本文選題：癌癥 + 住院　； 參考：《第四軍醫(yī)大學(xué)》2015年碩士論文

【摘要】：研究目的:本研究通過調(diào)查西安市兩所醫(yī)院癌癥患者住院放化療期生存質(zhì)量及家庭功能狀況,了解癌癥患的生存質(zhì)量與家庭功能情況,以及兩者之間的相關(guān)性,分析影響患者生存質(zhì)量的影響因素,為癌癥照護(hù)人員制定個性化醫(yī)療服務(wù)及護(hù)理措施提供理論指導(dǎo),并為下一步制定癌癥患者住院放化療期的生存質(zhì)量及家庭功能干預(yù)措施提供理論依據(jù)。研究方法:1.現(xiàn)況研究采用流行病學(xué)橫斷面研究方法,選取西安市兩所有代表性的三甲醫(yī)院進(jìn)行放化療的住院癌癥患者為研究對象。查閱相關(guān)資料自編一般情況調(diào)查表,選用世界衛(wèi)生組織生存質(zhì)量測定量表(WHOQOL-100)和家庭功能指數(shù)問卷(Family APGAR Index,APGAR)作為調(diào)查工具。調(diào)查方式采用調(diào)查員下科獲得患者知情同意,調(diào)查對象自填問卷形式取得問卷結(jié)果。按照WHOQOL-100、APGAR提供的計算方法與評分標(biāo)準(zhǔn),對結(jié)果進(jìn)行整理。2.統(tǒng)計學(xué)方法使用Epidata3.1建立數(shù)據(jù)庫,雙人錄入調(diào)查數(shù)據(jù),采用SPSS17.0統(tǒng)計軟件進(jìn)行數(shù)據(jù)分析,所用的統(tǒng)計方法有:對患者一般資料進(jìn)行描述性分析,單因素分析采用單樣本t檢驗(yàn)、獨(dú)立樣本t檢驗(yàn)、方差分析、pearson相關(guān)分析,多因素分析采用多元線性逐步回歸,p0.05差異具有統(tǒng)計學(xué)意義。研究結(jié)果:1患者的生存質(zhì)量情況1.1不同情況患者生存質(zhì)量比較1.1.1不同性別患者在生存質(zhì)量的6個領(lǐng)域得分差異無統(tǒng)計學(xué)意義(p0.05);在生存質(zhì)量各方面之間比較,男性患者在精神支柱和休閑娛樂活動的參與機(jī)會與參與程度2個方面滿意度均低于女性患者(p0.05)。1.1.2不同年齡段患者[1]在生存質(zhì)量的6個領(lǐng)域得分差異均無統(tǒng)計學(xué)意義,在生存質(zhì)量各方面之間比較,經(jīng)濟(jì)來源方面,45~59歲中年患者得分最低(p0.05),60歲及以上老年患者得分最高(p0.05),對總的健康狀況與生存感受和家庭摩擦對患者的影響兩個條目得分進(jìn)行比較,18~44歲青年患者得分最低,60歲及以上老年患者得分最高(p0.05)。1.1.3不同學(xué)歷患者在心理領(lǐng)域及精神支柱領(lǐng)域得分差異有統(tǒng)計學(xué)意義(p0.05);對生存質(zhì)量各方面得分比較,積極感受、工作能力、經(jīng)濟(jì)壓力和精神支柱4個方面得分差異有統(tǒng)計學(xué)意義(p0.05),呈現(xiàn)出學(xué)歷越低,平均分越低的趨勢。1.1.4在婚患者社會關(guān)系領(lǐng)域及性生活方面滿意度高于非再婚患者,其他方面生存質(zhì)量差異無統(tǒng)計學(xué)差異(p0.05)。1.1.5不同職業(yè)患者在心理領(lǐng)域、環(huán)境領(lǐng)域、精神支柱領(lǐng)域得分差異有統(tǒng)計學(xué)意義(p0.05);生存質(zhì)量各方面比較,患者在積極感受、思想學(xué)習(xí)記憶和注意力、對藥物及醫(yī)療手段的依賴性、工作能力、經(jīng)濟(jì)來源、獲取新信息知識技能的機(jī)會、休閑娛樂活動的參與、環(huán)境條件8方面的得分差異有統(tǒng)計學(xué)意義(p0.05);家庭摩擦對患者的影響條目得分差異有統(tǒng)計學(xué)意義;農(nóng)民及從事服務(wù)業(yè)患者以上得分較低。1.1.6不同癌癥類型的患者生存質(zhì)量得分無統(tǒng)計學(xué)差異(p0.05)。1.1.7不同治療方式的患者在生理領(lǐng)域、社會關(guān)系領(lǐng)域及精神支柱領(lǐng)域得分差異有統(tǒng)計學(xué)意義(p0.05);對生存質(zhì)量各方面得分進(jìn)行比較,患者的疼痛與不適、對藥物及醫(yī)療手段的依賴、個人關(guān)系、所需社會支持的滿意度、交通條件、精神支柱等6個方面得分差異有統(tǒng)計學(xué)意義(p0.05),在總的健康狀況與生存感受和家庭摩擦對患者的影響2個條目得分差異有統(tǒng)計學(xué)意義(p0.05);同步放化療的患者以上得分低于單獨(dú)進(jìn)行放療的患者(p0.05)。1.1.8患者住院期間不同照顧者分組比較,配偶照顧的患者社會關(guān)系領(lǐng)域得分高于其他人員照顧的患者得分(p0.05);生存質(zhì)量各方面進(jìn)行比較,睡眠與休息、思想學(xué)習(xí)記憶和注意力、個人關(guān)系、所需社會支持的滿意程度4個方面的得分差異有統(tǒng)計學(xué)意義(p0.05),配偶照顧的患者睡眠與休息、個人關(guān)系、所需社會支持的滿意程度得分高于其他人員照顧的患者得分(p0.05);家庭摩擦對患者的影響條目,配偶照顧的患者影響小于其他人員照顧的患者(p0.05)。1.2患者生存質(zhì)量與常模比較癌癥患者住院放化療期生存質(zhì)量在生理領(lǐng)域、心理領(lǐng)域、獨(dú)立性領(lǐng)域、精神支柱領(lǐng)域得分與常模相比,差異有統(tǒng)計學(xué)意義(p0.000),社會關(guān)系領(lǐng)域和環(huán)境領(lǐng)域得分與常模相比,差異無統(tǒng)計學(xué)意義(p0.05);在生存質(zhì)量的24個方面中,研究對象除在積極感受,個人關(guān)系,社會安全保障,獲取新信息、知識、技能機(jī)會,交通條件等5個方面的感受得分與常模相比差異無統(tǒng)計學(xué)意義外(p0.05),其他19個方面得分與常模相比差異有統(tǒng)計學(xué)意義(p0.05);調(diào)查對象總的健康狀況和生存質(zhì)量的感受得分與常模相比差異有統(tǒng)計學(xué)意義(p0.000)。2.患者家庭功能情況分析青年患者家庭功能低于中年患者,不在婚患者家庭功能低于在婚患者,農(nóng)民患者家庭功低于工人、行政工作者、專業(yè)技術(shù)從業(yè)者,同步放化療患者家庭功能低于單獨(dú)放療或化療的患者,得分差異有統(tǒng)計學(xué)意義(p0.05)。家庭功能各緯度得分比較,青年患者感知的家庭合作度和成長度低于中年患者,并且也低于60歲及以上年齡的老年患者感知的家庭成長度(p0.05);男性患者感知的家庭適應(yīng)度低于女性患者(p0.05);同時進(jìn)行放化療的患者感知的家庭功能除親密度外,其他維度家庭功能低于單獨(dú)放療或化療的患者(p0.05);行政工作者感知的家庭合作度高于工人、農(nóng)民、服務(wù)業(yè)從業(yè)者,知識分子、行政工作者、工人感知的情感度和親密度高于農(nóng)民和服務(wù)業(yè)從業(yè)者(p0.05)。3.患者生存質(zhì)量與家庭功能的相關(guān)性患者家庭適應(yīng)度得分與心理領(lǐng)域、社會關(guān)系領(lǐng)域、環(huán)境領(lǐng)域、精神支柱領(lǐng)域得分正相關(guān)(P0.05);合作度得分除和獨(dú)立性領(lǐng)域外其余領(lǐng)域得分均正相關(guān)(P0.05);成長度得分和生存質(zhì)量的所有領(lǐng)域及總的健康狀況與生存質(zhì)量感受得分正向關(guān)(P0.05);情感度得分與社會關(guān)系領(lǐng)域、環(huán)境領(lǐng)域得分正相關(guān)(P0.05);親密度得分與心理領(lǐng)域、社會關(guān)系領(lǐng)域、精神支柱領(lǐng)域得分正相關(guān)(P0.05);家庭功能總得分與除獨(dú)立性領(lǐng)域外其他領(lǐng)域得分均正相關(guān)(P0.05)。4.癌癥患者住院放化療期生存質(zhì)量的多因素分析家庭功能是患者心理領(lǐng)域、社會關(guān)系、環(huán)境、精神支柱、總的健康狀況和生存質(zhì)量感受、家庭摩擦的影響因素,年齡和婚姻狀況是總的健康狀況和生存質(zhì)量感受、家庭摩擦的影響因素,性別是環(huán)境領(lǐng)域的影響因素,住院照顧者是家庭摩擦的影響因素。研究結(jié)論:1.癌癥患者在住院放化療期生存質(zhì)量顯著下降2.患者生存質(zhì)量受多種因素影響,主要影響因素為家庭功能3.不同情況患者感知的家庭功能有差別,青年患者、非在婚患者、農(nóng)民患者、聯(lián)合放化療患者家庭功能較低
