【摘要】：目的了解分化型甲狀腺癌(DTC)術后行放射性碘(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)護工作提高患者的自我管理能力提供參考依據。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后患者進行問卷調查,采用自行設計的患者一般資料和疾病相關資料調查問卷、癌癥患者自我管理效能感測評量表、社會支持測評問卷、綜合醫(yī)院焦慮和抑郁測評量表、生命質量評估問卷、醫(yī)學應對問卷對患者進行調查。建立Excel數據庫,通過SPSS22.0軟件對數據進行統(tǒng)計學分析,患者的一般資料和疾病相關資料等分類變量采用獨立樣本t檢驗和ANOVA方差分析;患者的抑郁和焦慮狀態(tài)、社會支持情況、生命質量和醫(yī)學應對行為等連續(xù)變量采用Pearson相關分析,多元逐步回歸方法解析分化型甲狀腺癌術后行RAI治療患者自我管理效能感水平的影響因素。結果1分化型甲狀腺癌術后行RAI治療患者自我管理效能感總分為(89.71±19.45)分。2單因素方差分析結果:不同婚姻狀況、文化水平、照顧者、醫(yī)療費用支付類型、家庭人均月收入、性格類型、鍛煉情況、知曉情況、患病時間、病理分期、淋巴結是否轉移、腫瘤體積和復發(fā)危險度分層的分化型甲狀腺癌術后行RAI治療的患者自我管理效能感得分間差異具有統(tǒng)計學意義(P(27)0.05);軀體、角色、認知、情緒、社會等功能領域、患者總體健康狀況、面對、回避、社會支持各維度與自我管理效能感均呈正相關;焦慮、抑郁、疲倦、惡心嘔吐、疼痛、失眠、食欲喪失、經濟困難、屈服與自我管理效能感均呈負相關。3多元逐步回歸分析結果:最終有12個變量進入到回歸方程式中,根據影響力度由大到小排序依次為:面對、屈服、知情、復發(fā)危險度分層、性格類型、抑郁、淋巴結是否轉移、回避、病理分期、經濟困難、居住區(qū)域、服碘頻次;12個變量共同解釋患者自我管理效能感水平總變異的72%。結論1分化型甲狀腺癌術后行RAI治療患者的自我管理效能感處于中等水平。2分化型甲狀腺癌術后行RAI治療患者自我管理效能感水平的影響因素據影響力由大到小排序依次為:面對、屈服、知情、復發(fā)危險度分層、性格類型、抑郁、淋巴結轉移、回避、病理分期、經濟困難、居住區(qū)域和服碘次數。積極的醫(yī)學應對方式、開朗樂觀的性格、減輕患者經濟負擔、針對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)域為城市、服碘次數越少、復發(fā)危險度分層和病理分期越低的患者自我管理效能感水平相對較高。3評價甲狀腺癌術后行RAI治療患者自我管理效能感水平,參考上述因素對患者制定個體化干預措施,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.
【學位授予單位】：華北理工大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.73

【參考文獻】

相關期刊論文 前10條

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

2 謝芳;;甲狀腺癌術后患者抑郁狀況與社會支持、應對方式、自我效能感的相關性研究[J];齊魯護理雜志;2016年24期

3 華夏;周芳;;杭州地區(qū)甲狀腺癌患者社會支持對生存質量的影響[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;戴夢娟;郭瑜潔;;癌癥患者自我效能對抑郁發(fā)生率的影響[J];齊魯護理雜志;2016年19期

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

6 周毅娟;張艷玲;焦妙蕊;何愛蓮;;乳腺癌復發(fā)轉移患者心理調查及護理[J];中國民康醫(yī)學;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、抑郁相關性分析[J];右江民族醫(yī)學院學報;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動現(xiàn)狀調查[J];護理研究;2015年33期

10 崔海琳;肖曉嵐;;甲狀腺乳頭狀癌患者疾病應對方式與生活質量的相關性研究[J];中國護理管理;2015年09期

相關碩士學位論文 前10條

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

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

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

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

5 張燕燕;放射性碘治療對分化型甲狀腺癌患者生命質量的影響[D];山東大學;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因素研究[D];吉林大學;2013年

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

8 張國芬;分化型甲狀腺癌術后相關激素水平變化及對促甲狀腺素抑制治療的意義[D];北京協(xié)和醫(yī)學院;2012年

9 石紅偉;癌癥患者宗教應對體驗的質性研究[D];泰山醫(yī)學院;2012年

10 錢會娟;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;2011年

，

本文編號：2370714