631例全膀胱切除术后患者支持性照护需求及影响因素分析

Supportive care needs and influencing factors of 631 patients after total cystectomy

目的 调查全膀胱切除术后患者支持性照护需求现状并分析其影响因素。方法 选取2020年1月至2021年9月重庆市5所三级甲等医院的631例全膀胱切除术后患者作为研究对象。在患者术后1个月,采用一般资料调查问卷、全膀胱切除术后患者特异性支持照护需求量表进行调查;采用多元线性回归分析其相关影响因素。结果 全膀胱切除术后患者支持性照护需求总分为(107.71±7.77)分、条目均分为(4.14±0.30)分。多元线性回归分析显示:家庭人均月收入越高(≥1 000元),主要照顾者为配偶/子女,曾经接受保留膀胱三联疗法(trimodal therapy, TMT),职业为农民,已婚/同居,农村合作医疗保险及手术方式为原位新膀胱术的患者术后支持性照护需求更低(P<0.05)。结论 全膀胱切除术后患者的特异性支持照护需求为高度需求水平,家庭人均月收入、主要照顾者、是否接受TMT治疗及手术方式是全膀胱切除术后患者支持性照护需求的主要影响因素。

Objective To investigate the current status of supportive care needs in patients after total cystectomy and analyze its influencing factors. Methods A total of 631 patients undergoing total cystectomy in 5 tertiary Class-A hospitals in Chongqing from January 2020 to September 2021 were enrolled in this study. In 1 month after surgery, the patients were investigated by general data questionnaire and supportive care needs survey. Multiple linear regression analysis was used to analyze the influencing factors. Results The total score of supportive care needs for post-cystectomy patients was 107.71±7.77 and the mean score of the items was 4.14±0.30. Multiple linear regression analysis showed the post-cystectomy patients with higher monthly household income per capita(≥1 000 Yuan), spouse/children as primary caregivers, receiving bladder-sparing triple therapy(trimodal therapy, TMT), occupation as farmers, married/cohabitation, having rural cooperative medical insurance and undergoing surgical method with in situ neobladder had lower supportive care needs(P<0.05). Conclusion The demand for specific supportive care of post-cystectomy patients is quite high. Monthly household income per capita, primary caregivers, receiving TMT or not, and surgical method with in situ neobladder are main factors influencing the demand for supportive care need in post-cystectomy patients.