非小细胞肺癌患者疾病不确定感水平与感知控制能力的相关性
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摘要
目的探讨非小细胞肺癌患者住院化疗期间的疾病不确定感水平与感知控制能力的相关性。方法采用自制的一般资料调查表、疾病不确定感量表以及癌症经验与效能量表对145例住院化疗的非小细胞肺癌患者进行调查。结果 (1)非小细胞肺癌患者的疾病不确定感总分平均为(98.56±9.99)分。(2)感知控制能力的患癌经验总分平均为(3.97±0.40)分,癌症效能总分平均为(3.13±0.52)分,该量表各维度得分由高到低依次是社会经济(4.25±0.59)分、情绪经验(3.89±0.50)分、个人经验(3.82±0.42)分、集体效能(3.30±0.83)分、医护效能(3.18±0.52)分和个人效能(2.93±0.76)分。(3)非小细胞肺癌患者化疗期间疾病不确定感总分与患癌经验总分呈正相关(r=0.291,P<0.01),与患癌控制效能总分呈负相关(r=-0.325,P<0.01)。结论非小细胞肺癌患者住院化疗期间,疾病不确定感水平与感知控制能力两者相互影响,提示护理人员要重视非小细胞肺癌化疗患者对疾病的认知评估能力,改善患者对疾病的控制效能,从而提高其生活质量。
Objective To analysis the correlation between uncertainty in illnesses and perceived control in patients with non-small-cell lung cancer(NSCLC) undergoing chemotherapy.Methods A consecutive sample of 145 patients with NSCLC were recruited and assessed with socio-demographic,medical data,the scales of the Michel's Chinese version of uncertainty in illness and the cancer experience and efficacy scale(CEES).Results The total score of the uncertainty in illness in patients with NSCLC was(98.56 ± 9.99) points,the total score of the cancer experience was(3.97 ± 0.40) points,and the total score of the cancer efficacy was(3.13 ± 0.52) points.In CEES,the scores of each dimension from the highest to the lowest were social economics [(4.25 ± 0.59) points],emotional experience [(3.89 ±0.50) points],personal experience [(3.82 ± 0.42) points],collective efficacy [(3.30 ± 0.83) points],medical efficacy [(3.18 ± 0.52) points],and personal efficacy [(2.93 ± 0.76) points].The score of the uncertainty in illness was significantly positively correlated with experience subscales(r = 0.291,P < 0.001),and negatively correlated with efficacy subscale(r =-0.334,P < 0.05).Conclusion Uncertainty in illnesses of the patients is correlated with perceived control.To raise the efficacy of patients and improve their quality of life,it is important for health-care workers to pay attention to the ability of cognition in patients.
Objective To analysis the correlation between uncertainty in illnesses and perceived control in patients with non-small-cell lung cancer(NSCLC) undergoing chemotherapy.Methods A consecutive sample of 145 patients with NSCLC were recruited and assessed with socio-demographic,medical data,the scales of the Michel's Chinese version of uncertainty in illness and the cancer experience and efficacy scale(CEES).Results The total score of the uncertainty in illness in patients with NSCLC was(98.56 ± 9.99) points,the total score of the cancer experience was(3.97 ± 0.40) points,and the total score of the cancer efficacy was(3.13 ± 0.52) points.In CEES,the scores of each dimension from the highest to the lowest were social economics [(4.25 ± 0.59) points],emotional experience [(3.89 ±0.50) points],personal experience [(3.82 ± 0.42) points],collective efficacy [(3.30 ± 0.83) points],medical efficacy [(3.18 ± 0.52) points],and personal efficacy [(2.93 ± 0.76) points].The score of the uncertainty in illness was significantly positively correlated with experience subscales(r = 0.291,P < 0.001),and negatively correlated with efficacy subscale(r =-0.334,P < 0.05).Conclusion Uncertainty in illnesses of the patients is correlated with perceived control.To raise the efficacy of patients and improve their quality of life,it is important for health-care workers to pay attention to the ability of cognition in patients.
引文
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[16]Bostr9m B,Hinic H,Lundberg D,et al.Pain and health-related quality of life among cancer patients in final stage of life:a comparison between two palliative care teams[J].J Nurs Manag,2003,11(3):189-196.
