结直肠癌患者术前疾病不确定感的影响因素分析及治疗性沟通护理的意义

The Uncertainty of Colorectal Carcinoma Patients in Illness:An Analysis on Influencing it Factors,and the Significance of Implementing Therapeutical Communication Nursing

为分析结直肠癌患者术前疾病不确定感的影响因素,并探讨治疗性沟通护理对患者疾病不确定感的影响,选择于我院接受手术治疗的190例结直肠癌患者作为观察对象,入院当天采用Mishel疾病不确定感量表(MUIS)对患者疾病不确定感情况进行评分,并分析不同结直肠癌患者疾病不确定感之间的差异;同时将190例患者随机分为对照组和观察组,各95例,对照组患者接受常规护理,观察组在对照组基础上接受治疗性沟通护理,比较2组患者护理干预前后的疾病不确定感情况。结果显示,1)190例患者入院时MUIS评分低等水平2例(1.05%),中等水平170例(89.47%),高等水平18例(9.47%)。2)不同性别、年龄、婚姻状况、病变部位的结直肠癌患者的疾病不确定感总分及不明确性、复杂性、信息缺乏、不可预测性各维度评分比较差异均无统计学意义,P>0.05;不同文化程度、收入水平、性格、付费方式的结直肠癌患者疾病不确定感总分及各维度评分比较差异均有统计学意义,P<0.05。3)2组患者护理干预前疾病不确定感总分及各维度评分比较差异均无统计学意义,P>0.05;护理干预后,观察组疾病不确定感总分及各维度评分均明显低于对照组,P<0.05。结果表明,结直肠癌患者普遍存在中等水平的疾病不确定感。文化程度低、收入水平低、性格内向、自费者疾病不确定感强。治疗性沟通护理能降低结直肠癌患者术前疾病不确定感。

This study was to analyse the factors influencing patient’s uncertainty in their colorectal carcinoma before surgery,and to explore the role of implementing therapeutical communication nursing on their uncertainty,enrolled 190 cases surgically treated in author’s hospital as observation objects:on the day of admission to assess patients’uncertainty,to analyse patients’difference of the feeling;at the same time to divided them into control group(95 cases,received routine nursing)and observation group(95 cases,routine nursing combined with therapeutical communication nursing);then compared both groups’patients’uncertainty status.As results,1)on the day of admission 2 cases lied low-level MUIS score(1.05%),170 lied mid-level one(89.47%),18 lied high-level one(9.47%);2)in the total rating on uncerbainty,as well in the score rating on the dimensions as uncertainty,complexity,information absence and unpredictability,etc there were no statistical difference between the patients with different gender,age,marriage situation,and lesion sites of cancer(P>0.05);but there were statistical differences between the patients with different educational levels,income levels,disposition,and types of payment(P<0.05);3)before intervention in above comparisons there were no statistical difference,but after intervention the total ratings of uncertainty,and the score ratings of all dimensions in observation group were significantly lower than that in control group(P<0.05).Results show that generally,colorectal carcinoma patients have mid-level of uncertainty,and who with low educational level,low income levet,be introverted by nature,and at whose own expence have strong uncertainty;implementing therapeutical communication nursing can decline this undertainty.