原发性肝癌患者心理弹性现状及影响因素分析

Primary liver cancer patients’psychological resilience statue and analysis of the influencing factors

目的了解原发性肝癌患者心理弹性的现况,分析心理弹性与人口学特征、疾病特点、应对方式、人格特质、自我效能、家庭关怀的关系,探索影响原发性肝癌患者心理弹性的主要因素。方法选取2018年1—12月在上海某三甲专科医院住院治疗的377例原发性肝癌患者,使用中文版心理弹性量表(CD-RISC)、简易应对方式问卷、大五人格量表、自我效能感量表和家庭关怀度指数量表进行调查,应用多元线性回归分析原发性肝癌患者心理弹性的主要影响因素。结果377例患者心理弹性得分平均57.66±18.02分。相关性分析结果显示:积极应对、消极应对、人格外倾性、宜人性、责任感、开放性、自我效能、家庭关怀度与患者心理弹性呈正相关(P<0.05);人格神经质与患者心理弹性呈负相关(P<0.001)。多元线性回归分析结果显示:自我效能、积极应对、人格外倾性、家庭关怀度、责任感为影响患者心理弹性的主要因素(P<0.05)。结论原发性肝癌患者心理弹性水平偏低。无职业、文化程度低、家庭人均月收入低、非手术治疗的患者心理弹性较低。临床护理人员应加强该人群的心理状态评估,早期识别心理弹性水平低的患者,护士应指导患者采用积极应对方式,激励患者的自我效能,鼓励家属给予患者足够的家庭关怀,共同促进患者心理弹性水平的提高。

Objective To explore the primary liver cancer patients’psychological resilience statue,analyzed the relationship between the psychological resilience and demographic characteristics,disease characteristics,coping style,personality traits,self-efficacy,family care,found out the mainly effect factors of the primary liver cancer patients’psychological resilience.Methods To select 377 liver cancer hospitalized patients admitted in a Shanghai class A specialized hospital from January to December 2018,research was underwent by using the Connor-Davidson resilience scale(CD-RISC)in Chinese version,simplified coping style questionaire,big five personality scale,general self-efficacy scale and family APGAR index,the multiple linear regression was applied to find out the main influencing factors of the primary liver cancer patients’psychological resilience.Results The average psychological resilience score of 377 patients was 57.66±18.02,Correlation analysis results showed that:positive coping,negative coping,personality extroversion,agreeableness,sense of responsibility,openness,self-efficacy,family care and the patients’psychological resilience were positive correlation(P<0.05),Personality trait showed that negative correlation with the patients’psychological resilience(P<0.001).The multiple linear regression showed that self-efficacy,positive response,personality extroversion,family care and responsibility were the main factors effect the the patients’psychological resilience(P<0.05).Conclusion The psychological resilience level of the primary liver cancer patients was low.Unemployed,low educated level,low average monthly income,non-surgical treated patients’psychological resilience were low.Clinical nursing staffs should strengthen the physical statue assessment of those patients,identified early those patients with the low level psychological resilience,the nurses should guide the patients to cope positively,stimulate the patients’selfefficacy,encourage the family members offer the patients more care,promote the patients’psychological resilience together.