头颈部肿瘤患者术后自我形象和社会支持状况的相关性研究

Correlation study of postoperative self-image and social support status in patients with head and neck cancer

目的 探讨自我形象紊乱在头颈部肿瘤患者中的发生率,分析头颈部肿瘤患者术后自我形象紊乱的影响因素及其与社会支持的相关性。方法 选取2019年9月至2020年7月在中国科学院大学附属肿瘤医院实施头颈外科手术后的201例患者为研究对象,通过社会支持量表(SSRS)和自我形象紊乱诊断,采用多元线性回归分析头颈部肿瘤患者术后自我形象紊乱的影响因素,对患者术后的自我形象和社会支持状况进行相关性分析。结果63.4%的患者存在自我形象紊乱,患者自我形象紊乱发生率与SSRS中的客观支持呈负相关(r=3.92,P=0.009)。多元线性回归分析显示,术后外形改变(B=-0.802,t=3.099,P=0.002,95%CI=-1.312~-0.292)、在意伤口瘢痕(B=-0.561,t=2.229,P=0.027,95%CI=-1.057~-0.065)、放疗(B=-1.460,t=3.148,P=0.002,95%CI=-2.374~-0.545)、客观支持(B=0.099,t=3.258,P=0.001,95%CI=0.039~0.158)是自我形象紊乱发生率的主要影响因素。结论 医护人员应重视头颈部患者术后的自我形象紊乱发生及其影响因素的特点,对患者实施针对性的护理,以降低自我形象紊乱的发生率。

Objective To investigate the incidence of self-image disorder in patients with head and neck cancer,and analyze the influencing factors of postoperative self-image disorder in patients with head and neck tumors and their correlation with social support.Methods A total of 201 patients who underwent head and neck surgery in Cancer Hospital Affiliated to University of Chinese Academy of Sciences from September 2019 to July 2020 were selected as the study objects.Through social support scale(SSRS) and self-image disorder diagnosis,multiple linear regression was used to analyze the influencing factors of postoperative self-image disorder in patients with head and neck tumor.The correlation between self-image and social support was analyzed.Results 63.4% of the patients had self-image disorder,and the incidence of self-image disorder was negatively correlated with SSRS(r=3.92,P=0.009).Multiple linear regression analysis showed that postoperative appearance changes(B=-0.802,t=3.099,P=0.002,95%CI=-1.312 to-0.292),wound scars(B=-0.561,t=2.229,P=0.027,95%CI=-1.057 to-0.065),radiotherapy(B=-0.460,t=3.148,P=0.002,95%CI=-2.374 to-0.545),objective support(B=0.099,t=3.258,P=0.001,95%CI=0.039-0.158) were the main influencing factors for the incidence of self-image disorder.Conclusion Medical staff should pay attention to the occurrence of postoperative self-image disorder and its influencing factors of head and neck patients,and implement targeted care for patients to reduce the incidence of self-image disorder.