结直肠癌预防性肠造口患者疾病感知与生活质量的纵向研究

Longitudinal Study of Illness Perception and Quality of Life in Colorectal Cancer Patients with Protec⁃tive Stomas

目的描述结直肠癌预防性肠造口患者不同阶段疾病感知和生活质量的动态变化,并探讨其相关性。方法采用便利抽样法,于2020年11月至2021年12月选取福建某三级甲等医院符合纳入标准的结直肠癌预防性肠造口患者作为调查对象。采用一般资料调查表、简易版疾病感知问卷、造口患者生活质量量表对其进行问卷调查。结果经过纳入、排除标准筛选并取得调查对象知情同意后最初纳入121例研究对象,术后1个月脱落2例,术后3个月脱落3例,最终116例调查对象完成3次问卷调查。结直肠癌预防性肠造口患者住院时、术后1个月、术后3个月的疾病感知总分分别为(57.90±5.10)分、(50.78±5.00)分、(44.07±5.61)分,呈逐渐下降趋势(P<0.001),且均处于中等偏上水平;生活质量总分分别为(2.74±0.66)分、(3.94±0.61)分、(5.09±0.76)分,呈逐渐上升趋势(P<0.001)。Pearson相关分析显示,疾病感知与生活质量在住院时、术后1个月、术后3个月呈负相关(r=-0.735,P<0.001;r=-0.846,P<0.001;r=-0.923,P<0.001)。结论结直肠癌预防性肠造口患者疾病感知与生活质量在疾病不同阶段呈动态变化。患者负性疾病感知越少,则其生活质量越好。医务人员应科学评估不同阶段患者疾病感知水平,有针对性地进行护理干预,以提高患者生活质量。

Objective To describe the dynamic changes in illness perception and quality of life in colorectal cancer patients with protective stomas at different stages of the disease, and to explore their correlation.Methods From November 2020 to December 2021, colorectal cancer patients with protective stomas who met our inclusion criteria in a Grade Ⅲ-A hospital in Fujian were selected by convenience sampling. They were investigated by using the General Information Questionnaire, the Brief Illness Perception Questionnaire and the Stoma-Quality of Life.Results Initially, 121 subjects were included after screening against the inclusion and exclusion criteria and obtaining informed consent from them, then 2 dropped out 1 month after surgery and3 dropped out 3 months after surgery, and 116 finally completed the 3 questionnaires. The total scores for illness perception in colorectal cancer patients with protective stomas at hospitalization, 1 month after surgery and 3 months after surgery were(57.90±5.10) points,(50.78±5.00) points and(44.07±5.61) points,respectively, showing a gradually decreasing trend(P<0.001), all at an upper-middle level;the total scores for their quality of life were(2.74±0.66) points,(3.94±0.61) points and(5.09±0.76) points, respectively,showing a gradually increasing trend(P<0.001).Pearson correlation analysis showed that illness perception was negatively correlated with quality of life at hospitalization, 1 month after surgery and 3 months after surgery(r=-0.735,P<0.001;r=-0.846,P<0.001;r=-0.923,P<0.001).Conclusion The illness perception and quality of life of colorectal cancer patients with protective stomas show dynamic changes at different stages of the disease. Patients with less negative illness perception have a better quality of life. Healthcare providers should assess the level of illness perception in patients at different stages of the disease in a reasonable manner and take targeted nursing interventions in order to improve the quality of life of patients.