诊断期乳腺癌患者病耻感现状及其影响因素的分析

Current status and influencing factors of stigma among breast cancer patients in diagnostic stage

目的了解诊断期乳腺癌患者病耻感现状及探讨其影响因素。方法选取广州市某三级甲等肿瘤专科医院108例诊断期乳腺癌患者,采用一般资料调查表、社会影响量表、一般自我效能量表进行横断面调查。结果诊断期乳腺癌患者病耻感得分(55.82±14.49)分,其中经济歧视维度均分最高(2.49±0.70)分。多重线性回归结果显示,医护人员对患者的支持、患者自我效能、配偶对患者的支持和医疗费自付是诊断期乳腺癌患者病耻感的重要影响因素,其可解释病耻感变异的56.10%。结论诊断期乳腺癌患者病耻感处于中等偏上水平,主要的影响因素为医护人员对患者的支持、患者自我效能、配偶对患者的支持以及医疗费支付方式。护理人员应在乳腺癌患者诊断期就应对患者及其配偶进行相关的健康宣教和心理疏导,鼓励其以积极乐观的心态面对疾病,根据患者的经济情况考虑诊疗方案等,以减轻患者的病耻感,有助于后续治疗的顺利开展。

Objective To investigate the level and influencing factors of stigma among breast cancer patients in diagnostic stage. Methods All 108 breast cancer patients in diagnostic stage were included to complete self-designed demographic questionnaires, social impact scale, general self-efficacy scale and medical coping modes questionnaires. Results The patients got an average score of middle level stigma (55.82±14.49), in which the dimension of "financial insecurity" was the highest (2.49±0.70). The influencing factors included healthcare givers' support to patients, self-efficacy, husbands' support to patients and self-pay proportion (adjR2=0.561). Conclusions The stigma of breast cancer patients started since the diagnostic stage and its level of breast cancer patients in diagnostic stage was at a middle level. Clinical nurses should implement related care interventions before treatment, give patients and her husband more support to improve patients' self-efficacy and consider more about patients' economic burden when choosing treatment plans.