结直肠癌永久性肠造口患者自我接受度、病耻感及负性情绪调查分析

Investigation and analysis of self-acceptance,stigma,and negative emotion in patients with permanent colostomy of colorectal cancer

目的调查结直肠癌永久性肠造口(PC)患者自我接受度、病耻感及负性情绪现状并分析影响因素。方法2019年3月至2022年3月选取江苏省海安市人民医院收治的198例结直肠癌PC患者为调查对象,利用一般资料问卷、自我接纳问卷(SAQ)、社会影响量表(SIS)、焦虑自评量表(SAS)、抑郁自评量表(SDS)对调查对象进行问卷调查,并利用多重线性回归分析PC患者的自我接受度、病耻感、负性情绪的影响因素。结果发放210份问卷,回收有效问卷198份,有效回收率为94.3%。198例患者SAQ、SIS、SAS与SDS得分依次为(29.03±3.95)、(68.74±12.91)、(49.06±7.11)分与(47.45±7.68)分。多重线性回归分析结果显示,近1个月内是否发生粪便泄漏、漏味、排气声响是PC患者SAQ评分的影响因素(P<0.05);性别,近1个月内是否发生漏味、排气声响,有无自觉形象改变是PC患者SIS评分的影响因素(P<0.05);医保类型,近1个月内是否发生漏味、排气声响是PC患者SAS评分的影响因素(P<0.05);性别、配偶状况、近1个月内是否发生排气声响、有无自觉形象改变是PC患者SDS评分的影响因素(P<0.05)。结论结直肠癌PC患者自我接受度不高,而病耻感和负性情绪较高,患者自我接受度、病耻感、负性情绪与性别、医疗花费、配偶状况、粪便泄漏、排气声响、漏味、自觉形象改变等有关,应予以关注。

Objective To investigate the status quo of self-acceptance,stigma,and negative emotion in patients with permanent colostomy(PC)for colorectal cancer and analyze the influencing factors.Methods From March 2019 to March 2022,198 cases of PC patients with colorectal cancer admitted to Haian People’s Hospital in Jiangsu Province were selected as the investigation objects.General information questionnaire,self-acceptance questionnaire(SAQ),social impact scale(SIS),self-rating anxiety scale(SAS),and self-rating depression scale(SDS)were used to investigate the subjects.Multivariate regression was used to analyze the influencing factors of PC patients’self-acceptance,stigma,and negative emotion.Results A total of 210 questionnaires were distributed,and 198 valid questionnaires were collected,with an effective recovery rate of 94.3%.The scores of SAQ,SIS,SAS,and SDS of 198 patients were(29.03±3.95),(68.74±12.91),(49.06±7.11)points and(47.45±7.68)points,respectively.Multivariate linear regression analysis results showed that the SAQ score of PC patients was affected by fecal leakage,odor leakage,and exhaust sound in the past one month(P<0.05).Gender,odor leakage,exhaust sound,and conscious image change in the past one month were the factors influencing SIS score of PC patients(P<0.05).The type of medical insurance,whether there was odor leakage and exhaust sound in the past one month were the influencing factors of SAS score of PC patients(P<0.05).Gender,spouse status,exhaust sound in the past one month,and conscious image change were the influencing factors for SDS scores of PC patients(P<0.05).Conclusion PC patients with colorectal cancer self-acceptance is not high,while stigma and negative emotions are high,patients self-acceptance,stigma,negative emotions are related to gender,medical costs,spouse status,stool leakage,exhaust sound,leakage of smell,conscious image change,etc.,should be paid attention to.