【摘要】：目的:了解消化道惡性腫瘤患者配偶的創(chuàng)傷后成長(Posttraumatic Growth,PTG)現(xiàn)狀,深入探討PTG影響因素,旨在關(guān)注、引導(dǎo)消化道惡性腫瘤患者配偶積極應(yīng)對不良的創(chuàng)傷體驗(yàn),改變其認(rèn)知加工過程,提高自我效能,促進(jìn)臨床及社區(qū)護(hù)士以不同的視角幫助其處于良好的身心狀態(tài),提高其照護(hù)質(zhì)量。方法:本研究為橫斷面研究,采用便利抽樣的方法,在2016年7月-12月選擇符合納入、排除標(biāo)準(zhǔn)的山東省某三甲醫(yī)院消化內(nèi)科住院的消化道惡性腫瘤患者配偶160人進(jìn)行問卷調(diào)查。問卷內(nèi)容包括消化道惡性腫瘤患者配偶的一般人口學(xué)資料及患者臨床疾病資料、創(chuàng)傷后成長評定量表、事件相關(guān)反芻問卷和一般自我效能量表。所有數(shù)據(jù)采用SPSS 21.0軟件進(jìn)行統(tǒng)計(jì)分析,統(tǒng)計(jì)方法包括描述性統(tǒng)計(jì)、t檢驗(yàn)、單因素方差分析、Pearson相關(guān)分析和多元線性回歸分析。結(jié)果:1.消化道惡性腫瘤患者配偶PTG水平總分為(52.99±19.88),PTG水平較低。各維度得分由高到低依次是對生活的欣賞(3.07± 1.21)、個(gè)人力量(2.59土1.12)、與他人關(guān)系(2.46±0.89)、新的可能性(2.42±1.04)、精神改變(2.02±1.15)。2.消化道惡性腫瘤患者配偶反芻性沉思總分為(33.61 土8.13),處于中等水平。各維度得分為目的性反芻(18.13±5.39),侵入性反芻(15.48±4.78)。3.消化道惡性腫瘤患者配偶的自我效能總分為(25.44±6.10),低于全國常模(28.64±5.21 分)。4.獨(dú)立樣本t檢驗(yàn)和單因素方差分析顯示:在配偶的年齡、職業(yè)、家庭平均月收入、照顧時(shí)間、家庭關(guān)系及患者的自理能力、病理分期方面不同組別的消化道惡性腫瘤患者配偶PTG總分差異有統(tǒng)計(jì)學(xué)意義(P0.05),消化道惡性腫瘤患者配偶的性別、文化程度、宗教信仰、費(fèi)用支付方式及患者的入院次數(shù)、治療方式對其PTG總分的影響差異無統(tǒng)計(jì)學(xué)意義(P0.05)。5.Pearson相關(guān)分析顯示:消化道腫瘤患者配偶反芻性沉思總分及目的性反芻維度與PTG呈高度正相關(guān)(P0.05)。侵入性反芻與PTG呈低度負(fù)相關(guān)(P0.05),自我效能與PTG呈高度正相關(guān)(P0.05)。6.多元線性回歸分析顯示:影響消化道惡性腫瘤患者配偶PTG水平的因素包括患者的自理能力、病理分期、目的性反芻、侵入性反芻和自我效能。多元相關(guān)系數(shù)為0.807,共解釋變異量65.20%。配偶的PTG水平隨著患者的自理能力降低而提高,病理分期處于Ⅱ期的患者配偶成長水平最高。消化道惡性腫瘤患者配偶目的性反芻越多,侵入性反芻越少,自我效能越高,其PTG越高。結(jié)論:1.消化道惡性腫瘤患者配偶存在較低水平的創(chuàng)傷后成長。2.影響消化道惡性腫瘤患者配偶創(chuàng)傷后成長水平的人口學(xué)因素主要有年齡、職業(yè)、家庭平均月收入、照顧時(shí)間和家庭關(guān)系,患者的腫瘤病理分期及自理能力。3.消化道惡性腫瘤患者配偶的目的性反芻越多,自我效能越高,創(chuàng)傷后成長水平就越高,侵入性反芻越多,創(chuàng)傷后成長水平就越低。4.患者的自理能力、病理分期、目的性反芻、侵入性反芻和自我效能是消化道惡性腫瘤患者配偶創(chuàng)傷后成長的顯著影響因素。
[Abstract]:Objective: To study the status of post-traumatic growth (PTG) of the patients with malignant tumor of the digestive tract, and to explore the influence factors of PTG. To promote the clinical and community nurses to help the clinical and community nurses to improve their care quality with different visual angles. Methods: The study was a cross-sectional study. In July-December, 2016, 160 patients with digestive tract malignant tumor who were hospitalized for digestive system of a third-grade hospital in Shandong province were investigated by means of a method of convenient sampling. The contents of the questionnaire included general demographic data of the patient's mate in the digestive tract malignant tumor and the clinical data of the patient, the post-traumatic growth rating scale, the event-related anti-questionnaire and the general self-efficacy scale. All the data were analyzed by SPSS 10.0 software. The statistical methods include descriptive statistics, t-test, single-factor analysis of variance, Pearson correlation analysis and multiple linear regression analysis. Results: 1. The level of PTG in the patients with malignant tumor of the digestive tract was divided into 52. 99 (19. 