喉癌患者术后领悟社会支持及相关影响因素分析

The perceived social support and its predictors in laryngeal cancer patients after surgery

目的：探讨喉癌患者术后社会支持现状、变化趋势及相关影响因素。方法：以2012年1月至2015年1月我院接受喉癌手术治疗的患者为对象,用领悟社会支持量表分别于术前、术后1个月,6个月和12个月进行测评。共173例患者实现完全随访。采用重复测量设计的方差分析评估变化趋势。结果：与术前比较,术后1个月社会支持总得分无明显变化,但随后得分明显下降（F=67.4,P〈0.01）。3个分量表也呈相似的变化趋势,来自家庭（F=27.8,P〈0.01）、朋友（F=43.8,P〈0.01）及其它人（F=58.2,P〈0.01）的支持在1个月后明显下降。Logisitc回归分析表明,无配偶（OR=1.75,95%CI：1.45～5.77）、全喉切除术者（OR=2.04,95%CI：1.44～7.13）及术后并发症较多者（OR=2.59,95%CI：1.48～5.27）社会支持水平明显较低。结论：喉癌患者术后社会支持水平随时间而明显下降,提高社会支持水平应成为术后康复计划的重要内容。

Objective： To investigate the variation of social support and its predictors in postoperative laryngeal cancer patients.Methods： Patients who were admitted to our hospital for laryngeal cancer operation between January 2012 and January 2015 were legible for the present study. The perceived social support scale（ PSSS） was employed to examine the level of social support during hospitalization 1month,6 months and 12 months after surgery. A total of 173 patients were followed at each weave of measurement. The oneway repeated measurement ANOVA was used to analyze the trend of social support with time. Results： There was no significant variation of the level of social support at 1 month after surgery with reference to that during hospitalization,however,a marked decreasing trend was observed since then（ F = 67. 4,P〈0. 01）. Similarly,the scores of the three subscales including family,friends and significant others showed obvious decrease 1 month after surgery. Analysis of logistic regression indicated that factors like no spouse,patients with total laryngectomy or with complications negatively predicted the level of social support. Conclusion： Laryngeal cancer patients acquire decreased social support after surgery. It should be one of the key components of rehabilitation program to improve the level of social support for postoperative laryngeal cancer patients.