直肠癌患者Miles术后病耻感现状及影响因素

Analysis of postoperative symptoms and influencing factors after Miles in patients with rectal cancer

目的分析直肠癌患者Miles术后病耻感现状及影响因素,为制定有效的护理措施和进行健康教育提供依据。方法对100例直肠癌行Miles术患者进行一般资料问卷调查和社会影响量表调查,了解患者的一般情况及其Miles术后病耻感现状,采用t检验、方差分析和线性多元逐步回归分析病耻感得分的影响因素。结果100例直肠Miles患者SIS总分为62.5±10.7分,社会排斥、经济歧视、内在羞耻感、社会隔离维度得分分别为22.3±4.7分、8.2±1.6分、13.0±2.7分和19.0±3.5分。得分最高的5个条目依次为比过去更需要确定别人是否关心我、这个疾病已经影响了我的工作、感觉我的能力与过去相比下降、外表上的改变影响了我与他人的交往、因为我的病我遇到一些令我尴尬的事情。单因素及多因素分析结果显示,参加过造口人活动和与医护人员的交流程度是直肠癌行Miles术患者病耻感得分的重要影响因素(P<0.05)。结论直肠癌患者行Miles术后病耻感处于中等水平,护理人员应增大与患者的交流程度,鼓励患者以积极向上的态度面对,做好相关健康教育,教会患者及其家属予以正确的造口护理,并按期开展并鼓励患者积极参加造口联谊会,降低患者的病耻感,促进其身心健康发展,早日回归和融入社会。

Objective To analyze the current status and influencing factors of Miles postoperative symptoms in rectal cancer patients,and provide the basis for formulating effective nursing measures and conducting health education.Methods The questionnaire and social impact scale in rectal cancer understood the general condition and symptoms after Miles and analyzed the influencing factors by t test,variance analysis and linear multiple regression.Results The total SIS score of 100 patients with rectal Miles was 10.7,62.5,social exclusion,economic discrimination,internal shame,and social isolation dimension score were 22.3±4.7,8.2±1.6,13.0±2.7 and 19.0±3.5,respectively.The top five entries in turn are more than in the past to determine if someone cares about me,the disease has affected my work,feeling my ability is down compared to the past,appearance changes affect my relationship with others,because I encounter something that embarrass me.Thesingle and multifactor analysis showed that ostomy activities and com-munication with medical staff were significant factors affecting the shame score in patients with Miles for rectal cancer(P<0.05).Conclusion rectal cancer patients Miles postoperative shame at medium level,nursing staff should increase communication with patients,encourage patients with positive attitude,related health education,teach patients and their families to give correct stomy care,and on schedule and encourage patients to actively participate in stomy fraternity,reduce patient shame,promote their physical and mental health development,early return and integration into society.