【摘要】：目的了解分化型甲狀腺癌(DTC)術(shù)后行放射性碘(RAI)治療患者自我管理效能感水平,分析探討患者的自我管理效能感的影響因素,為臨床醫(yī)護(hù)工作提高患者的自我管理能力提供參考依據(jù)。方法選取363名就診于北京市四所綜合醫(yī)院接受RAI治療的分化型甲狀腺癌術(shù)后患者進(jìn)行問(wèn)卷調(diào)查,采用自行設(shè)計(jì)的患者一般資料和疾病相關(guān)資料調(diào)查問(wèn)卷、癌癥患者自我管理效能感測(cè)評(píng)量表、社會(huì)支持測(cè)評(píng)問(wèn)卷、綜合醫(yī)院焦慮和抑郁測(cè)評(píng)量表、生命質(zhì)量評(píng)估問(wèn)卷、醫(yī)學(xué)應(yīng)對(duì)問(wèn)卷對(duì)患者進(jìn)行調(diào)查。建立Excel數(shù)據(jù)庫(kù),通過(guò)SPSS22.0軟件對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析,患者的一般資料和疾病相關(guān)資料等分類變量采用獨(dú)立樣本t檢驗(yàn)和ANOVA方差分析;患者的抑郁和焦慮狀態(tài)、社會(huì)支持情況、生命質(zhì)量和醫(yī)學(xué)應(yīng)對(duì)行為等連續(xù)變量采用Pearson相關(guān)分析,多元逐步回歸方法解析分化型甲狀腺癌術(shù)后行RAI治療患者自我管理效能感水平的影響因素。結(jié)果1分化型甲狀腺癌術(shù)后行RAI治療患者自我管理效能感總分為(89.71±19.45)分。2單因素方差分析結(jié)果:不同婚姻狀況、文化水平、照顧者、醫(yī)療費(fèi)用支付類型、家庭人均月收入、性格類型、鍛煉情況、知曉情況、患病時(shí)間、病理分期、淋巴結(jié)是否轉(zhuǎn)移、腫瘤體積和復(fù)發(fā)危險(xiǎn)度分層的分化型甲狀腺癌術(shù)后行RAI治療的患者自我管理效能感得分間差異具有統(tǒng)計(jì)學(xué)意義(P(27)0.05);軀體、角色、認(rèn)知、情緒、社會(huì)等功能領(lǐng)域、患者總體健康狀況、面對(duì)、回避、社會(huì)支持各維度與自我管理效能感均呈正相關(guān);焦慮、抑郁、疲倦、惡心嘔吐、疼痛、失眠、食欲喪失、經(jīng)濟(jì)困難、屈服與自我管理效能感均呈負(fù)相關(guān)。3多元逐步回歸分析結(jié)果:最終有12個(gè)變量進(jìn)入到回歸方程式中,根據(jù)影響力度由大到小排序依次為:面對(duì)、屈服、知情、復(fù)發(fā)危險(xiǎn)度分層、性格類型、抑郁、淋巴結(jié)是否轉(zhuǎn)移、回避、病理分期、經(jīng)濟(jì)困難、居住區(qū)域、服碘頻次;12個(gè)變量共同解釋患者自我管理效能感水平總變異的72%。結(jié)論1分化型甲狀腺癌術(shù)后行RAI治療患者的自我管理效能感處于中等水平。2分化型甲狀腺癌術(shù)后行RAI治療患者自我管理效能感水平的影響因素?fù)?jù)影響力由大到小排序依次為:面對(duì)、屈服、知情、復(fù)發(fā)危險(xiǎn)度分層、性格類型、抑郁、淋巴結(jié)轉(zhuǎn)移、回避、病理分期、經(jīng)濟(jì)困難、居住區(qū)域和服碘次數(shù)。積極的醫(yī)學(xué)應(yīng)對(duì)方式、開(kāi)朗樂(lè)觀的性格、減輕患者經(jīng)濟(jì)負(fù)擔(dān)、針對(duì)性隱瞞病情有利于提高患者的自我管理效能感水平;居住區(qū)域?yàn)槌鞘�、服碘次�?shù)越少、復(fù)發(fā)危險(xiǎn)度分層和病理分期越低的患者自我管理效能感水平相對(duì)較高。3評(píng)價(jià)甲狀腺癌術(shù)后行RAI治療患者自我管理效能感水平,參考上述因素對(duì)患者制定個(gè)體化干預(yù)措施,有助于提升患者的自我管理效能感水平,提高患者的自我管理能力。
[Abstract]:Objective to investigate the level of self-management efficacy in patients with differentiated thyroid carcinoma treated with radioactive iodine (RAI) after (DTC), and to analyze the influencing factors of self-management efficacy. To provide a reference for clinical nursing work to improve the ability of self-management of patients. Methods A total of 363 patients with differentiated thyroid carcinoma treated with RAI in four general hospitals in Beijing were investigated by questionnaire. The general data of patients and disease related data were investigated by self-designed questionnaire. The self-management efficacy scale, the social support scale, the comprehensive hospital anxiety and depression scale, the quality of life assessment questionnaire and the medical response questionnaire were investigated. The Excel database was established and the data were analyzed statistically by SPSS22.0 software. The patients' general data and disease related data were classified by independent sample t-test and ANOVA variance analysis. Continuous variables such as depression and anxiety, social support, quality of life and medical coping behavior were analyzed by Pearson correlation. Multivariate stepwise regression method was used to analyze the influencing factors of self-management efficacy in patients with differentiated thyroid carcinoma treated with RAI. Results (1) the total score of self-management efficacy was (89.71 鹵19.45) in patients with differentiated thyroid carcinoma treated with RAI after operation. 