食管癌患者围术期疾病不确定感和焦虑水平的关系分析

Correlation analysis of anxiety levels and illness uncertainty caused by esophageal cancer during perioperative period

目的：探讨食管癌患者围术期疾病不确定感、焦虑状况以及疾病不确定感与焦虑两者之间的相关性。方法选取2012年3月—2013年9月行食管癌切除术的患者90例为研究对象,采用疾病不确定感量表和住院患者焦虑自评量表对其进行问卷调查。结果食管癌患者围术期对疾病的不确定感评分处于中等水平,术前、手术日及术后3 d疾病不确定感的总分分别为（108.43±13.51）,（106.89±11.97）,（98.57±12.48）分；患者的年龄、性别及文化水平对疾病不确定感总分差异有统计学意义（P〈0.05）；焦虑得分为（70.48±16.92）分；其疾病不确定感中的不明确性（r=0.401,P〈0.05）、复杂性（r=0.217,P〈0.05）、不连贯性（r=0.634,P〈0.05）、疾病不确定感总分为（r=0.352,P〈0.05）与焦虑呈正相关,而不可预测性与焦虑不相关（r=0.142,P〉0.05）。结论食管癌患者围术期存在较高程度的疾病不确定感和焦虑情绪,且两者之间存在正相关。护理人员采取有效措施干预患者疾病不确定感可改善患者焦虑的情绪状态,提高护理质量。

Objective To investigate anxiety levels and illness uncertainty caused by esophageal cancer during perioperative period, and to analyze the correlation between them. Methods A total of 90 patients with esophageal carcinectomy were selected in our hospital from March 2012 to September 2013 as sample, and were investigated with Mishel′s uncertainty in illness scale （ MUIS ） and Zung′s self-rating anxiety scale （ SAS ） . Results The MUIS level of esophageal carcinoma patients was medium. Total score of MUIS in preoperative, operative and 3 days of postoperative were （108. 43 ± 13. 51）, （106. 89 ± 11. 97） and （98. 57 ± 12. 48）; patient′s age, gender and educational level had significant differences impacting on illness uncertainty （P〈0. 05）. The total score of anxiety was （70. 48 ± 16. 92）. The score of SAS was positively correlated with the total score of unclarity in illness （r=0. 352,P〈0. 05）, with uncertain of illness （r=0. 401,P〈0. 05）, with complexity （r=0. 217,P〈0. 05）, with incoherence （r=0. 634,P〈0. 05）, and with unpredictability （r=0. 142,P〉0. 05）. Conclusions Esophageal cancer patients in perioperative period shows a high level uncertainty of illness and anxiety, and there is a positive correlation between the two. Nurses should take effective measures to improve the uncertainty of illness and anxiety states for patients, and to improve the quality of care.