中青年乳腺癌患者手术方式决策困境及影响因素研究

The level and determinants of conflict in decision making about breast cancer surgery among young and middle aged patients

目的了解中青年乳腺癌患者手术方式决策困境现状及其影响因素,为针对性干预提供参考。方法对198例住院拟行手术治疗的中青年乳腺癌患者,采用一般资料调查表、中文版决策困境量表和领悟社会支持量表进行问卷调查。结果患者决策困境总分(43.59±15.68)分,多元逐步回归分析结果显示,领悟社会支持量表中的家庭支持和其他支持、家庭人均月收入、年龄、文化程度和对疾病知识了解程度是患者决策困境的主要影响因素(调整R 2=0.783,P<0.05,P<0.01)。结论中青年乳腺癌患者手术方式决策困境程度较严重,宜从患者家庭及工作关系入手提高其社会支持水平,应特别重视年轻、文化程度较低、疾病知识不足等患者针对性决策信息的提供,从而降低决策困境。

Objective To investigate the level and determinants of decisional conflict in young and middle aged breast cancer patients to make decision for breast cancer surgery.Methods A total of 198 young and middle aged breast cancer patients to receive surgical management were investigated using a self-designed general information questionnaire,the Decisional Conflict Scale(DCS)and Perceived Social Support Scale(PSSS).Results The sample scored(43.59±15.68)points in decisional conflict.Multiple stepwise regression analysis showed that family support and other support in the PSSS,average monthly household income,age,educational attainment,and disease knowledge were predictors of decisional conflict in young and middle aged breast cancer patients(adjusted R 2=0.783,P<0.05,P<0.01).Conclusion Young and middle aged breast cancer patients reported severe decisional conflict in surgical choice.It is suggested to improve social support for patients from the perspective of family and work relationships,and provide consultation for those who are young,who have lower educational level and poor disease knowledge level,thus to reduce their decisional conflict.