[Abstract]:The purpose of this study was to investigate the quality of life and family function of cancer patients in hospital in Xi'an, and to understand the quality of life and family function of cancer patients and the relationship between them, and to analyze the influencing factors of the quality of life of the patients, and to make personalized medical services for the cancer care workers and to make personalized medical services for the cancer care workers. The nursing measures provide theoretical guidance, and provide a theoretical basis for the next step of formulating the quality of life and family function intervention during the stage of chemotherapy for cancer patients. Research methods: 1. the epidemiological cross-sectional study method was used to select all the representative three a hospital of Xi'an for chemotherapy and chemotherapy in hospital. The research object is to consult the relevant information for the general situation questionnaire, select the WHO quality of life scale (WHOQOL-100) and the family function index questionnaire (Family APGAR Index, APGAR) as the investigation tool. The investigation method uses the investigator's lower department to obtain the informed consent of the patient, and the questionnaire results are obtained by the questionnaire. According to the calculation method and grading standard provided by WHOQOL-100 and APGAR, the results are collated and.2. statistics method is used to establish the database using Epidata3.1. Two people are entered into the survey data and the SPSS17.0 statistics software is used to analyze the data. The statistical methods used are: the descriptive analysis of the general materials for the patients and the single factor analysis using the single sample t. Test, independent sample t test, variance analysis, Pearson correlation analysis, multi factor analysis using multiple linear stepwise regression, P0.05 difference had statistical significance. The results of the study: 1 patients' quality of life 1.1 different cases of patients' quality of life comparison of 1.1.1 different sex patients in the 6 areas of quality of life score difference is not statistically significant Meaning (P0.05); in comparison of all aspects of quality of life, the satisfaction of male patients in the 2 aspects of the opportunity and participation of spiritual support and recreational activities was lower than that of women (P0.05) and there was no significant difference in the score of [1] in the quality of life of the patients with different age groups of.1.1.2, and the ratio of the quality of life to all aspects was compared. In terms of economic origin, middle-aged patients aged 45~59 was the lowest (P0.05), and the scores of 60 years old and older were the highest (P0.05). Compared with the total health status and the impact of two items on the survival experience and family friction, the 18~44 year old patients scored the lowest score, and the 60 years old and older patients had the highest score (P0.05).1.1.3 difference. There were significant differences in