88) and the PTG level was lower. The scores of each dimension from high to low are the appreciation of life (3.07-1.21), the personal strength (2.59, 1.12), the relationship with others (2.46-0.89), the new possibility (2.42-1.04), and the spiritual change (2.02-1.15). A total of 33. 61 (8.13) of the patients with malignant tumor of the digestive tract were divided into two groups (33.61, 8.13). The dimensions of each dimension are divided into the purpose of the purpose (18.9 to 5.39), and the invasive anti-dumping (15.48, 4.78). The self-efficacy of the spouses in the malignant tumor of the digestive tract is divided into (25. 44 to 6.10), which is lower than that of the national norm (28. 64 to 5.21). the independent sample t-test and the single-factor analysis of variance showed that the age, occupation, average monthly income of the family, the care time, the family relationship, and the self-management of the patient, There was a significant difference in the total score of PTG in the patients with malignant tumor of the digestive tract (P0.05), the sex, the degree of culture, the religious belief, the method of payment and the number of admission to the patient. There was no significant difference in the effect of treatment on the total score of PTG (P0.05). There was a low negative correlation between the invasion and the PTG (P0.05), and the self-efficacy was positively correlated with the PTG (P0.05). The multivariate linear regression analysis showed that the factors that affect the level of PTG in the patients with digestive tract malignant tumor include the self-regulation ability, the pathological stage, the purpose anti-dumping, the invasive anti-interference and the self-efficacy of the patients. The multivariate correlation coefficient was 0.807, and the total amount of variation was 65. 20%. The level of PTG of the spousal was increased with the decrease of the patient's self-regulation, and the level of the partner's growth in the second stage was the highest. The more the patients with malignant tumor of the digestive tract, the more the purpose, the less invasive, the higher the self-efficacy and the higher the PTG. Conclusion: 1. The patients with malignant tumor of the digestive tract have low levels of post-traumatic growth. The demographic factors that affect the post-traumatic growth of the patients with malignant tumor of the digestive tract are mainly age, occupation, average monthly income of the family, the time of care and family, the pathological staging and self-management of the patients. The higher the purpose of the patient's spouse, the higher the self-efficacy, the higher the level of post-traumatic growth, the more invasive anti-cancer, and the lower the level of post-traumatic growth. The patient's self-regulation, the pathological stage, the purpose-back-resistance, the invasive reverse-resistance and the self-efficacy are the significant factors that affect the growth of the partner of the patients with the digestive tract malignant tumor.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R473.73

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