妇科恶性肿瘤患者自我倡权潜在剖面分析及影响因素研究

Latent profile analysis and influnencing factors of self-advocacy of patients with gynecological malignant tumor

目的分析妇科恶性肿瘤患者自我倡权潜在类别及影响因素。方法采用一般资料问卷、女性癌症幸存者自我倡权量表、护患关系信任度量表、社会支持评定量表、患者参与医疗决策期望量表、妇科癌症患者特异性支持照护需求量表对367例妇科恶性肿瘤患者进行调查,采用潜在剖面分析建立了4个妇科恶性肿瘤患者自我倡权潜在类别模型,采用无序多元Logistic回归分析探讨妇科恶性肿瘤患者自我倡权潜在类别的影响因素。结果妇科恶性肿瘤患者自我倡权分为“低自我倡权型”(23.98%)、“有效社会支持促自我倡权型”(3.54%)、“中自我倡权型”(54.50%)、“高自我倡权型”(17.98%)4个潜在类别,多元Logistic回归分析显示,年龄(OR=2.995)、未婚(OR=3.391,0.302)、癌症分期I~II期(OR=0.298)、护患关系信任度(OR=0.538,0.832,0.820)、社会支持(OR=0.401,0.842,0.783)、参与医疗决策期望(OR=0.417,0.807,0.736)和特异性支持照护需求(OR=0.448,0.821,0.772)为妇科恶性肿瘤患者自我倡权潜在类别的影响因素。结论妇科恶性肿瘤患者自我倡权处于中等水平,4个类别在年龄、婚姻状况、癌症分期、护患关系信任度、社会支持、参与医疗决策期望、特异性支持照护需求方面具有显著差异。提示临床护理人员应采用个性化和通俗易懂的沟通方式与其沟通交流,并主动提供传达信息的途径,如医院公众号、媒体科普、电话咨询等,提高患者收集信息的渠道,提升自我倡权水平。

Objective To explore the categories of self-advocacy in patients with gynecological malignant tumor and analyze its influencing factors.Methods A total of 367 patients with gynecological malignant tumors were investigated using the general information questionnaire,Female Cancer Survivor Self-Advocacy Right Scale,Nurse-Patient Relationship Trust Scale,Social Support Rating Scale,Patient Participation Expectation Scale,and Gynecological Cancer Patient-Specific Support Care Need Scale.Four potential models of self-advocacy right for gynecological malignant tumors were established by latent profile analysis.Multiple Logistic regression analysis was used to explore the influencing factors of latent categories of self-advocacy rights in patients with gynecological malignant tumors.Results Patients with gynecological malignant tumors were divided into four potential categories:"low self-advocacy type"(23.98%),"effective social support to promote self-advocacy type"(3.54%),"medium self-advocacy type"(54.50%)and"high self-advocacy type"(17.98%).Multiple Logistic regression analysis showed that age(OR=2.995),marital status unmarried(OR=3.391,0.302),cancer stage I to II(OR=0.298),nurse-patient relationship trust degree(OR=0.538,0.832,0.820),social support(OR=0.401,0.842,0.783),expectation of participation in medical decision making(OR=0.417,0.807,0.736)and need for specific support care(OR=0.448,0.821,0.772)were the influencing factors of latent categories of self-advocacy rights in patients with gynecological malignant tumors.Conclusion The self-advocacy rights of patients with gynecological malignant tumors are in the middle level,and the four categories have significant differences in age,marital status,cancer stage,nursery-patient relationship trust,social support,expectation of participation in medical decision-making,and specific support care needs.Clinical nursing staff should adopt personalized communication methods to convey information,such as hospital public accounts,media popularization,telephone consultation,etc.,to improve the way of collecting information and self-advocacy.