[1]雷琛,杨婕,蒋理立,等.结直肠癌患者术前疾病不确定感的影响因素及治疗性沟通护理的意义[J].西部中医药,2018,31(05):121-125.
　LEI Chen,YANG Jie,JIANG Lili,et al.On Influencing Factors of Illness Uncertainty of the Patients before the Surgery of Colorectal Cancer and the Meaning of Therapeutic Communication Nursing[J].Western Journal of Traditional Chinese Medicine,2018,31(05):121-125.
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结直肠癌患者术前疾病不确定感的影响因素及治疗性沟通护理的意义()
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《西部中医药》[ISSN:2096-9600/CN:62-1204/R]

卷:
31
期数:
2018年05期
页码:
121-125
栏目:
出版日期:
2018-05-15

文章信息/Info

Title:
On Influencing Factors of Illness Uncertainty of the Patients before the Surgery of Colorectal Cancer and the Meaning of Therapeutic Communication Nursing
文章编号:
1004-6852(2018)05-0121-05
作者:
雷琛，杨婕，蒋理立，李卡△
四川大学华西医院，四川 成都 610041
Author(s):
LEI Chen, YANG Jie, JIANG Lili, LI Ka△
West China School of Medicine/West China Hospital, Sichuan University, Chengdu 610041, China
关键词:
结直肠癌; 术前; 疾病不确定感; 沟通护理; 治疗性
Keywords:
colorectal cancer;  preoperative;  illness uncertainty;  communication nursing;  therapeutic
分类号:
R473.73
文献标志码:
B
摘要:
目的：探讨结直肠癌患者术前疾病不确定感的影响因素及治疗性沟通护理对患者生活质量的影响。方法：将结直肠癌患者180例按照随机数字表法分为观察组91例、对照组89例，对照组进行常规护理，观察组在对照组常规护理的基础上进行治疗性沟通护理，内容包括护患关系沟通、客观评估沟通、针对性治疗沟通。入院当天、出院时，分别进行Mishel疾病不确定感量表(MUIS)、生活质量核心问卷(QLQ-C30)测评。结果：护理干预前2组患者对疾病不确定感总分为68～123分，平均(92.17±8.75)分，属中等水平。干预后观察组疾病不确定感、不明确性、复杂性得分分别为(67.36±6.28)分、(35.23±4.76)分、(13.58±2.85)分，均明显低于对照组(70.32±7.13)分、（40.68±5.23)分、（16.76±3.43)分，差异有统计学意义(P＜0.01)。1)初中至大专文化程度患者疾病不确定感、不明确性、复杂性得分分别为(78.24±8.16)分、（43.55±6.27)分、（19.67±3.97)分，高于大专以上文化程度的(73.39±7.67)分、（40.73±5.56)分、（15.53±3.03)分，差异有统计学意义(P＜0.05)。2）家庭月均收入≤3000元患者疾病不确定感、不明确性、复杂性得分分别为(80.12±7.69)分、（44.95±6.49)分、（19.96±4.21)分，高于收入＞3000元得分(72.58±7.45)分、（38.79±5.32)分、（15.24±3.22)分，差异有统计学意义(P＜0.05)。3）自费患者疾病不确定感、不明确性、复杂性得分分别为(75.67±7.78)分、（45.12±6.27)分、（19.25±3.23))分，高于医保/农合得分(71.35±7.28)分、（38.53±5.28）、（14.93±3.06)分，差异有统计学意义(P＜0.05)。4）内向性格患者疾病不确定感、不明确性、复杂性得分分别为(76.67±8.03)分、（43.75±6.29)分、（19.15±3.98)分，高于外向性格得分(72.52±7.59)分、（38.23±5.16)分、（15.21±3.12)分，差异有统计学意义(P＜0.05)。生活质量问卷QLQ-C30评分，观察组患者干预后情绪功能(72.5±16.8)分、角色功能(68.9±23.5)分、社会功能(64.6±22.3)分、躯体功能(70.3±20.6)分、认知功能(76.8±25.2)分和整体生活质量(69.5±21.3)分均高于对照组得分(64.1±15.7)分、（56.7±22.3)分、（58.3±20.1)分、（64.5±19.1)分、（68.5±22.8)分、（59.4±18.2)分，差异有统计学意义(P＜0.05)。结论：治疗性沟通护理能明显降低结直肠癌患者术前对疾病的不确定感，能提高患者生活质量。
Abstract:
Objective: To explore the influencing factors of illness uncertainty of the patients before the surgery of colorectal cancer and the effects of therapeutic communication nursing on quality of life of the patients. Methods: All 180 patients were allocated to 91 cases of the observation group and 89 cases of the control group according to random number table method, the control group accepted conventional care and the observation group therapeutic communication nursing based on conventional care, the contents contained nurse-patients relationship communication, objectively assessing communication and corresponding therapeutic communication. The patients were evaluated by QLQ-C30 and Mishel uncertainty in illness scale (MUIS) respectively at