^131I治疗期间甲状腺癌患者未满足的照顾需求分析

Analysis of unmet supportive care needs in patients with thyroid cancer during ^131I treatment

目的探讨甲状腺癌患者在接受^131I治疗期间未满足的照顾需求及其与心理痛苦和生活质量的关系。方法对2014年10至2016年3月间338例[男106例、女232例，平均年龄（35.50±9.98）岁]正接受^131I治疗的甲状腺癌患者进行问卷调查，采用34项支持性照顾需求问卷（SNCS－SF34）调查患者未满足的照顾需求，采用心理痛苦温度计（DT）及问题清单获得患者感知的痛苦程度及引起痛苦的主要原因，采用简易健康生活质量问卷（SF－12）测量患者的生活质量。采用Person相关分析处理数据。结果患者照顾需求未满足程度由高到低分别为：健康信息需求（65.38%，221/338）、心理需求（47.93%，162/338）、患者照顾与支持需求（44.08%，149/338）、躯体与日常生活需求（36.09%，122/338）及性需求（34.32%，116/338）。47.93%（162/338）的患者痛苦程度显著（评分〉4分），导致痛苦的前3位原因分别为担忧、疲乏及记忆力下降。照顾需求未满足程度与心理痛苦程度呈正相关（r值：0.232～0.462,均P〈0.01），患者的躯体与日常生活需求及心理需求未满足程度分别与多个生活质量维度呈负相关（r值：－0.367～－0.202，均P〈0.05）。结论甲状腺癌患者未满足的照顾需求与其心理痛苦及生活质量有关，据此可为制定针对性护理措施提供指导。

ObjectiveTo investigate the unmet needs of thyroid cancer patients undergoing 131I treatment and their relationship with psychological distress and quality of life.MethodsFrom October 2014 to March 2016, a total of 338 patients （106 males, 232 females, average age （35.50±9.98） years） with thyroid cancer who were receiving 131I treatment were enrolled. The 34 items of Supportive Care Needs Survey Short Form （SNCS-SF34） were used to investigate the unmet care needs of patients. Patients′ perceptions of distress and main causes of distress were measured by Distress Thermometers （DT） and issue list. The 12-item Short-Form Health Survey （SF-12） was used to measure patients′ quality of life. Pearson correlation analysis was used to analyze the data.ResultsThe degrees of patients′ unmet care needs from high to low were as following： health information needs （65.38%, 221/338）, psychological needs （47.93%, 162/338）, patients′ care and support needs （44.08%, 149/338）, physical and daily needs （36.09%, 122/338） and sexual needs （34.32%, 116/338）. There were 47.93%（162/388） patients with DT score 〉4. The top three causes of patients′ distress were fears, fatigue and memory deterioration. Degree of unmet needs for patients had positive correlation with the degree of psychological distress （r values： 0.232-0.462, all P〈0.01）. The unmet physiological and daily needs and psychological needs of patients had negative correlations with several dimensions of quality of life （r values： from -0.367 to -0.202, all P〈0.05）.ConclusionsThe unmet care needs of patients with thyroid cancer have correlations with their psychological distress and quality of life. Evaluation of the unmet care needs of patients with thyroid cancer could be beneficial for providing the targeted care.