死亡教育对家居晚期癌症患者生活质量的影响  

Influence of death education on quality of life in advanced caner patients at home

作　　者：周晓敏[1] 张华萍[1] 林章华[1] 韦永凤[1] 

机构地区：[1]广西医科大学第一附属医院宁养院,广西壮族自治区南宁市530021

出　　处：《中国临床康复》2005年第40期54-56,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:通过死亡教育前后家居晚期癌症患者对死亡观的认识及行为变化,探讨死亡教育对其生活质量的影响。方法:2004-08/2005-03在广西医科大学第一附属医院宁养院接受宁养服务的113例家居晚期癌症患者。开展调查前统一对参与调查评估人员进行死亡教育计划培训。采用自行拟定的死亡观认识与行为问卷评估患者对死亡的认识、面临死亡的态度及行为,采用生活质量评估表评定患者的生活质量,主要包括8项内容,采用1-5级评分,得分越高,生活质量越好。于死亡教育前发放问卷及评估表,根据评估结果针对性发放死亡教育资料,引导、启发、解说典型事例等,每周服务(上门、电话、门诊)1次,1个月后再次发放问卷调查、评估。主要观察家居晚期癌症患者死亡教育前后死亡观的认识与行为及生活质量的变化。组间比较采用χ2检验和t检验。结果:发放问卷113份,回收有效问卷100份,回收率为88.5%。①死亡教育前所有患者均存在不同程度的死亡观不良认识与行为,而进行教育后这些情况均得到显著的改善,比例明显下降(P<0.001)。②死亡教育后,生活质量各项得分显著高于教育前,生活质量明显提高(P<0.001～0.05).结论:死亡教育可改善家居晚期癌症患者对死亡的不良认知及行为,促进患者的心理健康,提高其生活质量。AIM： To discuss the influence of death education on the quality of life （QOL） in the advanced cancer patients at home by the changes of cognition and behaviors to death before and after the education. METHODS： 113 advanced cancer patients at home, who were receiving care in the hospice of the First Affiliated Hospital of Guangxi Medical University from August 2004 to March 2005, were selected. Death education training plan was held to people who joined in the work before investigation. Patients were investigated by self-designed questionnaire about their cognition, attitudes and behaviors to death. QOL questionnaire assessment were used to assess the QOL in patients, including mainly 8 items, taking 1-5 grades, the higher the score, the better the QOL was. The questionnaires and evaluation sheets were sent out before death education. Education material, typical examples on inducing, arousing and explaining to death, etc. were firing aimedly according to the evaluation result. Once every week （go to house, telephone or out-patient clinic）, the investigation and assessment were carried on again after a month. Their cognitions and behaviors to death and assessment scores of QOL before and after the education were compared mainly. The χ^2 test and t test were adopted on comparison among groups. RESULTS： 113 questionnaires were sent out, receiving 100 efficient questionnaires with 88.5% retrieving rate. ① All the patients had various wrong cognitions and behaviors to death before the death education. Such situation had been ameliorated remarkably after the education, and the proportion dropped greatly （P〈0.001）. ②After the death education, scores on all items for the assessment of QOL were higher remarkably than those before education, and the QOL was improved greatly （P〈0.001-0.05 ）. CONCLUSION： The death education can improve the wrong cognitions and behaviors to death in the advanced cancer patients at home, accelerate their mental health and enhance their QOL.

关 键 词：肿瘤 教育 生活质量 

分 类 号：R399.39[医药卫生—基础医学]