scores in psychological and spiritual pillar areas (P0.05), and there were significant differences in scores of scores in all aspects of life quality, positive feeling, work ability, economic pressure and spiritual support (P0.05), which showed that the lower the learning calendar and the lower average score, the trend.1.1.4 was in the social customs of the married patients. The degree of satisfaction in the field and sexual life was higher than that of non remarried patients, and there was no statistical difference in other aspects of quality of life (P0.05).1.1.5 different occupational patients had statistical significance (P0.05) in the psychological, environmental and spiritual pillar areas (P0.05); the quality of life in all aspects, the patients were positive, thought, learning, memory and attention. Strength, dependence on drugs and medical means, work ability, economic sources, opportunities to acquire new information knowledge and skills, the participation of leisure and entertainment activities, and the 8 aspects of the environmental conditions are statistically significant (P0.05); family friction has a statistically significant difference in the score of the impact items on the patients; the peasants and the patients engaged in the service industry are above. There was no statistical difference in the score of quality of life of the patients with different types of.1.1.6 with different types of cancer (P0.05). The scores of the patients in different ways of.1.1.7 treatment were statistically significant (P0.05) in the field of physiology, social relations and spiritual pillar areas (P0.05); the scores of the quality of life were compared, the pain and discomfort of the patients, and the medicine and medical treatment There were statistically significant differences in the scores of 6 aspects, such as the dependence of means, personal relationship, the satisfaction of social support, traffic conditions, and spiritual support (P0.05). There were statistically significant differences in the scores of 2 items in the total health status and survival feelings and family friction (P0.05); the scores of patients with synchronous radiotherapy and chemotherapy were lower than those of the single group. The patients (P0.05).1.1.8 alone were compared with the different caregivers during the period of hospitalization, and the social relationships in the field of spouse care were higher than those of the other patients (P0.05); the quality of life was compared, sleep and rest, thought, memory and attention, personal relationship, and the satisfaction of social support required. There were significant differences in scores between 4 aspects (P0.05). The scores of sleep and rest, personal relationship, and social support needed by spouses were higher than those of other patients (P0.05); the impact items of family friction on patients, the effect of the spouse taking care of the patients were less than those of other patients (P0.05).1.2 The quality of survival of the patients was compared with the normal model. Compared with the norm, the difference was statistically significant (p0.000), compared with the norm in the field of social relations and the environment (P0.05), and 2 in the quality of life. In the 4 aspects, the subjects had no statistically significant difference (P0.05) in 5 aspects, such as positive feelings, personal relations, social security, access to new information, knowledge, skill opportunities and traffic conditions (P0.05), and