乳腺癌术后化疗患者赋权水平现状及其影响因素的横断面研究

Influence factors of empowerment in patients with breast cancer during postoperative chemotherapy

目的了解乳腺癌术后化疗患者赋权水平现状,并分析其影响因素,为医护人员开展赋权教育提供理论依据。方法应用横断面研究方法,通过便利抽样法,抽取长沙市某2所三级甲等综合医院和1所专科肿瘤医院住院的350例女性乳腺癌术后化疗患者作为研究对象,采用一般资料问卷、乳腺癌赋权量表(breast cancer empowerment scale,BCES)、乳腺癌幸存者自我效能感量表(breast cancer survivors self-efficacy scale,BCSES)、中文版领悟社会支持量表(Chinese version of perceived social support scale,CV-PSSS)和住院患者感知护理服务质量评价量表对患者进行问卷调查。使用多重线性回归分析法探讨术后化疗患者赋权水平的影响因素。结果乳腺癌术后化疗患者赋权水平总分为(90.22±20.19)分,处于中等偏高水平,3个维度得分由低至高依次为内在资源的应用、健康管理行为和社会支持的利用。多重线性回归结果表明,合并慢性病(B=-3.804)、自我效能感(B=1.147)、领悟社会支持(B=0.367)和感知护理服务质量(B=0.216)是赋权行为水平的独立影响因素(均P<0.05),共能解释因变量61.1%的变异。结论乳腺癌术后化疗患者赋权行为尚可,但在外貌以及人生目标、健康管理方面表现为信心不足;合并其他慢性病、自我效能低的患者其赋权行为较差;社会支持、感知护理服务质量越好者其赋权行为越好。医护人员可从患者疾病因素、心理状态、家庭支持等多方面考虑,提供更多专业支持和情感支持,以提高其赋权水平。

Objective To study the status quo of empowerment level of breast cancer patients during postoperative chemotherapy and investigate its influencing factors as so to provide theoretical basis for healthcare workers to carry out empowerment education.Methods A cross-sectional study was conducted among 350 breast cancer patients with postoperative chemotherapy from 2 general hospitals and 1 specialised hospital in Changsha by convenience sampling.General information questionnaire,breast cancer empowerment scale(BCEQ),breast cancer survivors self-efficacy scale(BCSES),the Chinese version of perceived social support scale CV-PSSS)and inpatient perceived nursing service quality rating scale were used in the investigation.Multiple linear regression analysis was used to explore the influencing factors of the empowerment of patients during postoperative chemotherapy.Results The total score of empowerment level was(90.22±20.19),at medium to high level.The three dimensions based on scores,from low to high,were the application of internal resources,the health management behaviour and the use of social support.The results of multiple linear regression showed that chronic diseases(B=-3.804),self-efficacy(B=1.147),perceived social support(B=0.367)and perceived nursing service quality(B=0.216)were the independent influencing factors of empowerment behaviour(P<0.05).They explained 61.1%of the variation of the dependent variable.Conclusions The empowerment behaviour is in average level among the patients undergoing chemotherapy after breast cancer surgery.The patients are lack of the confidence in appearance,self-recognition and goals of life and have poor empowerment behaviour while suffered complications from other chronic diseases and at lower level of self-efficacy.Therefore,healthcare workers should provide more professional and emotional supports to improve the empowerment level from the respects of the disease factors,psychological state and family support.