乳腺肿瘤患者围手术期疾病不确定感状况分析

Illness uncertainty analysis in perioperative patients with breast tumor

目的:调查乳腺肿瘤患者围手术期疾病不确定感状况,分析其影响因素。方法:采用Mishel疾病不确定感量表和一般情况调查问卷,对85例术前诊断不明确的乳腺肿瘤患者进行手术前、后疾病不确定感状况调查,根据术中病理分为良性病变和乳腺癌2组,对相关资料进行统计学分析。结果:术前疾病不确定感总分37～89分,平均(69.98±11.93)分,80%处于中等水平;术后总分27～78分,平均(49.26±11.19)分,21%处于中等水平。术前2组比较无差异,术后差异具有统计学意义(P<0.05)。不同年龄、学历层次和职业间比较无差异。结论:术前疾病性质不确定性和术后乳腺癌预后的不明确性是疾病不确定感的主要影响因素。对围手术期患者加强术前诊断的明确性,降低患者对手术的恐惧心理,术后对乳腺癌患者进行健康教育可有效降低疾病不确定感。

Objective： To investigate the status of illness uncertainty in perioperative patients with breast tumor and analyze the influence factors.Methods： The questionnaire was conducted with the Mishel Uncertainty in Illness Scale（MUIS） and a basic data.85 patients with unconfirmed breast tumor participated in this research.They were divided into two groups——the benign tumor and the mammary cancer based on the surgical results,and all of them were evaluated both before and after the operation with the questionnaire.Results： The total scores on illness uncertainty before the operation ranged from 37 to 89 with a mean score of（69.98±11.93）,80% of them showed moderate illness uncertainty,while after the operation it ranged from 27 to 78 with a mean score of（49.26±11.19）,21% of them showed moderate illness uncertainty.It showed no difference between the two groups before operation,but difference was significant after the surgery（P0.05）.Age,educational backgrounds and occupation have no influence on illness uncertainty of preoperative patients with breast tumor.Conclusion： The main influence factors of illness uncertainty in patients with breast tumor include the uncertainty of the tumor nature before the surgery and the prognosis after it.Medical workers should take the following methods to reduce illness uncertainty： enhancing the clarity of the diagnosis before the surgery,helping the patients coping with preoperative anxiety and implementing health education to the patients with mammary cancer after the surgery.