直肠癌肠造口患者自我隐瞒现状及影响因素分析

Investigation of self-concealment and the influencing factors in rectal cancer patients with ostomy

目的了解直肠癌肠造口患者的自我隐瞒现状并分析相关影响因素。方法应用一般资料调查问卷、自我隐瞒量表、医学应对方式问卷和社会影响量表对广州市4所医院门诊及病房的220例直肠癌肠造口患者进行问卷调查。结果直肠癌肠造口患者的自我隐瞒得分为(30.44±10.58)分,72例(32.72%)达高水平。单因素分析结果显示,家庭所在地、婚姻状况、职业情况以及个人月收入影响患者的自我隐瞒倾向,差异有统计学意义(P<0.01)。多元线性回归分析结果显示,病耻感、应对方式中的屈服维度进入回归方程,可共同解释总变异的66.80%(P<0.01)。结论直肠癌肠造口患者自我隐瞒处于中等水平,其中32.7%处于高水平,病耻感和应对方式是其影响因素。建议构建医护患交流平台,加强指导与鼓励,帮助患者正确面对,降低病耻感。

Objective To describe self-concealment in rectal cancer patients with ostomy and to evaluate the influencing factors.Me-thods Data collection occurred at four hospitals′wards and clinics.A convenience sample of 220 rectal cancer patients living with ostomy participated in the study.The General information questionnaire,Self-Concealment Scale(SCS),Social Impact Scale(SIS)、and Medical Coping Modes Questionnaire(MCMQ)were completed by them.Results The rectal cancer patients living with ostomy scored(30.44±10.58)points in SCS,with 72(32.7%)cases at high level of concealment.Univariate analysis showed that family locations,marital status,occupation status and personal monthly income had a significant impact on patients′self-concealment(P<0.01 for all).Multiple linear regression analysis showed that stigma and acceptance-resignation coping strategy accounted for 66.80%of the total variance for self-concealment(P<0.01).Conclusion Rectal cancer patients with colostomy demonstrated a moderate level of self-concealment,with 32.7%at high level of soncealment.Stigma and coping style were its predicting factors.Medical staff can provide a platform to facilitate doctor-nurse-patient communication,give guidance and encouragement to the patients,help them face facts,so as to mitigate the level of stigma.