脊髓损伤清洁间歇导尿患者自我管理现状及影响因素  

Self-management status and related factors of patients with intermittent clean catheterization after spinal cord injury

作　　者：张妙媛[1] 何英[1] 李晓霞 彭敏[1] 张蕾[1] 刘姝颖 孔瑛[1] ZHANG Miaoyuan;HE Ying;LI Xiaoxia;PENG Min;ZHANG Lei;LIU Shuying;KONG Ying(Rehabilitation Department,the Second Xiangya Hospital of Central South University,Changsha,Hunan 410011,China)

机构地区：[1]中南大学湘雅二医院康复医学科

出　　处：《中国康复理论与实践》2022年第6期716-724,共9页Chinese Journal of Rehabilitation Theory and Practice

基　　金：湖南省自然科学基金青年基金项目(No.2019JJ50903)。

摘　　要：目的调查脊髓损伤清洁间歇导尿患者自我管理现状并探讨其影响因素。方法2020年5月至2021年2月,便利抽样选取某脊髓损伤病友俱乐部255例脊髓损伤患者为调查对象,采用一般资料调查表、自制自我管理量表、自我效能感量表进行网络问卷调查,多元线性逐步回归探讨其影响因素。结果脊髓损伤清洁间歇导尿患者自我管理量表中疾病症状管理、日常生活管理、间歇导尿行为管理及情绪管理和社会回归各维度得分分别为(40.458±9.122)分、(33.945±6.800)分、(36.709±8.736)分、(25.011±4.932)分;日常生活管理维度单题平均得分最高(3.772±0.755),情绪管理和社会回归维度单题平均得分最低(3.573±0.705)。间歇导尿时长、患病后家人的态度、自我效能感、职业是疾病症状管理维度的主要影响因素(R^(2)=0.135,F=7.744,P<0.001);自我效能感、间歇导尿时长、使用亲水涂层导尿管、并发症是日常生活管理维度的主要影响因素(R^(2)=0.173,F=13.042,P<0.001);自我效能感、间歇导尿时长、使用亲水涂层导尿管、医疗费用支付方式是间歇导尿行为管理维度的主要影响因素(R^(2)=0.141,F=10.259,P<0.001);自我效能感、间歇导尿时长、并发症、近一周每日间歇导尿次数是情绪管理和社会回归维度的主要影响因素(R^(2)=0.282,F=19.590,P<0.001)。结论脊髓损伤清洁间歇导尿患者自我管理能力处于中等水平。患者自我管理能力受诸多因素影响,医护人员应针对其中可控因素,制定相应策略。Objective To investigate the status of self-management in patients with spinal cord injury and the related factors.Methods From May,2020 to February,2021,255 patients from a spinal cord injury club were enrolled,and investigated with the general information questionnaire,self-management ability scale,Chronic Disease Self-efficacy Scale through internet.Multiple linear stepwise regression was used to explore the related factors.Results The scores of disease symptom management,daily life management,intermittent catheterization behavior management,emotional management and social return were(40.458±9.122),(33.945±6.800),(36.709±8.736)and(25.011±4.932),respectively.The average score for the single question of daily life management was the highest(3.772±0.755),while emotional management and social return was the lowest(3.573±0.705).Duration of intermittent catheterization,family members’attitude,self-efficacy and occupation were the related factors of symptom management(R2=0.135,F=7.744,P<0.001).Self-efficacy,duration of intermittent catheterization,use of hydrophilic coated catheters and complications were the related factors of daily life management(R2=0.173,F=13.042,P<0.001).Self-efficacy,duration of intermittent catheterization,use of hydrophilic coated catheters and medical insurance were the related factors of intermittent catheterization behavior management(R2=0.141,F=10.259,P<0.001).Self-efficacy,duration of intermittent catheterization,complications and frequency of intermittent catheter in the last week were the related factors of emotional management and social regression dimensions(R2=0.282,F=19.590,P<0.001).Conclusion The self-management of patients with spinal cord injury by clean intermittent catheterization is at medium level.Moreover,it may be affected by many factors.Some of them can be targets of intervention.

关 键 词：脊髓损伤 清洁间歇导尿 自我管理 

分 类 号：R651.2[医药卫生—外科学]