肝硬化失代偿期患者医学应对方式现状及影响因素

Status and influencing factors of medical coping styles in patients with decompensated cirrhosis

目的:观察肝硬化失代偿期(DC)患者医学应对方式现状,并分析其影响因素。方法:选取2017年1月至2021年7月该院收治的150例DC患者进行前瞻性研究,采用医学应对方式问卷(MCMQ)评估患者治疗1个月时的医学应对方式,并将其分为积极应对组和消极应对组,比较两组基线资料,采用Logistic回归分析DC患者倾向于采取消极应对方式的影响因素。结果:150例患者中,68例倾向于消极应对,占45.33%(68/150);两组年龄、肝硬化类型、性别、婚姻状况、医疗付费方式、合并其他慢性病占比比较,差异均无统计学意义(P>0.05);消极应对组受教育程度初中及以下、高水平疾病不确定感、家庭功能差占比均高于积极应对组,差异有统计学意义(P<0.05);Logistic回归分析结果显示,受教育程度初中及以下、高水平疾病不确定感、家庭功能差均为DC患者倾向于采取消极应对的危险因素(P<0.05)。结论:受教育程度初中及以下、高水平疾病不确定感、家庭功能差均为DC患者倾向于采取消极应对方式的危险因素。

Objective:To observe status of medical coping style in patients with decompensated cirrhosis(DC)and to analyze its influencing factors.Methods:A prospective study was conducted on 150 DC patients admitted to the hospital from January 2017 to July 2021.The medical coping modes questionnaire(MCMQ)was used to evaluate the medical coping styles of the patients at 1 month of treatment.They were divided into positive coping group and negative coping group.The baseline data were compared between the two groups.The influencing factors of the DC patients’tendency to adopt negative coping were analyzed using Logistic regression analysis.Results:Among the 150 patients,68 had a higher negative coping tendency,accounting for 45.33%(68/150).There were no significant differences in age,type of cirrhosis,gender,marital status,medical payment method,and proportion of other chronic diseases between the two groups(P>0.05).The proportions of junior high school education and below,high level of disease uncertainty and poor family function in the negative coping group were higher than those in the positive coping group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that junior high school education and below,high level of disease uncertainty,and poor family function were risk factors for the DC patients’tendency to adopt negative coping(P<0.05).Conclusions:Junior high school education and below,high level of uncertainty in illness,and poor family function are all risk factors that affect the DC patients'tendency to adopt the negative coping style.