2 the results of ANOVA were as follows: different marital status, educational level, caregivers, types of payment of medical expenses. Per capita monthly income, personality type, exercise, knowledge, time of illness, pathological stage, lymph node metastasis, There was significant difference in the scores of self-management efficacy between the patients who received RAI treatment after the operation of tumor volume and recurrence risk stratified differentiated thyroid carcinoma (P (27). The functional fields of body, role, cognition, emotion, society and so on, the overall health status of patients, the dimensions of face, avoidance and social support were positively correlated with the sense of self-management efficacy. Anxiety, depression, fatigue, nausea and vomiting, pain, insomnia, loss of appetite, financial difficulties, yield were negatively correlated with self-management efficacy. According to the order of influence intensity from big to small, the order is: face, yield, know, recurrence risk stratification, personality type, depression, lymph node metastasis, avoidance, pathological stage, economic difficulty, living area, iodine frequency; Twelve variables explained 72% of the total variation in the level of self-management efficacy. Conclusion (1) Self-management efficacy of patients with differentiated thyroid carcinoma treated with RAI after operation is at a moderate level. (2) the influencing factors of self-management efficacy in patients with differentiated thyroid carcinoma treated with RAI after operation are from great to The small order is: face, Yield, knowledge, recurrence risk stratification, personality type, depression, lymph node metastasis, avoidance, pathological staging, financial difficulties, living area and iodine times. Positive medical coping style, cheerful and optimistic personality, lightening the economic burden of patients, and hiding their illness will help to improve the level of self-management efficacy of patients. The patients with less iodine intake, lower recurrence risk stratification and lower pathological stage had a higher level of self-management efficacy. 3 to evaluate the self-management efficacy level of patients treated with RAI after thyroid cancer operation. It is helpful to improve the level of self-management efficacy and the ability of self-management of patients to make individualized intervention measures according to the above factors.
【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R473.73

