老年结直肠癌肠造口病人术后早期衰弱发生现状及影响因素  

Status quo and influencing factors of early postoperative weakness in elderly patients with colorectal cancer enterostomy

作　　者：张亚娟 张伟英[1] 李丹[1] 马丽莉[1] 吕桂芬 刘柳 刘燕[1] 文丹 ZHANG Yajuan;ZHANG Weiying;LI Dan;MA Lili;LYU Guifen;LIU Liu;LIU Yan;WEN Dan(East Hospital Affiliated to Tongji University(Shanghai East Hospital),Shanghai 200120 China)

机构地区：[1]同济大学附属东方医院(上海市东方医院),上海200120

出　　处：《护理研究》2022年第12期2145-2150,共6页Chinese Nursing Research

基　　金：浦东新区卫生系统领先人才培养计划项目,编号:PWRl2020⁃10;上海市护理学会优秀青年人才育苗计划,编号:沪护会〔2020〕29号;2021年同济大学研究生教育研究与改革医学专项项目,编号:2021YXAL09;中华医学会杂志社2021-2022年护理学科研究课题,编号:CMAPH⁃NRI2021040。

摘　　要：目的:调查老年结直肠癌肠造口病人术后早期衰弱发生现状及其影响因素。方法:2020年8月—2021年10月,便利抽取在上海3所三级甲等医院住院的老年结直肠癌肠造口术后早期病人作为研究对象,采用自制一般情况调查表、Tilburg衰弱量表、中文版造口病人生活质量问卷(COH⁃QOL⁃OQ)、匹兹堡睡眠质量指数(PSQI)、社会支持评定量表(SSRS)及焦虑自评量表(SAS)进行调查。采用多重线性回归对病人衰弱的影响因素进行分析。结果:老年结直肠癌肠造口术后早期病人衰弱发生率为92.2%,Tilburg衰弱量表得分为(7.87±1.46)分,COH⁃QOL⁃OQ得分为(4.93±0.77)分,PSQI得分为(11.19±2.45)分,SSRS得分为(26.26±4.76)分,SAS得分为(47.16±4.36)分。单因素分析结果显示,不同年龄、学历、婚姻状况、自觉健康状况、现患急慢性疾病、家庭月收入、造口相关并发症的病人衰弱总分比较差异有统计学意义(P<0.001)。相关性分析结果显示,PSQI得分、SAS得分与Tilburg衰弱量表得分呈正相关(P<0.001),COH⁃QOL⁃OQ得分与Tilburg衰弱量表得分呈负相关(P<0.001)。多重线性回归分析结果显示,婚姻状况、现患急慢性疾病、造口相关并发症、PSQI、SAS得分能正向预测Tilburg衰弱量表总分(P<0.001);最高学历、自觉健康状况、家庭月收入、COH⁃QOL⁃OQ得分能负向Tilburg衰弱量表总分(P<0.001)。结论:老年结直肠癌肠造口病人术后早期衰弱发生率高医护人员应引起重视,完善衰弱病人的早期评估,并对高危病人进行有效干预,改善病人衰弱情况,提高病人的生活质量。Objective:To investigate the status quo and influencing factors of early postoperative weakness in elderly patients with colorectal cancer after enterostomy.Methods:From August 2020 to October 2021,elderly patients in the early stage after enterostomy for colorectal cancer hospitalized in three tertiary grade A hospitals in Shanghai were conveniently selected as the research subjects.Self⁃made general information questionnaire,City of Hope⁃Quality of Life Ostomy Questionnaire⁃Chinese Version(COH⁃QOL⁃OQ),Pittsburgh Sleep Quality Index(PSQI),Social Support Rating Scale(SSRS),and Self⁃Rating Anxiety Scale(SAS)were used to conduct a survey.Multiple linear regression was used to analyze the influencing factors of patient frailty.Results:The incidence of frailty in elderly patients with colorectal cancer after enterostomy was 92.2%.The Tilburg frailty scale score was(7.87±1.46)points,the COH⁃QOL⁃OQ score was(4.93±0.77)points,the PSQI score was(11.19±2.45)points,the SSRS score was(26.26±4.76)points,and the SAS score was(47.16±4.36)points.Univariate analysis showed that differences in the total frailty scores of patients with different ages,education levels,marital statuses,perceived health status,current acute and chronic diseases,family monthly income,and stoma⁃related complications were statistically significant(P<0.001).The results of correlation analysis showed that the PSQI score,SAS score,and Tilburg frailty scale score were positively correlated(P<0.001),and the COH⁃QOL⁃OQ score were negatively correlated with the Tilburg frailty scale score(P<0.001).The results of multiple linear regression analysis showed that marital status,existing acute and chronic diseases,stoma⁃related complications,PSQI scores,and SAS scores could positively predict the total score of the Tilburg Frailty Scale(P<0.001);the highest education level,perceived health status,family monthly income,and COH⁃QOL⁃OQ scores could negatively be correlated with the total score of Tilburg Frailty Scale(P<0.001).Conclusi

关 键 词：结直肠癌 老年人 肠造口 衰弱 影响因素 护理 

分 类 号：R473.73[医药卫生—护理学]