乳腺癌术后患者支持性照护需求的纵向研究

A longitudinal study on the status and influencing factors of patients'supportive care needs after breast cancer surgery

目的了解乳腺癌患者手术后不同阶段支持性照护需求现状及影响因素,为制定不同阶段支持性照护干预方案提供依据。方法采用癌症患者支持性需求简明问卷对初次确诊的126例乳腺癌患者分别在手术后第3天、第14天、1个月、3个月、6个月进行调查。结果乳腺癌术后患者支持性照护需求在术后第14天得分最高,自术后1个月后逐渐下降。不同特征乳腺癌患者术后6个月支持性照护需求比较,差异无统计学意义(均P>0.05)。不同阶段乳腺癌手术后患者支持性照护需求的主要影响因素包括医疗服务满意度、包块部位、主要照顾人员、职业、对疾病了解程度、获取疾病知识的主要途径、业余爱好、肿瘤类型(P<0.05,P<0.01)。结论初次诊断乳腺癌患者手术后各阶段均存在支持性照护需求,且各维度随着时间的推移呈动态变化,建议医务人员进一步加强对患者的健康信息及支持照护指导,并针对主要影响因素与照顾者共同制订有效的干预措施,满足患者不同阶段的支持性照护需求。

Objective To understand the status of supportive care needs in patients with breast cancer at different stages after surgery,to explore the factors affecting the changes of their supportive care needs,and to provide basis for stage-specific supportive care intervention programs for patients with breast cancer.Methods A total of 126 patients with primary diagnosis of breast cancer was investigated by using the Supportive Care Needs Survey questionnaire for Cancer Patients at the time points of 3 days,14 days,1 month,3 months and 6 months post-operation.Results The total score of supportive care needs in breast cancer patients peaked on 14 days post-operation,then flattened up,and gradually decreased since 1 month post-operation.At 6 months post-operation,total score of breast cancer patients'supportive care needs showed no significant differences by various factors(P>0.05 for all).Multiple linear regression analysis revealed that breast cancer patients'supportive care needs after surgery were mainly influenced by such factors as medical service satisfaction,the location of tumor mass,major caregivers,occupations,patient knowledge of diseases,disease-related knowledge acquisition,hobbies,and types of breast cancer(P<0.05,P<0.01).Conclusion Breast cancer patients'supportive care needs after surgery changed dynamically over time.Medical staff were suggested to further strengthen health information and support care guidance for patients,develop with caregivers effective interventions which should be based on key influencing factors,so as to satisfy patients'supportive needs at different stages.