乳腺癌患者术后满意度影响因素的有序logistic分析

Ordinal logistic regression analysis of breast cancer patient satisfaction after operation

目的研究社会人口学及临床因素与乳腺癌患者术后满意度的关系。方法随机选取2004年1月至2006年1月天津肿瘤医院收治的500例Ⅰ-Ⅱ期乳腺癌患者进行横断面问卷调查。患者在本院完成保乳手术或改良根治术，年龄24～75岁，平均48．5岁。采用乳腺癌患者一般情况调查表进行问卷凋查，用有序logistic回归分析与患者术后恢复满意度有关的社会人口学（包括年龄、收入、文化程度等）及临床相关因素。结果量表的回收率是97．6％，有效的量表468份。手术方式是患者术后形体满意度的影响因素（P〈0．05）；在上肢恢复情况方面，收入（P〈0．05）和手术方式（P〈0．05）是重要的影响因素：结论保乳手术后患者的形体和上肢恢复满意度均高于根治术患者，另外收入水平通过影响患者对治疗方式的选择而间接影响患者的上肢恢复情况；应针对这些因素采取进一步的措施以提高患者术后的满意度。

Objective To evaluate the clinical and social factors associating with postoperative satisfaction level in breast cancer patients. Methods A cross-sectional questionnaire survey was conducted. A total of 500 stage Ⅰ-Ⅱ breast cancer patients treated with breast conservation therapy（BCT） or modified radical mastectomy aged 24 - 75 years （ mean, 48.5 years） between January 2004 and January 2006 were selected from Tianjin Cancer Hospital for the study. They were asked to fulfill the general condition questionnaires. Ordinal logistic regression was used to analyze the factors that may affect the postoperative satisfaction level. Results The return rate of the questionnaires was 97, 6% and the effective ones were 468 copies. The operative methods were found to be statistically significant in the aspect of body configuration（ P 〈 0.05）. The operative methods （P 〈 0.05） and income （ P 〈 0.05 ） were found to be statistically significant in the aspect of upper extremity symptoms improvement. Conclusions In general, the patients undergoing BCT are much more satisfied with postoperative body configuration and upper extremity symptom improvement than the patients undergoing modified radical masteetomy. Patientg economic status has great effect on arm function recovery after operation. Therefore, further measures are needed to improve breast cancer patient satisfaction.