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永久性腸造口患者健康相關(guān)行為與生活質(zhì)量的關(guān)系研究

發(fā)布時(shí)間:2018-01-05 22:06

  本文關(guān)鍵詞:永久性腸造口患者健康相關(guān)行為與生活質(zhì)量的關(guān)系研究 出處:《青島大學(xué)》2017年碩士論文 論文類(lèi)型:學(xué)位論文


  更多相關(guān)文章: 永久性腸造口 自我表露 反芻思維 健康促進(jìn)行為 生活質(zhì)量


【摘要】:目的本研究通過(guò)調(diào)查永久性腸造口患者自我表露、反芻思維、孤獨(dú)感、健康促進(jìn)行為和生活質(zhì)量現(xiàn)狀及其影響因素,分析自我表露、反芻思維、孤獨(dú)感、健康促進(jìn)行為、生活質(zhì)量間的相關(guān)性,探討自我表露、反芻思維、孤獨(dú)感、健康促進(jìn)行為對(duì)生活質(zhì)量的作用路徑,以便為患者進(jìn)行有效的心理行為指導(dǎo)、改善其生活質(zhì)量提供參考依據(jù)。方法本研究屬于橫斷面研究。采用方便抽樣法,選取2014年11月至2016年9月在青島市某三所三級(jí)甲等醫(yī)院復(fù)查及參加造口聯(lián)誼會(huì)的225名永久性腸造口患者,采用自我表露指數(shù)問(wèn)卷、反芻思維量表、孤獨(dú)感中文簡(jiǎn)版量表、健康促進(jìn)生活方式量表Ⅱ、造口患者生活質(zhì)量問(wèn)卷中文版及患者一般資料調(diào)查表,分別調(diào)查患者的健康相關(guān)行為和生活質(zhì)量。采用SPSS17.0軟件和AMOS21.0軟件對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析,主要的統(tǒng)計(jì)方法包括:描述性分析、獨(dú)立樣本t檢驗(yàn)、單因素方差分析、Pearson相關(guān)分析、多元線(xiàn)性回歸分析以及結(jié)構(gòu)方程模型等。結(jié)果1.永久性腸造口患者自我表露得分為30.35±8.09分;自我表露的影響因素包括每日護(hù)理造口時(shí)間、年齡、文化程度、造口并發(fā)癥、性別和居住情況。2.永久性腸造口患者反芻思維得分為2.44±0.46分,各維度得分由高到低依次為癥狀反芻、強(qiáng)迫思考和反省深思;反芻思維的影響因素包括每日護(hù)理造口時(shí)間、性別、造口術(shù)后時(shí)間、是否放化療、造口并發(fā)癥以及目前工作狀況。3.永久性腸造口患者孤獨(dú)感得分為19.81±3.77分;孤獨(dú)感的影響因素包括造口術(shù)后時(shí)間、婚姻狀況、文化程度、性別、目前工作狀況、是否放化療以及造口并發(fā)癥。4.永久性腸造口患者健康促進(jìn)行為得分為122.76±25.00分,各維度得分由高到低排序依次是人際關(guān)系、營(yíng)養(yǎng)、運(yùn)動(dòng)鍛煉、健康職責(zé)、自我實(shí)現(xiàn)和壓力處理;健康促進(jìn)行為的影響因素包括每日護(hù)理造口時(shí)間、文化程度和職業(yè)。5.永久性腸造口患者生活質(zhì)量得分為4.84±0.92分,各維度得分由高到低排序依次是心理健康、精神健康、生理健康和社會(huì)健康;生活質(zhì)量的影響因素包括文化程度和每日護(hù)理造口時(shí)間。6.相關(guān)分析結(jié)果表明:自我表露與反芻思維和孤獨(dú)感呈負(fù)相關(guān)(r=-0.762;r=-0.372,P0.01),自我表露與健康促進(jìn)行為和生活質(zhì)量呈正相關(guān)(r=0.527;r=0.411,P0.01);反芻思維與孤獨(dú)感呈正相關(guān)(r=0.593,P0.01),反芻思維與健康促進(jìn)行為和生活質(zhì)量呈負(fù)相關(guān)(r=-0.523;r=-0.405,P0.01);孤獨(dú)感與健康促進(jìn)行為和生活質(zhì)量呈負(fù)相關(guān)(r=-0.525,r=-0.430,P0.01);健康促進(jìn)行為與生活質(zhì)量呈正相關(guān)(r=0.840,P0.01)。7.結(jié)構(gòu)方程模型顯示:自我表露對(duì)生活質(zhì)量具有直接正向預(yù)測(cè)作用(β=0.124,P0.05);孤獨(dú)感對(duì)生活質(zhì)量具有直接負(fù)向預(yù)測(cè)作用(β=-0.124,P0.05);健康促進(jìn)行為對(duì)生活質(zhì)量具有直接正向預(yù)測(cè)作用(β=0.831,P0.001);反芻思維對(duì)生活質(zhì)量具有直接負(fù)向預(yù)測(cè)作用(β=-0.452,P0.01)。反芻思維、孤獨(dú)感、健康促進(jìn)行為在自我表露對(duì)生活質(zhì)量路徑中都起到部分中介作用,中介效應(yīng)值分別占總效應(yīng)的53.69%、7.06%、19.78%;健康促進(jìn)行為在孤獨(dú)感對(duì)生活質(zhì)量路徑中起部分中介作用,中介效應(yīng)值占總效應(yīng)的48.55%;孤獨(dú)感和健康促進(jìn)行為在反芻思維對(duì)生活質(zhì)量路徑中起到部分中介作用,中介效應(yīng)值分別占總效應(yīng)的7.89%、43.30%。結(jié)論1.文化程度、每日護(hù)理造口時(shí)間、造口術(shù)后時(shí)間等對(duì)永久性腸造口患者自我表露、孤獨(dú)感、反芻思維、健康促進(jìn)行為和生活質(zhì)量有一定的影響。2.自我表露和健康促進(jìn)行為與生活質(zhì)量均呈正相關(guān),反芻思維和孤獨(dú)感與生活質(zhì)量均呈負(fù)相關(guān)。3.患者的自我表露可直接影響其生活質(zhì)量,反芻思維、孤獨(dú)感和健康促進(jìn)行為又可作為中介變量調(diào)節(jié)自我表露對(duì)生活質(zhì)量的影響;孤獨(dú)感可直接影響患者的生活質(zhì)量,健康促進(jìn)行為又可作為中介變量調(diào)節(jié)兩者之間的關(guān)系;反芻思維可直接影響患者的生活質(zhì)量,孤獨(dú)感和健康促進(jìn)行為又可作為中介變量調(diào)節(jié)反芻思維對(duì)患者生活質(zhì)量的影響。
[Abstract]:The purpose of this study is through self disclosure, investigation of permanent colostomy patients of rumination, loneliness, health promotion factors of behavior and quality of life situation and effect analysis, self disclosure, rumination, loneliness, health promoting behavior, the correlation between quality of life and the discussion of self disclosure, rumination, loneliness, health promotion the path to the quality of life for patients with psychological behavior, effective guidance, to provide reference for improving their quality of life. Methods this study was a cross-sectional study. By convenient sampling method, from November 2014 to September 2016 in a three review of three hospitals in Qingdao city and Stoma Association 225 permanent colostomy with the self disclosure index questionnaire, rumination scale, loneliness scale Chinese Jane version, Health Promoting Lifestyle Profile II, made in the quality of life in patients with. The volume Chinese version and the general data of patients were investigated with questionnaire, health behavior and quality of life. The data was analyzed using SPSS17.0 software and AMOS21.0 software, including the main statistical methods: descriptive analysis, independent sample t test, single factor variance analysis, Pearson correlation analysis, regression analysis and structural equation model the results of self disclosure. 