初诊原发性肝癌手术患者心理弹性现状及其影响因素

Psychological Resilience Status and Influencing Factors of Patients Primarily Diagnosed of Primary Liver Cancer

目的调查初诊原发性肝癌手术患者心理弹性的现状,并探讨其影响因素。方法方便抽样选取2016年11月至2017年1月在上海市某三级甲等肝胆专科医院诊断为原发性肝癌、行手术治疗的患者为研究对象,应用自行设计的一般资料问卷、中文版Conner-Davidson心理弹性量表(Chinese version Connor and Davidson’s resilience scale,CD-RISC)、医学应对问卷(medical coping modes questionnaire,MCMQ)对其进行问卷调查,并分析调查结果。结果原发性肝癌手术患者心理弹性总分为(69.74±14.53)分,其中坚韧维度(36.09±8.13)分、自强维度(23.25±5.35)分、乐观维度、(10.41±2.69);应对方式总分为总分(44.03±5.63)分,其中面对维度(19.48±3.67)分、回避维度(16.23±2.85)分,屈服维度(8.31±2.64)分。不同文化程度、家庭人均月收入、职业、居住地的患者心理弹性水平,差异有统计学意义(P<0.05);多元回归分析显示,文化程度、职业、面对应对方式、屈服应对方式可预测肝癌手术患者的心理弹性水平(P<0.05)。结论原发性肝癌手术患者心理弹性水平较低,并受到多种因素的影响。临床护理工作中,应关注患者心理变化,采取积极有效措施,以降低肝癌手术患者心理压力,进而提高其生存质量。

Objective To investigate the psychological resilience status and influencing factors of patients primarily diagnosed of primary liver cancer(PLC).Methods Patients with primarily diagnosed of PLC and underwent surgery were selected by convenient sampling method,and patients were assessed by using self designed general questionnaire,Chinese version Connor and Davidson’s resilience scale(CD-RISC),medical coping modes questionnaire(MCMQ),the results were analyzed.Results The total score of resilience in PLC patients was(69.74±14.53),in which the dimension score of tenacity was(36.09±8.13),the score of self reliant was(23.25±5.35),and the score of optimism was(10.41±2.69).The total score of coping styles was(44.03±5.63),in which the dimension score of confrontation was(19.48±3.67),the score of avoidance was(16.23±2.85),the score of resignation was(8.31±2.64).There were significantly statistical differences in psychological resilience in patients with different educational levels,economic pressure,occupations,and residences(P<0.05).Multiple regression analysis revealed educational levels,occupations,coping style with avoidance,and coping style with resignation were predictor of psychological resilience(P<0.05).Conclusion Resilience of postoperative patients with PLC is in a lower level which is related with many factors.Nursing staffs should pay more attention to patients’psychological status,so as to take effective measures to eliminate their physiologic and improve their quality of life.