结直肠癌术后病人自我管理效能、压力知觉和癌因性疲乏的相关性研究

Study on the correlation between self-management efficacy,perceived stressand cancer-related fatigue in patients with colorectal cancer after surgery

目的:调查结直肠癌术后病人癌因性疲乏程度现状,分析疾病自我管理效能、压力知觉与癌因性疲乏的关系,探讨癌因性疲乏水平的影响因素。方法:应用便利抽样法,选择结直肠癌术后病人63例为研究对象。收集病人一般资料及疾病相关资料,采用视觉模拟评分(VAS)、厌食/恶液质量表-12(A/CS-12)、自我管理效能感量表(SUPPH)、压力知觉量表(PSS)和癌因性疲乏量表(CFS)进行问卷调查。结果:结直肠癌术后病人癌因性疲乏得分为(31.30±10.13)分,轻度、中度和重度疲乏病人分别占比为26.98%、44.44%和28.57%。不同年龄、居住状态、主要照护者、病程时间、步行步数、睡眠质量、是否新辅助放化疗、有无肠造口、消化道症状、疼痛及有无癌性厌食的病人癌因性疲乏得分差异均有统计学意义(P<0.05~P<0.01);SUPPH各维度得分与CFS总分呈负相关关系,CPSS各维度得分与CFS总分呈正相关关系(r=0.295~0.574,P<0.01)。年龄、睡眠质量、既往新辅助放化疗、癌性厌食、SUPPH和CPSS是癌因性疲乏水平的主要影响因素(P<0.05~P<0.01),共解释总变异的的78.20%。结论:结直肠癌术后病人以中度癌因性疲乏为主,疾病自我管理效能、压力知觉与癌因性疲乏有一定相关性。临床护理人员应实施科学性干预措施,提升病人的疾病自我管理效能,降低压力知觉水平,从而缓解癌因性疲乏程度。

Objective:To investigate the status quo of cancer-related fatigue in patients with colorectal cancer after operation,analyze the relationship between self-management efficacy,stress perception and cancer-related fatigue,and explore the influencing factors of cancer-related fatigue level.Methods:A total of 63 patients with colorectal cancer after surgery were selected by convenience sampling method.The general data and disease-related data of patients were collected,and the patients were investigated using the visual analogue scale(VAS),anorexia/fluid quality list-12(A/CS-12),self-management efficacy scale(SUPPH),stress perception scale(PSS)and cancer related fatigue scale(CFS).Results:The score of cancer-related fatigue was(31.30±10.13)points,and the proportions of mild,moderate and severe fatigue patients were 26.98%,44.44%and 28.57%,respectively.The differences of the score of cancer-related fatigue among patients with different ages,residential status,main caregivers,duration of disease,walking steps,sleep quality,whether neoadjuvant chemoradiotherapy,enterostomy or not,gastrointestinal symptoms,pain,and cancer anorexia were statistically significant(P<0.05 to P<0.01).The score of SUPPH was negatively correlated with the total score of CFS,while the score of each dimension of CPSS was positively correlated with the total score of CFS(r=0.295-0.574,P<0.01).The age,sleep quality,previous neoadjuvant chemoradiotherapy,anorexia,SUPPH and CPSS were the main influencing factors of cancer-related fatigue level(P<0.05 to P<0.01),accounting for 78.20%of the total variation.Conclusions:The moderate cancer-related fatigue in patients with colorectal cancer after operation is major,and the self-management efficacy and stress perception are related to the cancer-related fatigue to some extent.Clinical nursing staff should implement scientific intervention measures to improve patients′self-management efficacy and reduce the perceived level of stress,so as to alleviate the degree of cancer-related fatigue.