老年根治性膀胱全切术输尿管皮肤造口患者自我效能及应对方式的影响因素

Analysis of the influencing factors on self-efficacy and coping style in elderly patients with radical cystectomy and ureterostomy

目的探讨老年根治性膀胱全切术输尿管皮肤造口患者自我效能及应对方式状况,并分析其影响因素。方法选取2018年1月至2021年6月接受输尿管皮肤造口的72例老年根治性膀胱全切术患者为研究对象,采用一般自我效能感量表(General Self-Efficacy Scale,GSES)、简易疾病应对方式问卷(Simplified Coping Style Questionnaire,SCSQ)评估所有患者自我效能及应对方式状况,并由研究人员设计基线资料调查表填写两组患者基线资料,分析可能影响老年根治性膀胱全切术输尿管皮肤造口患者自我效能及应对方式的相关因素。结果术后3个月,72例老年根治性膀胱全切术输尿管皮肤造口患者术后自我效能不佳25例(34.72%),自我效能良好47例(65.28%);消极应对22例(30.56%),积极应对50例(69.44%)。自我效能不佳组文化程度、心理状况、家庭关怀度与自我效能良好组比较,差异有统计学意义(P<0.05);消极应对组文化程度、心理状况、个人收入、家庭关怀度与积极应对组比较,差异有统计学意义(P<0.05)。经多元logistic回归分析显示,文化程度在初中及以下、焦虑、家庭关怀度低是老年根治性膀胱全切术输尿管皮肤造口患者术后自我效能不佳的影响因素(OR>1,P<0.05);文化程度在初中及以下、焦虑、个人收入低、家庭关怀度低是根治性膀胱全切术输尿管皮肤造口患者术后消极应对的影响因素(OR>1,P<0.05)。结论文化程度在初中及以下、焦虑、家庭关怀度低是老年根治性膀胱全切术输尿管皮肤造口患者术后自我效能不佳的影响因素;文化程度在初中及以下、焦虑、个人收入低、家庭关怀度低是根治性膀胱全切术输尿管皮肤造口患者术后消极应对的影响因素。

Objective To investigate the self-efficacy and coping style of elderly patients with radical cystectomy and ureterostomy,and analyze their influencing factors.Methods A total of 72 elderly patients who underwent radical cystectomy with ureterostomy from January 2018 to June 2021 were selected for this study.The General Self-Efficacy Scale(GSES)and the Simplified Coping Style Questionnaire(SCSQ)were used to assess the self-efficacy and coping styles of all patients.A baseline data questionnaire designed by the researchers was completed by both groups of patients,and factors that may influence the self-efficacy and coping styles of elderly patients with radical cystectomy and ureterostomy were analyzed.Results Three months after surgery,25 cases(34.72%)of the 72 elderly patients with radical cystectomy and ureterostomy had poor postoperative self-efficacy,while 47 cases(65.28%)had good self-efficacy.Among them,22 cases(30.56%)had a negative coping style,and 50 cases(69.44%)had a positive coping style.There were statistically significant differences in educational level,psychological status,and family care between the group with poor self-efficacy and the group with good self-efficacy(P<0.05).Similarly,there were statistically significant differences in educational level,psychological status,personal income,and family care between the negative coping group and the positive coping group(P<0.05).Multivariate logistic regression analysis showed that an educational level of junior high school and below,anxiety,and low family care were influencing factors for poor postoperative self-efficacy in elderly patients undergoing radical cystectomy with ureterostomy.An educational level of junior high school and below,anxiety,low personal income,and low family care were influencing factors for negative coping after radical cystectomy with ureterostomy(OR>1,P<0.05).Conclusion An educational level of junior high school and below,anxiety,and low family care are influencing factors for poor postoperative self-efficacy in elderly patients with radical cystectomy and ureterostomy.An educational level of junior high school and below,anxiety,low personal income,and low family care are influencing factors for negative coping in patients undergoing radical cystectomy with ureterostomy.