胃肠道恶性肿瘤患者术前疾病不确定感与疾病症状的相关性研究

Study on the correlation between pre-operative uncertainty of the disease and the symptoms for patients with gastrointestinal cancer

目的探讨胃肠道恶性肿瘤住院患者术前疾病不确定感与疾病症状的相关性。方法采用方便取样法调查北京某三甲医院普通外科住院的胃肠道恶性肿瘤术前患者117例,问卷内容包括一般资料、中文版Mishel疾病不确定感量表(MUIS-A)、记忆症状评估量表(MSAS)。结果患者疾病不确定感总分为(74.79±8.88)分,具有较高的疾病不确定感水平,其中两个维度得分分别为:复杂性因素得分(27.53±4.42)分,不明确性因素得分(47.26±5.53)分,记忆评估症状评估量表(TMSAS)总分为(0.57±0.24)分,其中生理症状总分(PHYS)为(0.77±0.409)分,心理症状总分(PSYCH)为(0.70±0.57)分,整体困扰指数(GDI)总分为(0.73±0.39)分;疾病不确定感总得分与生理症状得分呈正相关(r=0.197,P<0.05),术前不确定因素总分与生理症状得分呈正相关(r=0.223,P<0.05),术前复杂性因素得分与TMSAS、PHYS、GDI得分均无相关(P>0.1)。结论胃肠道恶性肿瘤患者术前不确定感总分和不确定性维度与疾病生理症状呈正相关,提示护理工作者在术前应加强对患者生理症状的评估与护理,并根据患者病情进行疾病相关知识教育和心理护理,以降低患者的疾病不确定感。

Objective To investigate the correlation between pre operative uncertainty and the symptoms of the patients with gastrointestinal cancer. Method Using convenient sampling method, 117 patients with gastrointestinal malignant tumor from department of general surgery in grade three hospital in Beijing was selected for the study. The contents of the questionnaire included general information, the Chinese version of Mishel disease uncertainty scale （MUIS A） ,memorial symptom assessment scale（MSAs）. Results The disease uncertainty score was（74.79±8.88）. has a high level of uncertainty in illness,of which score for two dimensions as following：complexity factor score was （27.53±4.42） ,scores of uncertainty factors was（47.26±5.53） ,the total score of memory assessment symptom as sessment scale（TMSAS） was （0.57±0.24 ）, the physiological symptom score （PHYS） was （0. 77±0. 409 ）, mental symptom score （PSYCH） for（0.70±0.57） ,the overall distress index （GDI） score was（0.73±0.39）. Disease un certainty was positively correlated with the total score of physiology the symptom score （r=0. 197 ,P 〈 0.05）. Pre- operative uncertainty score was positively correlated with physiological symptoms score （r= 0. 223 ,P 〈 0.05）, pre operative complexity factor scores and TMSAS, PHYS,GDI scores were not related （P 〉 0. 1 ）. Conclusion The un-certain perception score, uncertainty dimensions and physiological disease symptoms for preoperative patients with gastrointestinal tract malignant tumor were positively correlated. It suggested that care workers should strengthen assessment and nursing care of patients with physical symptoms, and according to the patient＇s condition of disease related knowledge education and psychological nursing,in order to reduce the uncertainty in illness.