前列腺癌患者自我效能与急诊就诊频率的关系

Relationship between self-efficacy and frequency of emergency visits in patients with prostate cancer

目的探讨前列腺癌患者自我效能与急诊就诊频率的关系。方法选取2014年1月—2015年1月于江苏省徐州市肿瘤医院泌尿外科门诊就诊的前列腺癌患者105例。采用问卷调查法收集一般资料,应用医患相互作用自我效能感简表(perceived efficacy in patient-physician Interactions,PEPPI)评价患者的自我效能,电话随访患者急诊就诊次数。根据其是否存在急诊就诊经历,分成急诊就诊组和非急诊就诊组。采用生存曲线分析患者急诊就诊率,单因素t检验分析患者一般资料和PEPPI评分差异,将存在统计学差异的因素纳入多因素Cox回归分析;采用Spearman相关性分析研究患者急诊就诊次数与PEPPI评分的关系,比较两组患者PEPPI分值分布差异。结果随访期间,31例患者到急诊就诊,急诊就诊率31.0%;单因素分析显示,两组患者年龄、前列腺特异性抗原(prostate-specific antigen,PSA)、PEPPI评分、肿瘤直径、首次治疗方式、Gleason评分比较,差异均有统计学意义(P<0.05);多因素Cox回归进一步筛选,PEPPI评分、肿瘤直径、根治性手术方式、Gleason评分>7分对患者是否急诊就诊具有显著影响,且PEPPI评分的影响程度较大;相关性分析提示,急诊就诊组患者就诊频率与患者PEPPI评分存在负相关关系;两组患者PEPPI评分构成比差异较大。结论 PEPPI评分可能影响前列腺癌患者急诊就诊的概率,且其与急诊就诊频率呈负相关,自我效能高的患者急诊就诊频率低。临床可采取干预措施提高前列腺癌患者的自我效能,避免非急诊患者的急诊就诊,有利于急诊资源的合理利用。

Objective To explore the relationship between the self-efficacy and frequency of emergency visits in the patients with prostate cancer,and the influencing factors of emergency visits. Methods A total of 105 patients with prostate cancer in Xuzhou Cancer Hospital,Jiangsu Province were enrolled in the study from January 2014 to January 2015. The general clinical data and Perceived Efficacy in Patient-Physician Interactions（ PEPPI） score were collected by questionnaire. The frequency of emergency visits was obtained by telephone follow-up. According to the frequency of emergency visits,the patients were divided into emergency visit group and non-emergency visit group. The frequency of emergency visits was analyzed by survival curves and the differences in general information and PEPPI score were analyzed by single factor t test. Then the factors with significant difference were included in Cox regression analysis,and the relationship between the frequency of emergency visits and PEPPI score was analyzed by Spearman correlation analysis. Results During the follow-up,31 patients with emergency treatment were enrolled in the emergency visit group and the emergency visit rate was 31. 0%. Age,prostate-specific antigen（ PSA）,PEPPI score,tumor diameter,the first treatment,Gleason score were significantly different between the two groups（ P〈0. 05）. Cox regression analysis showed that the PEPPI score,tumor diameter,radical surgery,Gleason score 7 had significant influences on the emergency visit rate,and PEPPI score had great effects. The correlation analysis showed that the frequency of emergency visits was negatively correlated with PEPPI score. There was significant difference in PEPPI score between the two groups. Conclusion PEPPI score may have an adverse impact on the emergency visit rate in the patients with prostate cancer. The patients with high self-efficacy have lower frequency of emergency visits. Some intervention measures should be adopted to improve the patient self-efficacy,so as to avoid frequent emergency treatment.