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 房居高;;提高甲狀腺腫瘤診療的精準(zhǔn)化程度,改善患者生存質(zhì)量[J];中國(guó)耳鼻咽喉頭頸外科;2017年02期

2 謝芳;;甲狀腺癌術(shù)后患者抑郁狀況與社會(huì)支持、應(yīng)對(duì)方式、自我效能感的相關(guān)性研究[J];齊魯護(hù)理雜志;2016年24期

3 華夏;周芳;;杭州地區(qū)甲狀腺癌患者社會(huì)支持對(duì)生存質(zhì)量的影響[J];中醫(yī)藥管理雜志;2016年21期

4 董晨;趙芳芳;李珍宇;肖倩云;楊影;戴夢(mèng)娟;郭瑜潔;;癌癥患者自我效能對(duì)抑郁發(fā)生率的影響[J];齊魯護(hù)理雜志;2016年19期

5 陸云;;護(hù)理專業(yè)性社會(huì)支持在腫瘤患者自我效能感的應(yīng)用現(xiàn)狀[J];臨床護(hù)理雜志;2016年02期

6 周毅娟;張艷玲;焦妙蕊;何愛(ài)蓮;;乳腺癌復(fù)發(fā)轉(zhuǎn)移患者心理調(diào)查及護(hù)理[J];中國(guó)民康醫(yī)學(xué);2016年05期

7 穆欣;李娟;劉瑞榮;鄭曉英;;首發(fā)腦卒中患者自我管理行為及影響因素的研究[J];中華護(hù)理雜志;2016年03期

8 馮茜茜;陳麗君;黃英凡;陳英;;子宮頸癌患者自我管理效能感與焦慮、抑郁相關(guān)性分析[J];右江民族醫(yī)學(xué)院學(xué)報(bào);2016年01期

9 何平;丁亞媛;楊悅;蔣玲;楊莉;;南京市中老年人健身運(yùn)動(dòng)現(xiàn)狀調(diào)查[J];護(hù)理研究;2015年33期

10 崔海琳;肖曉嵐;;甲狀腺乳頭狀癌患者疾病應(yīng)對(duì)方式與生活質(zhì)量的相關(guān)性研究[J];中國(guó)護(hù)理管理;2015年09期

相關(guān)碩士學(xué)位論文 前10條

1 馮玉如;基于結(jié)構(gòu)方程模型的城鄉(xiāng)老年人一般自我效能感影響因素分析[D];華北理工大學(xué);2016年

2 郭婷;社區(qū)老年慢性疼痛患者社會(huì)支持、自我效能與生活質(zhì)量的關(guān)系研究[D];天津醫(yī)科大學(xué);2014年

3 徐靜;安徽省農(nóng)村地區(qū)健康素養(yǎng)與健康傳播現(xiàn)狀及其關(guān)系的實(shí)證研究[D];安徽醫(yī)科大學(xué);2014年

4 孫淑娟;宮頸癌患者術(shù)后抑郁和焦慮情緒發(fā)生率及影響因素分析[D];中南大學(xué);2013年

5 張燕燕;放射性碘治療對(duì)分化型甲狀腺癌患者生命質(zhì)量的影響[D];山東大學(xué);2013年

6 馬穎;108例癌癥住院患者自我管理效能感水平及相關(guān)因素研究[D];吉林大學(xué);2013年

7 皋文君;腸造口患者自我效能感水平橫斷面調(diào)查及其影響因素分析[D];第二軍醫(yī)大學(xué);2012年

8 張國(guó)芬;分化型甲狀腺癌術(shù)后相關(guān)激素水平變化及對(duì)促甲狀腺素抑制治療的意義[D];北京協(xié)和醫(yī)學(xué)院;2012年

9 石紅偉;癌癥患者宗教應(yīng)對(duì)體驗(yàn)的質(zhì)性研究[D];泰山醫(yī)學(xué)院;2012年

10 錢(qián)會(huì)娟;癌癥患者自我管理效能感水平的橫斷面研究及其影響因素分析[D];第二軍醫(yī)大學(xué);2011年

，

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