复发性肝细胞癌患者疾病不确定感与护理需求关系的纵向研究

Longitudinal study on the relationship between illness uncertainty and nursing needs in patients with recurrent hepatocellular carcinoma

目的探讨复发性肝细胞癌患者出院前后疾病不确定感水平变化及其与未满足的护理需求之间的关系。方法采用便利抽样法,选取2020年12月—2021年6月在郑州大学第一附属医院治疗的90例复发性肝细胞癌患者为研究对象。采用调查问卷收集患者出院前(T0,90例)、出院后1个月(T1,84例)、出院后2个月(T2,77例)的支持性护理需求、疾病不确定感、人口社会学和疾病状态等数据。利用广义估计方程考察疾病不确定感的影响因素。结果患者处于在职状态、年龄、未被满足的护理需求水平和出院前的中度和高度不确定感是患者3个时间点疾病不确定感变化的影响因素。结论疾病不确定感的变化与未满足的护理需求相关;对出院前疾病不确定感程度高的年轻在职患者,应制订个性化的出院教育计划,以满足患者的护理需求,改善患者出院后的疾病不确定感。

Objective To explore changes in the illness uncertainty before and after discharge in patients with recurrent hepatocellular carcinoma and its relationship with unmet nursing needs.Methods From December 2020 to June 2021,90 patients with recurrent hepatocellular carcinoma treated in the First Affiliated Hospital of Zhengzhou University were selected by convenience sampling method as the research object.A questionnaire was used to collect data such as the supportive care needs,illness uncertainty,demographic sociology,and disease status of patients before discharge(T0,90 cases),one month after discharge(T1,84 cases),and two months after discharge(T2,77 cases).Generalized estimating equations were used to examine the factors influencing the illness uncertainty.Results Patients'employment status,age,level of unmet nursing needs,and moderate and high uncertainty before discharge were the influencing factors for the change of patients'illness uncertainty at three time points.Conclusions Changes in illness uncertainty links to unmet nursing needs.For young working patients with a high degree of illness uncertainty before discharge,a personalized discharge education should be developed to meet the patients'nursing needs and improve the patients'illness uncertainty after discharge.