1. permanent colostomy patients score was 30.35 + 8.09; influence factors of self disclosure including the daily nursing stoma time, age, culture degree, stoma complications, sex and living conditions of.2. permanent colostomy patients rumination score was 2.44 + 0.46 points, the scores from high to low in order for the symptoms of rumination, brooding and reflection; influencing factors of rumination including the daily nursing stoma time, gender, time after colostomy, whether chemotherapy, stoma The complications and the current working condition of.3. permanent colostomy patients loneliness score was 19.81 + 3.77; influencing factors of loneliness after colostomy include time, marital status, education level, gender, current working conditions, whether chemotherapy and complication of.4. permanent colostomy patients health promoting behavior score was 122.76 + 25, the scores from high to low rank is the interpersonal relationship, nutrition, exercise, health responsibility, self realization and pressure treatment; health promoting behavior factors include the effect of daily nursing of colostomy time, education level and occupation.5. the quality of life in patients with permanent colostomy score was 4.84 + 0.92 points, the scores from high to low rank is mental health, mental health, physical health and social health; the factors affecting the quality of life including education and daily nursing stoma time.6. correlation analysis The results show that the self disclosure and rumination and loneliness were negatively correlated (r=-0.762; r=-0.372, P0.01), self disclosure and health promoting behaviors and quality of life were positively correlated (r=0.527; r=0.411, P0.01); rumination and loneliness was positively correlated (r=0.593, P0.01), rumination and health promotion behavior and quality of life is negative correlation (r=-0.523; r=-0.405, P0.01); loneliness and health promoting behaviors and quality of life were negatively correlated (r=-0.525, r=-0.430, P0.01); promote health related behavior and quality of life was positively (r=0.840, P0.01).7. structural equation model: self disclosure has a direct positive effect on the quality of life (beta =0.124, P0.05); loneliness has a direct negative effect on the quality of life (beta =-0.124, P0.05); the behavior has a direct positive prediction on the quality of life for health promotion (beta =0.831, P0.001); rumination directly with the quality of life Negative predictive effect (beta =-0.452, P0.01). Rumination, loneliness, health promoting behavior in self disclosure on the quality of life path plays a part intermediary role mediating effect of total effect values were 53.69%, 7.06%, 19.78%; health promoting behavior in the loneliness of the mediating effect of the quality of life path in the intermediary effect value of the total effect in 48.55%; promote the behavior of rumination to play the part of the intermediary role of quality of life in the path of loneliness and health, the mediating effect of total effect values were 7.89%, 1. 43.30%. conclusion education, daily nursing time after colostomy stoma, the time of self disclosure, permanent colostomy patients loneliness, rumination, health promoting behaviors and quality of life have certain effect of.2. self disclosure and health promoting behavior and quality of life were positively correlated, rumination and loneliness and life quality were Negative correlation with.3. self disclosure can directly affect the quality of life, rumination, loneliness and health promotion behavior as a mediating variable self disclosure regulation effect on quality of life; loneliness can directly affect the quality of life of patients, health promoting behaviors and can be used as an intermediary variable regulating the relationship between rumination; can directly affect the quality of life of patients, loneliness and health promotion behavior as a mediating variable regulation of rumination effects on the quality of life of patients.

【學(xué)位授予單位】:青島大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2017
【分類(lèi)號(hào)】:R473.73

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