肿瘤患者化疗依从性相关影响因素Logistic回归分析

Logistic regression analysis of effects related factors in chemotherapy compliance of patients with cancer

目的探讨影响肿瘤患者化疗依从性的相关因素及对策。方法选择2011年1月～2012年10月唐山市人民医院及河北联合大学附属医院进行化疗的肿瘤患者270例，观察化疗依从性情况，比较依从性好与依从性差两组患者可能影响因素的差异，并且统计学分析。结果270例患者化疗依从性好210例（77．78％），依从性差60例（22．22％）：单因素检验显示不同文化程度、家庭庭支持、化疗不良反应、家庭经济、肿瘤及化疗知识、医疗费用支付方式、求医条件的患者化疗依从性差异有统计学意义（P〈0．05），Logistic回归分析影响肿瘤患者化疗依从性的独立因素为：缺乏肿瘤及化疗知识（OR=4．42，P=0．002）、化疗不良反应（OR=3．84，P=0．003）、不良心理反应（OR=3．22，P=0．014）、家庭经济差（OR=2．96，P=0．016）、缺少家庭支持（OR=2．87，P=0．017）。结论肿瘤患者化疗存在一定程度不依从性，影响因素复杂，应针对上述危险因素实施相应措施提高依从性：健康教育；积极预治不良反应；建立良好的社会支持系统；实施心理支持；制定合理的治疗方案。

Objective To investigate the relevant factors affecting chemotherapy compliance of cancer patients and its countermeasures. Methods From January 2011 to October 2012 in Tangshan People＇s Hospital and the Affiliated Hos- pital of Hebei United University, 270 cases of cancer chemotherapy patients were selected as observed objects. Chemotherapy compliance was observed, possible factors that might affect the chemotherapy compliance of two group patients were compared, and statistical analysis was conducted. Results In 270 patients, 210 patients （77.78%） with good compliance were found, 60 cases （22.22%） with poor compliance were found. The differences of chemotherapy compliance in patients with different level of education, family support, adverse reaction of chemotherapy, family econ- omy, cancer and chemotherapy knowledge, medical expenses payment, treatment conditions were statistically significant （P 〈 0.05）. Lack of cancer and chemotherapy knowledge （OR = 4.42, P = 0.002）, adverse reaction of ehemotherapy （OR = 3.84, P = 0.003）, bad psychological reaction （OR = 3.22, P = 0.014）, poor family economy （OR = 2.96, P = 0.016）, lack of family support （OR = 2.87, P = 0.017） were the independent factors affecting the chemotherapy compliance accord- ing to the Logistic regression analysis. Conclusion Tumor patients have certain degree of chemotherapy incomplianee, the influence factors are complex. To improve compliance, it is right to take corresponding measures of these risk fac- tors, such as health education, active prevention of adverse reactions, good social support system, psychological support, reasonable treatment plan.