膀胱癌根治术后尿路造口患者社会疏离感现状及影响因素分析

Social Alienation and Its Influencing Factors in Patients with Urostomy after Radical Bladder Cancer Surgery

目的 调查膀胱癌根治术后尿路造口患者社会疏离感现状,并分析其影响因素,为临床干预提供参考。方法 采取便利抽样法,选取在南昌大学第一附属医院伤口造口门诊及泌尿外科门诊进行复诊的206例膀胱癌根治术后尿路造口患者为调查对象,采用一般资料调查表、一般疏离感量表(GAS)、社会影响量表(SIS)、社会支持评定量表(SSRS)对社会疏离感现状进行调查。结果 206例患者社会疏离总分为(42.44±3.16)分、社会影响总分为(65.53±7.54)分、社会支持总分为(33.11±6.10)分。患者社会疏离与造口病耻感呈正相关(r=0.724,P<0.01),与社会支持呈负相关(r=-0.459,P<0.01)。多元线性回归分析显示,社会支持、病耻感、性别、工作状况是患者社会疏离的主要影响因素。结论 膀胱癌根治术后尿路造口患者社会疏离水平较高,医护人员要加强对尿路造口患者的关注,在积极提高相关医源性支持的基础之上,为患者采取合理、有效的个性化干预措施,提高患者社会参与程度,降低其社会疏离水平,提高其生活质量。

Objective To investigate the social alienation and its influencing factors in patients with urostomy after radical bladder cancer surgery,and to provide reference for clinical intervention.Methods A total of 206 patients with urostomy after radical surgery for bladder cancer who underwent follow-up consultations in the wound stoma clinic and urology clinic of the First Affiliated Hospital of Nanchang University were selected with a convenient sampling method.General information questionnaire,General Alienation Scale(GAS),Social Impact Scale(SIS) and Social Support Rating Scale(SSRS) were used to investigate the status of social alienation.ResultsThe total GAS,SIS and SSRS scoresof the 206 patients were(42.44±3.16),(65.53±7.54) and(33.11±6.10),respectively.The social alienation was positively correlated with stoma stigma(r=0.724,P<0.01),but negatively correlated with social support(r=-0.459,P<0.01).Multivariate linear regression analysis showed that social support,stigma,gender and work status were the main factors influencing social alienation.Conclusion Patients with urostomy after radical bladder cancer surgery have a high level of social alienation.Medical staff should pay more attention to urostomy patients and take reasonable and effective personalized intervention measures on the basis of actively improving relevant iatrogenic support,so as to improve their social participation and quality of life and to reduce their social alienation.