以自我效能理论为指导护理干预对鼻咽癌患者自我效能水平变化趋势的影响

Effect of intervention based on self-efficacy theory on the fluctuation of self-efficacy level in patients with nasopharyngeal carcinoma

目的 探讨基于自我效能理论的干预措施对鼻咽癌患者自我效能水平变化趋势的影响.方法 将2009年6月至2010年9月广西医科大学第一附属医院放疗科收治的240例鼻咽癌患者作为研究对象,2009年6月至2010年1月收治的120例患者为对照组,2010年2-9月收治的120例患者为观察组.对照组患者给予常规治疗护理;观察组患者给予常规治疗护理＋自我效能理论为指导的干预措施.于不同治疗时段即治疗前、放疗1～10d、11～20d、21 d至结束分别采用一般自我效能感量表（GSES）评估两组患者的自我效能水平.结果 干预后观察组患者在放疗1～10d,放疗11 ～20d,放疗21 d至结束的自我效能水平评分分别为（29.62±3.20）,（28.68 ±2.65）,（29.25±2.73）分,均优于对照组患者的（26.98±3.16）,（25.19±3.62）,（24.28 ±3.31）分,差异有统计学意义（t分别为6.415,8.520,12.680;P ＜0.05）.对照组自我效能水平随着治疗进程的推进呈下降趋势,观察组患者自我效能水平呈先上升后下降,最后又上升的趋势;干预后两组组内不同治疗时段自我效能评分也不同,且观察组自我效能水平均较对照组高,差异有统计学意义（F分别为108.966,30.464;P ＜0.05）.结论 以自我效能理论为指导的干预措施能有效提高鼻咽癌患者自我效能水平,对鼻咽癌患者自我效能水平变化趋势起到积极影响作用.

Objective To discuss the influence of intervention based o self-efficacy theory on the fluctuation of self-efficacy level in patients with nasopharyngeal carcinoma.Methods Two hundred and forty patients with nasopharyngeal carcinoma who were treated in radiotherapy department in the First Affiliated Hospital of Guangxi Medical University from Jun 2009 to Sept 2010 were chosen as the objective of this study.120 patients from Jun 2009 to Jan 2010 were the control group while 120 patients from Dec 2010 to Sept 2010 were the observation group.The control group was given conventional nursing while the observation group received intervention based on self-efficacy theory in addition.Patients＇ self-efficacy level was evaluated before,1-10 days after,11-20 days after and 21 days to the end of the treatment.Results The self-efficacy level was respectively（29.62 ± 3.20）,（28.68 ± 2.65） and （29.25 ± 2.73） 1-10 days after,11-20 days after and 21 days to the end of the treatment in the observation group,better than （26.98 ± 3.16）,（25.19 ± 3.62） and （24.28 ± 3.31） in the control group,and the differences were statistically significant （t =6.415,8.520,12.680,respectively; P ＜ 0.05）.Self-efficacy level showed a descending trend in the control group during the process of tteatment,but first increased and then dropped but increased at last in the observation group.After intervention,patients＇ self-efficacy level was also different between two groups during different periods,and was better in the observation group than in the control group,with statistically significant differences （F =108.966,30.464,respectively; P ＜ 0.05）.Conclusions Intervention based on self-efficacy theory can improve the self-efficacy level in patients with nasopharyngeal carcinoma and plays a positive role on the fluctuation of self-efficacy level in patients with nasopharyngeal carcinoma.