220例预防性肠造口患者病耻感现状及影响因素分析  

Stigma of Patients with Preventive Ostomy and Its Influence Factors: A 220-case Study

作　　者：叶子文 甄莉[2] 朱木兰[2] 胡婷 王惠珍[1] YE Zi-wen;ZHWN Li;ZHU Mu-lan;HU Ting;WANG Hui-zhen(School of Nursing,Southern Medical University,Guangzhou 510515,China;Dept.of General Surgery,Nanfang Hospital,Guangzhou 510515,China)

机构地区：[1]南方医科大学护理学院,广东广州510515 [2]南方医科大学南方医院普外科,广东广州510515

出　　处：《护理学报》2019年第3期40-45,共6页Journal of Nursing（China）

基　　金：广州市科技计划项目(201709010035

摘　　要：目的调查预防性肠造口患者的病耻感现状,分析其影响因素。方法采用便利抽样法,选取某省4家三级甲等医院220例直肠癌预防性肠造口患者,采用一般资料调查问卷、社会影响量表、领悟社会支持量表、自我隐瞒量表、应对方式问卷进行调查。采用多元线性回归分析预防性肠造口患者病耻感的影响因素。结果预防性肠造口患者病耻感得分为(60.62±7.28)分。多重线性回归分析结果显示,自我隐瞒、家庭所在地、社会支持水平、应对方式、造口对性生活的影响程度、有无造口并发症进入回归方程(P<0.001),可解释预防性肠造口患者病耻感总变异的75.0%。结论预防性肠造口患者病耻感得分处于中等水平。减轻患者自我隐瞒倾向,给予患者良好的社会支持、帮助患者正确应对疾病,对降低其病耻感程度起着重要作用。此外,针对有性生活需求的患者,应主动对其进行性健康教育;针对居住在农村的患者,应注意采用多种健康教育形式和随访途径。为减少造口并发症的发生,应切实教会患者如何进行造口护理操作,并指导患者对造口进行动态监测,做到早发现、早处理。Objective To describe the current status of stigma in patients with preventive ostomy and analyze its influence factors.Methods By convenience sampling method,220 colorectal cancer patients with temporary ostomy in 4 tertiary grade A hospitals participated in the study and they were surveyed by using general information questionnaire,Social Impact Scale(SIS),Perceived Social Support Scale(PSSS),Self-Concealment Scale(SCS)and Medical Coping Modes Questionnaire(MCMQ).Multiple linear regression analysis was carried out for the influence factor of stigma.Results The total score of SIS was 60.62±7.28.Multiple linear regression analysis showed that stigma was affected by self-concealment,house location,social support,coping style,influence degree of stigma on sexual life and ostomy complications(P﹤0.001),which could explain 75.0%of the variation.Conclusion Stigma in patients with preventive ostomy is in a mediate level.Alleviating patients’self-concealment tendency,giving them enough social support and helping them cope with the disease correctly can reduce patients’stigma.Sexual health education should be given to patients with sexual needs.For patients living in rural areas,multiple forms of healthy education and follow-up should be provided.Practical ostomy nursing skills and dynamic monitoring of ostomy are beneficial to reducing the incidence of ostomy complications,.

关 键 词：预防性肠造口 病耻感 自我隐瞒 社会支持 应对方式 

分 类 号：R473.6[医药卫生—护理学]