老年妇科恶性肿瘤术后患者的不遵医行为因素分析  

Analysis of factors of non⁃compliance behavior in elderly patients with gynecological malignant tumors after surgery

作　　者：刁一欣 张佳佳 陈雅琼 Diao Yixin;Zhang Jiajia;Chen Yaqiong(Department of Nursing,Cancer Hospital Affiliated to Fudan University,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai,200032,P.R.China)

机构地区：[1]复旦大学附属肿瘤医院护理部,复旦大学上海医学院肿瘤学系,上海200032

出　　处：《老年医学与保健》2023年第2期304-308,共5页Geriatrics & Health Care

摘　　要：目的 分析老年妇科恶性肿瘤患者术后不遵医行为的影响因素,为确定相关管理对策提供据。方法 选取2022年1月—12月在复旦大学附属肿瘤医院就诊的老年妇科恶性肿瘤患者262例,均行恶性肿瘤根治性切除手术,术后采用遵医行为量表调查患者的遵医行为,依据调查结果分为遵医组(n=161)和不遵医组(n=101)。比较2组相关资料差异,采用二元Logistic多因素回归分析方程分析相关独立危险因素。结果 遵医组遵医行为量表得分明显高于不遵医组[(69.84±5.75)分vs(51.17±4.17)分](P<0.05);2组年龄、受教育程度、家庭收入、心理状态、情绪(HEI评分)及照顾者照顾能力评估值差异均有统计学意义(P<0.05),而2组疾病种类、居住地、支付方式、婚姻及照顾者评估值差异均无统计学意义(P>0.05);二元Logistic多因素回归分析显示,年龄>70岁(OR=2.184, 95CI%1.156~4.117)、受教育程度小学及以下(OR=2.486, 95CI%1.077~5.697)、家庭收入<3 000元(OR=2.430, 95CI%1.133~5.695)、 HEI评分≥17分(OR=2.782, 95CI%1.602~4.820)、照顾者照顾能力≥31分(OR=3.020, 95CI%1.531~6.134)为妇科恶性肿瘤患者不遵医行为的独立危险因素(P<0.05)。结论 老年妇科恶性肿瘤患者术后遵医行为的影响因素主要包括年龄、受教育程度、家庭收入、患者心理状态和照顾者照顾能力等;可根据这些因素采取有效和针对性的护理措施,提高术后患者的遵医行为和改善预后。Objective To analyze the influencing factors of non⁃compliance behavior in elderly patients with gynecolog⁃ical malignant tumors after surgery,and provide a basis for determining relevant management countermeasures.Methods A total of 262 elderly patients with gynecological malignancies treated in Affiliated Cancer Hospital of Fudan University from Jan⁃uary to December 2022 were selected.All patients underwent radical resection of malignant tumors.The compliance behavior scale was used to investigate patients􀆳compliance behavior after surgery,and they were divided into compliance group(n=161)and non⁃compliance group(n=101)according to the survey results.The differences in relevant data were compared between the two groups,and the relevant independent risk factors were analyzed by binary Logistic multiple regression analysis.Results The score of the compliance behavior scale of the compliance group was significantly higher than that of the non⁃com⁃pliance group[(69.84±5.75)vs(51.17±4.17)](P<0.05).There were statistically significant differences in age,educa⁃tion level,family income,mental state,emotion(Huaxi emotional⁃distress index,HEI)score and assessment value of caregiver􀆳s care ability between the two group(P<0.05),while there were no statistical differences in disease type,place of residence,payment method,marriage and caregiver􀆳s assessment value(P>0.05).Binary Logistic multiple factor regression analysis showed that age>70 years old(OR=2.184,95CI%1.156⁃4.117),education level of primary school and below(OR=2.486,95CI%1.077⁃5.697),family income<3000 yuan(OR=2.430,95CI%1.133⁃5.695),HEI score≥17 points(OR=2.782,95CI%1.602⁃4.820),assessment value of caregiver􀆳s care ability≥31 points(OR=3.020,95CI%1􀆰531⁃6.134)were independent risk factors for non⁃compliance in patients with gynecological malignant tumor.Conclusion The influencing factors of postoperative compliance behavior in elderly patients with gynecological malignant tumors mainly include age,education level,

关 键 词：老年 妇科恶性肿瘤 遵医行为 依从性 危险因素 

分 类 号：R473.73[医药卫生—护理学]