行125I粒子植入术后出院肿瘤患者放射防护自我管理及其影响因素分析

Self-management and the influencing factors of discharged patients with cancer after 125I seeds implantation

目的调查行125I粒子植入术后出院肿瘤患者的自我管理现状并分析其影响因素,为此类患者出院后的延续性护理指导提供参考。方法于2018年3—4月采用方便整群抽样抽取半年内在北京大学第三医院肿瘤放疗科行125I粒子植入术后的、符合纳入标准的院外肿瘤患者,应用自设的放射性防护知识及自我管理行为评价问卷通过电话回访及病案查阅收集资料,该问卷自设部分请2名粒子组医师、2名副主任护师及1名学院副教授对其进行内容效度评价,问卷总数为72份,共收回72份有效问卷。应用SPSS 21.0统计学软件进行数据的录入和分析。结果行125I粒子植入术后肿瘤患者的院外放射防护知识得分为(3.33±1.22)分,满分5分;放射防护自我管理得分为(27.40±9.47)分,满分44分;家中有铅衣患者的自我管理总分高于无铅衣患者(t=5.51,P<0.001);医保患者的放射防护自我管理水平高于自费患者(t=2.15,P<0.05);不同家庭状况经济患者自我管理得分差异有统计学意义(F=-4.41,P<0.05);放射防护知识与放射防护自我管理行为得分呈正相关关系(r=0.544,P<0.001)。多重线性回归分析显示,家庭经济状况、放射防护知识总分、是否有铅衣是125I粒子植入术后出院肿瘤患者放射防护自我管理水平的主要影响因素(P<0.05)。结论行125I粒子植入术后肿瘤患者的院外放射防护知识及放射防护自我管理能力均处于中等水平;是否自备铅衣、家庭经济收入、放射防护知识水平等是影响其放射防护自我管理的重要因素。医护人员应向患者宣教放射的危害与防护,提高患者的放射防护认知,鼓励患者购买铅衣,以达到更好的放射防护自我管理水平。

Objective To investigate the status of self-management of discharged patients after radioactive 125I seeds implantation and analyze the possible influencing factors,so as to provide reference for postoperative continuous nursing guidance.Methods From March to April 2018,convenient cluster sampling was used to select out of hospital tumor patients who met the inclusion criteria after 125I seed implantation in the Department of Radiation Oncology of Peking University Third Hospital within half a year.The self-designed Radiation Protection Knowledge and Self-management Behavior Evaluation Questionnaire was used to collect data through telephone follow-up and medical record review.In the self-designed part of the questionnaire,2 particle group doctors and 2 deputy directors and 1 associate professor was invited to evaluate the content validity of the questionnaire.The total number of questionnaires was 72 and 72 valid questionnaires were collected.SPSS 21.0 statistical software was used for data entry and analysis.Results After 125I seed implantation,the patients'knowledge score of radiation protection outside hospital was(3.33±1.22)with a full score of 5;the self-management score of radiation protection was(27.40±9.47)with a full score of 44;the total self-management score of patients with lead-free clothing was higher than that of patients with lead-free clothing(t=5.51,P<0.001);the self-management level of radiation protection of medical insurance patients was higher than that of self paid patients(t=2.15,P<0.05);family economic pressure was the influencing factor of self-management of radiation protection(F=-4.41,P<0.05);the knowledge of radiation protection was positively correlated with self-management behavior of radiation protection(r=0.544,P<0.001).Multivariate linear regression analysis showed that,the family economic incorne,the total score of radiation protection knowledge,and whether they have their own lead clothing were the main influencing factor of discharged patients with cancer after 125I seeds implantation(P<0.05).Conclusions The knowledge of radiation protection outside the hospital and the ability of self-management of radiation protection of the patients after 125I seed implantation are medium level.The important factors influencing the self-management of radiation protection of the patients after seed implantation are whether they have their own lead clothing,family economic income,and the cognitive level of radiation protection.In order to achieve better self-management level of radiation protection,medical staff should educate patients about the hazards and protection of radiation,improve patients'awareness of radiation protection,and encourage patients to buy lead clothing.