the other 19 aspects were statistically significant (P0.05); the total health of the subjects was in general health. The difference in the feeling score of the condition and the quality of life compared with the norm (p0.000) the family function of.2. patients was lower than that of the middle-aged patients, and the family function of the married patients was lower than that of the married patients. The family work of the farmers was lower than the workers, the administrative workers, the professional technical practitioners, and the concurrent chemoradiotherapy patients. The difference in score of family function was lower than that of radiotherapy alone or chemotherapy (P0.05). Compared with the score of family function, the degree of family cooperation and growth of young patients was lower than that of middle-aged patients, and the perceived family growth (P0.05) was lower than the age of 60 years and older. The degree of adaptation was lower than that of female patients (P0.05); the perceived family function of patients undergoing chemotherapy was lower than intimacy, and other dimensions of family function were lower than those of individual radiotherapy or chemotherapy (P0.05); the degree of family cooperation perceived by administrative workers was higher than that of workers, farmers, service practitioners, intellectuals, administrative workers, and workers. The degree and intimacy higher than the farmers and service industry practitioners (P0.05).3. patients with the quality of life and family function of the family fitness score and the psychological field, social relations, the environment, the spiritual pillar field score positive correlation (P0.05); the degree of cooperation is not only positively related to the other areas outside the field of independence (P0.05); The score of the length score and the quality of life, the overall health status and the score of the quality of life were positively correlated (P0.05); the score of emotion was positively related to the field of social relations, the score of the environment (P0.05); the score of intimacy was positively correlated with the field of psychology, social relations, and the spiritual pillar field (P0.05); the total score of family function and the elimination of the score were positive. Multiple factors of positive correlation in other fields outside the field of independence (P0.05) a multifactor analysis of the quality of life in patients with cancer in.4. cancer patients; family function is the psychological field, social relations, environment, mental support, overall health status and quality of life, the factors affecting family friction, age and marital status are the overall health conditions and the overall health status. The quality of life, the influencing factors of family friction, sex are the influencing factors in the environmental field, the hospitalized caregivers are the influencing factors of family friction. 1. the study conclusions: the quality of life of the cancer patients in the hospitalized stage of chemotherapy and chemotherapy is significantly decreased by 2., the main influence factors are the family function 3. different cases. The family function of perception is different. Young patients, non married patients, farmer patients, family members with combined chemoradiotherapy have lower family function.

【學(xué)位授予單位】：第四軍醫(yī)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R473.73

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本文編號：1886790