摘要
目的 探究结肠癌患者术后不同时间康复锻炼依从性的变化轨迹及影响因素。方法 选择138例结肠癌患者为研究对象,分别于术后2周、2个月、4个月、6个月采用康复锻炼依从性量表进行追踪调查,使用潜增长曲线模型识别结肠癌患者术后康复锻炼依从性的变化轨迹;运用logistic回归模型探究轨迹类别的影响因素。结果 结肠癌患者术后2周、2个月、4个月、6个月的康复锻炼依从性变化轨迹呈先上升后下降趋势;通过模型拟合分为3个康复锻炼依从性变化类别,即类别1(依从性持续升高组)、类别2(依从性平稳组)及类别3(依从性先升后降组);无序多分类logistic回归分析显示,社会支持、心理弹性、健康信念、文化程度、人均月收入、术后化疗以及并发症是影响结肠癌患者术后康复锻炼依从性变化类别的影响因素(均P<0.05)。结论 结肠癌患者术后康复锻炼依从性变化存在异质性,医护人员可通过患者文化程度、人均月收入、术后化疗以及并发症等临床资料,识别康复锻炼依从性水平较低的高危人群,并预测其动态变化。通过制定针对患者社会支持利用度、心理弹性、健康信念等变量的干预方案,提高患者术后康复锻炼依从性。
Objective To explore the change trajectory and influencing factors of postoperative rehabilitation exercise compliance in patients with colon cancer.Methods A total of 138 patients with colon cancer were selected as the research participants.The patients were followed up 4 times at 2 weeks,2 months,4 months and 6 months after surgery,respectively,by researchers′ using the Rehabilitation Exercise Compliance Scale.Latent growth curve modeling was used to identify the trajectory of postoperative rehabilitation exercise compliance in colon cancer patients.Multiple logistic regression model was used to explore the influencing factors of trajectory categories.Results The trajectory of rehabilitation exercise compliance of colon cancer patients from postoperative 2 weeks,2 months,4 months,through 6 months showed a first-upward-then-downward trend.Through model fitting,three trajectory categories of trajectory of rehabilitation exercise compliance were identified,namely category 1(compliance ascending group),category 2(compliance stable group) and category 3(compliance ascending-to-descending group).Multiple logistic regression analysis showed that social support,psychological resilience,health beliefs,educational level,per capita monthly income,postoperative chemotherapy and complications were influencing factors of the trajectory categories of postoperative rehabilitation exercise compliance in colon cancer patients.Conclusion The trajectory of postoperative rehabilitation exercise compliance in patients with colon cancer showed heterogeneity.Medical personnel can identify high-risk groups with low compliance level of rehabilitation exercise through running through clinical data such as patients′ education levels,per capita monthly income,postoperative chemotherapy and complications,and predict the dynamic change of compliance.Postoperative rehabilitation exercise compliance of patients can be improved by formulating intervention measures aiming at such variables as utilization of social support,psychological resilience,and health belief.
作者
王培培
姚翠
Wang Peipei;Yao Cui(Department of Colorectal Surgery,Jiangsu Provincial People′s Hospital,Nanjing 210029,China)
出处
《护理学杂志》
CSCD
北大核心
2023年第23期14-19,共6页
Journal of Nursing Science
关键词
结肠癌
康复锻炼
依从性
影响因素
社会支持
心理弹性
健康信念
康复护理
colon cancer
rehabilitation exercise
compliance
influencing factors
social support
psychological resilience
health belief
rehabilitation nursing