乳腺癌术后患者婚姻调适现状及其影响因素分析  

Current status and influencing factors of postoperative marital adjustment in patients with breast cancer

作　　者：杨洁 袁晓玲[1] 吴雨霏 方琼[2] 仇晓霞[3] 龚宇蓉 Yang Jie;Yuan Xiaoling;Wu Yufei;Fang Qiong;Qiu Xiaoxia;Gong Yurong(School of Nursing,Shanghai Jiao Tong University,Shanghai 200025,China;Nursing Department,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Day Chemotherapy Center,Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Breast Department,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学护理学院,200025 [2]上海交通大学医学院附属瑞金医院护理部,上海200025 [3]上海交通大学医学院附属仁济医院日间化疗中心,上海200127 [4]上海交通大学医学院附属新华医院乳腺科,上海200092

出　　处：《中华现代护理杂志》2021年第15期2039-2044,共6页Chinese Journal of Modern Nursing

摘　　要：目的调查乳腺癌术后患者婚姻调适现状,并分析其影响因素。方法采用方便抽样法,于2017年6月-2018年12月选取在上海市3所三级甲等综合性医院诊疗的乳腺癌术后患者为研究对象。采用一般资料问卷、修订版婚姻调适量表(RDAS)、乳腺癌自我效能量表、身体意象量表、医院焦虑抑郁量表、医疗社会支持量表进行调查。采用单因素分析、Pearson相关性分析和多重线性回归分析患者婚姻调适的影响因素。本研究共发放问卷300份,回收有效问卷240份,有效回收率为80.0%。结果乳腺癌术后患者RDAS总分为(48.88±10.38)分。Pearson相关分析结果显示,乳腺癌术后患者婚姻调适与自我效能、身体意象、医疗社会支持呈正相关(r值分别为0.357、0.382、0.507;P<0.01);与焦虑、抑郁呈负相关(r值分别为-0.362、-0.373;P<0.01)。多重线性回归分析结果显示,肿瘤分期知晓情况、实际性支持、自我接纳及身体意象是乳腺癌术后患者婚姻调适的影响因素(P<0.05),共解释总变异的32.9%。结论乳腺癌术后患者婚姻调适能力处于中等水平,肿瘤分期知晓情况、实际性支持、自我接纳、身体意象是影响患者婚姻调适的因素,应积极制订针对性的干预措施,增强患者心理调整能力,以提高婚姻调适能力。Objective To investigate the marital adjustment status of breast cancer patients after surgery and analyze its influencing factors.Methods Using the convenient sampling method,postoperative breast cancer patients who were treated in 3 ClassⅢGrade A hospitals in Shanghai from June 2017 to December 2018 were selected as the research objects.The general information questionnaire,Revised Dyadic Adjustment Scale(RDAS),Breast Cancer Self-Efficacy Scale(BCSES),Body Image Scale(BIS),Hospital Anxiety and Depression Scale(HADS)and Medical Outcomes Study Social Support Survey(MOS-SSS)were used for investigation.Univariate analysis,Pearson correlation analysis and multiple linear regression were used to analyze the influencing factors of marital adjustment.In this study,a total of 300 questionnaires were issued and 240 valid questionnaires were returned.The effective recovery rate was 80.0%.Results The total score of RDAS for postoperative breast cancer patients was(48.88±10.38).The results of Pearson correlation analysis showed that marital adjustment of postoperative breast cancer patients was positively correlated with self-efficacy,body image,and medical and social support(r=0.357,0.382,0.507;P<0.01),and it was negatively correlated with anxiety and depression(r=-0.362,-0.373;P<0.01).The results of multiple linear regression analysis showed that awareness of tumor staging,actual support,self-acceptance and body image were the influencing factors of marital adjustment in patients after breast cancer surgery(P<0.05),explaining 32.9%of the total variation.Conclusions The marital adjustment ability of patients after breast cancer surgery is at a moderate level.The awareness of tumor staging,actual support,self-acceptance and body image are factors that affect the patients'marital adjustment.It is necessary to actively formulate targeted intervention measures to enhance the psychological adjustment ability of patients in order to improve the ability of marriage adjustment.

关 键 词：乳腺肿瘤 婚姻调适 实际性支持 自我接纳 身体意象 影响因素 

分 类 号：R737.9[医药卫生—肿瘤]