影响肝癌患者动脉化疗栓塞术后自我管理效能感的多因素分析

Multi-factor Analysis of Self-care Efficacy for PHC Patients by Transcatheter Arterial Chemoembolization

目的探讨肝癌患者动脉化疗栓塞术后的自我管理效能感的现状和相关因素,为医务人员制定肝癌患者自我管理项目的内容提供依据。方法方便抽取2013年10月—2014年6月149例苏州和南通地区2家三级甲等医院住院的行肝动脉化疗栓塞术后的肝癌患者进行调查,发放调查问卷,应用一般资料调查表、中文版癌症患者自我管理效能感量表、肝癌患者生活质量评价量表、记忆症状评估量表和社会支持量表,进行单因素方差分析和多元逐步线性回归分析。结果肝癌患者的自我管理效能感总体处于中低水平,其中生活质量总分、介入治疗次数、生理症状、美国东部肿瘤协作组体能评分和社会支持总分共5个变量,是患者自我管理效能感总分的影响因素;生活质量总分、美国东部肿瘤协作组体能评分、介入治疗次数、生理症状、社会支持总分是正性态度维度的影响因素;生活质量总分、文化程度、白细胞值和有无接受健康培训是自我决策维度的影响因素;生活质量总分、有无接受健康培训状况和生理症状是自我减压维度的影响因素。结论肝动脉化疗栓塞术后肝癌患者自我管理效能感水平较低,各维度以及总自我管理效能感分别与不同的因素有关,医护人员应重视影响其自我管理效能感不同维度间的因素,为今后制定出适合肝癌患者自我管理项目的内容和措施提供理论依据。

Objective To explore the current status of self-care efficacy and correlated factors of primary hepatic carcinoma（PHC）patients by transcatheter arterial chemoembolization and to provide theoretical suggestions for PHC patient self-management program.Methods With convenience sampling in October 2013- June 2014, 149 cases of PHC patients received questionnaire survey by general information questionnaire, Strategies Used by People to Promote Health（SUPPH）, Quality of life-Liver cancer2.0（QOL-LC2.0）,Memorial Symptom Assessment Scales（MSAS） and Social Support Scale and one-way analysis of variance and multiple regression analysis were carried on. Results The level of self-efficacy was low and moderate. Quality of life, interventional treatment times,physical symptoms, ECOG physical ability scores and social supports entered the model and were influencing factors of self-care efficacy. Quality of life, ECOG physical ability scores, interventional treatment times, physical symptoms, social support were the influencing factors of positive attitude. Quality of life, educational background, blood leukocyte value and with training on health or not were influencing factors of decision-making. Quality of life, with training on health or not and physical symptoms were the influencing factors of stress reduction. Conclusion The self-efficacy of self-management of PHC patients by transcatheter arterial chemoembolization is low and scores different dimensions and the total scores relate respectively to different factors. Great importance should be attached to the influence factors to make quality self-management program for PHC patients in the future.