level of adaptation. The adaptation level of the patients more than 6 years after ostomy was higher than that of the less than 6 years, and the lower the score of yielding coping style, the higher the adaptation level of the patients. The results of this study can help to evaluate and screen the target population, and to improve the adaptation and long-term quality of life of patients with ostomy by setting up an intervention model aimed at influencing factors.
【学位授予单位】:南京中医药大学
【学位级别】:硕士
【学位授予年份】:2015
【分类号】:R473.73

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