肝硬化患者医学应对方式的调查分析

Investigation and analysis of medical coping styles in patients with liver cirrhosis

目的探讨肝硬化患者的医学应对能力现状以及相关影响因素。方法采用随机抽样的方法,选取北京佑安医院住院的138例肝硬化患者。应用医学应对问卷(MCMQ)进行调查。结果回收有效问卷131份,有效率94.9%。与常模得分比较,肝硬化患者的面对因子得分低于常模[(16.90±2.22)vs.(19.48±3.81),P=0.003)],回避因子和屈服因子得分高于常模[分别为(15.51±2.08)vs.(14.44±2.97),P=0.000;(13.59±1.51)vs.(8.81±3.17),P=0.000]。单因素分析显示,文化程度对应对方式中回避因子有影响(P=0.005),收入状况对应对方式中回避因子有影响(P=0.013),年龄对应对方式中的屈服因子有影响(P=0.017)。多元回归分析结果显示,文化程度和收入状况对回避因子的影响有统计学意义(r=0.09,P=0.016;r=0.04,P=0.030)。年龄对屈服因子的影响有统计学意义(回归系数=0.24,P=0.020)。结论肝硬化患者更易于采取消极的应对方式,尤其是文化程度较低及收入水平较差的患者,提示临床护理人员应积极采取个性化认知行为干预,纠正患者消极应对方式,提高疾病的自我管理能力。

Objective To study the medical coping styles and related influencing factors in patients with liver cirrhosis. Mehtods A total of 138 patients with liver cirrhosis in Beijing You＇ an Hospital were randomly enrolled. The pa- tients were surveyed with medical coping modes questionnaire （MCMQ）. Results Compared with the norm, patients had lower scores in the face-to-face coping than the norm [（16.90±2.22） vs. （19.48±3.81）, P = 0.003）] and had higher scores in avoiding and yielding coping than the norm [（15.51±2.08） vs. （14.44±2.97）, P = 0.000; （13.59±1.51） vs. （8.81±3.17）, P = 0,000]. Single factor analysis showed that education levels and income condition had impact on the avoidance factors in the coping style （P = 0.005, P = 0.013）, age had influence on the yield factor in coping style （P = 0.017）. A multiple regression test showed that education levels and income condition had influence on the avoidance factors in the coping style （r = 0.09, P = 0.016; r=0.04, P = 0.030, respectively）, age had influence on the yield factor in coping style （r=0.24, P = 0.020）. Conclusion Patients with cirrhosis are more likely to adopt passive coping styles, especially for patients with low educa- tional level and low income. It is suggested that clinical nurses should adopt individualized cognitive behavior interven- tion to correct the negative coping style and improve self-management ability for the patients.