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[19]Mystakidou K,Tsilika E,Parpa E,et al.The influence of sense of control and cognitive functioning in older cancer patients'depression[J].Psychooncology,2015,24(3):311-317.
[20]Stiegelis HE,Hagedoorn M,Sanderman R,et al.The impact of an informational self-management intervention on the association between control and illness uncertainty before and psychological distress after radiotherapy[J].Psychooncology,2004,13(4):248-259.
[21]罗苑玲,程锡芳,余玲玲.护理干预对肺癌放疗患者癌因性疲乏的影响[J].广东医学,2015,36(16):2476-2478.
[2]Mishel MH.The measurement of uncertainty in illness[J].Nurs Res,1981,30(5):258-263.
[3]Borneman T,Irish T,Sidhu R,et al.Death awareness,feelings of uncertainty,and hope in advanced lung cancer patients:can they coexist?[J].Int J Palliat Nurs,2014,20(6):271-277.
[4]Hoff AL,Mullins LL,Chaney JM,et al.Illness uncertainty,perceived control,and psychological distress among adolescents with type 1 diabetes[J].Res Theory Nurs Pract,2002,16(4):223-236.
[5]张丽娣,李乐之.慢性病感知控制研究现状及展望[J].中华护理杂志,2014,49(1):91-94.
[6]Kidd L,Hubbard G,O'Carroll R,et al.Perceived control and involvement in self care in patients with colorectal cancer[J].J Clin Nurs,2009,18(16):2292-2300.
[7]Donovan HS,Hartenbach EM,Method MW.Patient-provider communication and per-ceived control for women experiencing multi-ple symptoms associated with ovarian cancer[J].Gynecol Oncol,2005,99(2):404-411.
[8]Hsu TH,Lu MS,Tsou TS,et al.The relationship of pain,uncertainty,and hope in Taiwanese lung cancer patients[J].J Pain Symptom Manage,2003,26(3):835-842.
[9]李乐之,梁敉宁,邓露,等.肺癌患者疾病不确定感与生活质量的相关性研究[J].中华行为医学与脑科学杂志,2009,18(3):235-237.
[10]Mishel MH.Uncertainty in Illness[J].Image J Nurs Sch,1988,20(4):225-232.
[11]Hou WK.Intrapersonal and interpersonal dimensions of cancer perception:a confirmatory factor analysis of the cancer experience and efficacy scale(CEES)[J].Support Care Cancer,2010,18(5):561-571.
[12]Hou WK,Wan JH.Perceived control mediates the prospective impact of relationship quality in the year after colorectal cancer diagnosis[J].Ann Behav Med,2012,43(1):129-138.
[13]Mystakidou K,Tsilika E,Parpa E,et al.The influence of sense of control and cognitive functioning in older cancer patients'depression[J].Psychooncology,2015,24(3):311-317.
[14]Baker,Faulkner PM.Illness meanings and perceptions of control and uncertainty in women with breast cancer[D].Newfoundland&Labrador:Masters thesis,Memorial University of Newfoundland,1994.
[15]Kuo TT,Ma FC.Symptom distresses and coping strategies in patients with non-small cell lung cancer[J].Cancer Nurs,2002,25(4):309-317.
[16]Bostr9m B,Hinic H,Lundberg D,et al.Pain and health-related quality of life among cancer patients in final stage of life:a comparison between two palliative care teams[J].J Nurs Manag,2003,11(3):189-196.
[17]Lazarus RS,Folkman S.Stress,appraisal,and coping[M].New York:Springer Publishing Company,1984:141-180.
[18]Smith GC,Kohn SJ,Savagestevens SE,et al.The effects of interpersonal and personal agency on perceived control and psychological well-being in adulthood[J].Gerontologist,2000,40(4):458-468.
[19]Mystakidou K,Tsilika E,Parpa E,et al.The influence of sense of control and cognitive functioning in older cancer patients'depression[J].Psychooncology,2015,24(3):311-317.
[20]Stiegelis HE,Hagedoorn M,Sanderman R,et al.The impact of an informational self-management intervention on the association between control and illness uncertainty before and psychological distress after radiotherapy[J].Psychooncology,2004,13(4):248-259.
[21]罗苑玲,程锡芳,余玲玲.护理干预对肺癌放疗患者癌因性疲乏的影响[J].广东医学,2015,36(16):2476-2478.