肝癌患者经导管肝动脉栓塞化疗术前疾病不确定感的调查研究

Study of uncertainty in illness among patients with hepatocellular carcinoma intending to undergo transcatheter artery chemoembolization

目的：调查肝癌患者经导管肝动脉栓塞化疗（transcatheter artery chemoembolization， TACE）术前的疾病不确定感水平并分析其影响因素。方法采用描述性相关性研究设计，采取方便抽样的方法，对2011年8月至2012年2月在中山大学肿瘤防治中心拟行TACE治疗的95例肝癌患者进行调查研究。应用中文版25条目Mishel疾病不确定感量表、自行设计的一般资料调查表、患者信息需求自评量表分别调查患者术前的疾病不确定感、社会人口学资料、疾病与治疗资料和信息需求水平。结果肝癌患者TACE治疗前有中水平疾病不确定感（77.61±9.15）分，其中，不明确感得分较高（50.16±6.16）分；患者居住地、文化程度、家庭经济状况、病程、辅助治疗次数和信息需求水平是影响患者疾病不确定感水平的主要因素。结论肝癌患者TACE治疗前疾病不确定感为中水平，临床工作中应着重评估患者疾病不确定感，采取有效干预措施，满足患者信息需求以降低疾病不确定感水平。

Objective To describe uncertainty in illness of patients with hepatocellular carcinoma intending to undergo transcatheter artery chemoembolization (TACE) and to identify the related factors. Methods A descriptive and correlative design was used. By convenience sampling, 95 patients with hepatocellular carcinoma were recruited from Sun Yat-Sen University Cancer Center in this study. Mishel Uncertainty in Illness Scale was used to assess uncertainty in illness and information needs of patients with hepatocellular carcinoma intending to undergo TACE and the demographic questionnaire and Information Needs Assessment Scale were used to measure demographic data, disease and treatment characteristics and information needs of patients. Results The level of uncertainty in illness in most patients with hepatocellular carcinoma intending to undergo TACE was middle (77.61±9.15) points. The mean score of indeterminacy subscale was (50.16 ± 6.16) points. Uncertainty in illness of patients with hepatocellular carcinoma intending to undergo TACE was affected by the degree of education background, domicile, family economic status, way to pay for the medical expenses, course of diseases, how many times he (she) used to undergo assisted treatments and the level of information needs. Conclusions The level of uncertainty in illness in most patients with hepatocellular carcinoma intending to undergo TACE was middle and it is important to assess patients′uncertainty in illness at clinical work and to take effective interventions to content patients′information needs to decrease the level of uncertainty.