基于认知适应理论的晚期癌症患者预立医疗照护计划准备度及影响因素研究

Readiness for advance care planning and its influencing factors among advanced cancer patients based on cognitive adaptation theory

目的探究晚期癌症患者预立医疗照护计划准备度水平及影响因素,为预立医疗照护计划的开展提供参考。方法以认知适应理论为指导,采用预立医疗照护计划准备度量表、中文版人生意义问卷、生活定向测验问卷修订版、益处发现量表、心理控制源量表修订版、自尊量表对安徽省4所三甲医院肿瘤科的355例晚期癌症患者进行调查。结果晚期癌症患者预立医疗照护计划准备度总分及态度、信念、动机维度得分分别为(76.00±10.07)、(33.10±6.48)、(17.82±2.76)、(25.10±4.03)。回归分析结果显示,人生意义、益处发现、自尊、病程及受教育程度是预立医疗照护计划准备度的预测因子(均P<0.01)。结论晚期癌症患者预立医疗照护计划准备度处于中等偏上水平,病程短、受教育程度低、人生意义感弱、益处发现及自尊水平较低者预立医疗照护计划准备度水平更低。

Objective To explore the readiness for advance care planning and its influencing factors among patients with advanced cancer,so as to provide reference for implementing advance care planning.Methods Based on cognitive adaptation theory,a total of 355 advanced cancer patients from oncology departments of 4 grade three hospitals in Anhui province were investigated using the Readiness for Advance Care Planning Scale,Chinese Meaning in Life Questionnaire,revised Life Orientation Test,Benefit Finding Scale,Multidimentional Health Locus of Control and Self-esteem Scale.Results The overall score of readiness for advance care planning and subscale score of attitude,belief and motivation was(76.00±10.07),(33.10±6.48),(17.82±2.76)and(25.10±4.03)respectively.Regression analysis result showed that,the meaning in life,benefit discovery,self-esteem,length of disease and educational background were predictors of readiness for advance care planning among advanced cancer patients(P<0.01 for all).Conclusion The readiness for advance care planning among advanced cancer patients is in a medium and above level,and those patients with short length of disease,low level of educational background,poor sense of meaning in life,poor benefit discovery ability and low self-esteem level are prone to suffer from low readiness for advance care planning.