the day of hospitalization and discharging from the hospital. Results: Total scores of illness uncertainty of the patients in both groups before nursing intervention were 68 to 123 points, mean (92.17±8.75) points, which was in the middle level. The scores for illness uncertainty, vagueness and complexity in the observation group after the intervention were (67.36±6.28) points, (35.23±4.76) points and (13.58±2.85) points respectively, notably lower than (70.32±7.13) points, (40.68±5.23) points and (16.76±3.43) points of the control group, and the difference showed statistical meaning (P＜0.01). 1) The scores for illness uncertainty, vagueness and complexity of the patients with junior high school to junior college education were (78.24±8.16) points, (43.55±6.27) points and (19.67±3.97) points respectively, higher than (73.39±7.67) points, (40.73±5.56) points and (15.53±3.03) points of the patients with higher than junior college education, and the difference showed statistical meaning (P＜0.05). 2) The scores for illness uncertainty, vagueness and complexity of the patients with monthly average revenue less than 3, 000 Yuan were (80.12±7.69) points, (44.95±6.49) points and (19.96±4.21) points respectively, higher than (72.58±7.45) points, (38.79±5.32) points and (15.24±3.22) points of the patients with monthly average revenue more than 3, 000 Yuan, and the difference showed statistical meaning (P＜0.05). 3) The scores for illness uncertainty, vagueness and complexity of the patients at their own expense were (75.67±7.78) points, (45.12±6.27) points and (19.25±3.23) points respectively, higher than (71.35±7.28) points, (38.53±5.28) points and (14.93±3.06) points of the patients with medical insurance or rural cooperative medical insurance, and the difference showed statistical meaning(P＜0.05). 4) The scores for illness uncertainty, vagueness and complexity of the patients with inward personalities were (76.67±8.03) points, (43.75±6.29) points and (19.15±3.98) points respectively, higher than (72.52±7.59) points, (38.23±5.16) points and (15.21±3.12) points of the patients with extrovert personalities, and the difference had statistical meaning(P＜0.05). QLQ-C30 scores, emotional functional scores of the patients in the observation group after the intervention (72.5±16.8) points, role function (68.9±23.5) points, social function (64.6±22.3) points, somatic function (70.3±20.6) points, cognitive function (76.8±25.2) points and overall quality of life (69.5±21.3) points, were higher than (64.1±15.7) points, (56.7±22.3) points, (58.3±20.1) points, (64.5±19.1) points, (68.5±22.8) points and (59.4±18.2) points of the control group, and the difference was statistically significant(P＜0.05). Conclusion: Therapeutic communicationnursing could notably decrease illness uncertainty of the patients before the surgery of colorectal cancer and raise quality of life of the patients.

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备注/Memo

备注/Memo:
收稿日期：2017-08-20 作者简介：雷琛(1983—)，女，护师。研究方向：胃肠外科护理及静脉治疗专科护理。 △通讯作者：李卡(1977—)，女，主任护师。研究方向：护理管理。
更新日期/Last Update: 2018-05-15