晚期肿瘤患者化疗期间对社区卫生服务需求的调查及影响因素研究  

Demand and Influencing Factors for Community Health Services during Chemotherapy of Patients with Advanced Cancer

作　　者：李芊芊 陈循睿 张文颖[1] 袁海花[1] 张燕捷[1] 姜斌[1] 刘峰[1] LI Qianqian;CHEN Xunrui;ZHANG Wenying;YUAN Haihua;ZHANG Yanjie;JIANG Bin;LIU Feng(Department of Oncology,Shanghai Ninth People's Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 201999,China)

机构地区：[1]上海交通大学医学院附属第九人民医院肿瘤科,上海市201999

出　　处：《中国全科医学》2023年第33期4173-4180,4186,共9页Chinese General Practice

基　　金：上海交通大学医学院附属第九人民医院临床研究助推计划(临+计划)(JYLJ202019)。

摘　　要：背景如何针对晚期化疗患者实施有效、合理地需求支持和综合服务是目前值得社区卫生服务重点关注的一个问题。最新数据显示,上海市居民恶性肿瘤的死亡率已成为仅次于心脑血管疾病的第2位死因,当前对晚期肿瘤化疗患者的关注度也逐渐上升。因此本研究试图了解上海市此类患者对基层医疗的需求及其影响因素。目的了解上海市化疗期间的部分晚期肿瘤患者对社区卫生服务的需求情况以及影响因素,并探讨如何针对此类患者的需求开展社区干预及服务工作。方法选取2021年12月—2022年3月于上海交通大学医学院附属第九人民医院、吴淞医院、宝山区中西结合医院定期就诊或住院的晚期肿瘤化疗患者为研究对象。基于相关问卷、政府相关规范和访谈结果,形成《上海市部分社区晚期肿瘤化疗患者社区服务需求调查问卷》终版,共计3个需求维度(心理精神、医疗照护、社会支持),38项需求项目,内容包括患者的一般资料[人口社会学资料(性别、年龄、宗教信仰、受教育程度、婚姻状况、医疗费用来源、家庭可支配月收入、是否参加病友群)、肿瘤诊断情况(诊断疾病、诊断时间、疼痛评分、合并其他疾病)],6项心理精神需求项目,24项医疗照护需求项目,8项社会支持需求项目,采用3级评分法:1分为不需要,2分为需要,3分为很需要,得分越高,患者需求程度越高,根据各个需求项目的平均分进行需求程度排序。并采用单因素分析、多因素Logistic回归分析探究肿瘤晚期化疗患者社区卫生服务需求的影响因素。结果按照各个需求维度的平均分排序依次为心理精神需求(2.31分)、医疗照护需求(2.27分)和社会支持需求(2.18分)。所有需求项目中平均分排名前5位的是“化疗前血常规、肝肾功能等生化检查准备”(2.48分),“对化疗知识的科普”(2.47分),“化疗间期内经外周静Background How to implement effective and reasonable support and comprehensive services for patients with advanced cancer during chemotherapy is an issue worthy of attention in community health services at present.According to the latest data,the mortality rate of malignant tumors among residents in Shanghai has become the second place after cardiovascular and cerebrovascular diseases.The current attention to patients with advanced cancer during chemotherapy is also gradually increasing.Therefore,this study tries to understand the demand for primary care among such patients and the influencing factors.Objective To investigate the demand and influencing factors for community health services during chemotherapy of partial patients with advanced cancer in Shanghai,and to explore how to develop community interventions and services to address the demand of such patients.Methods Patients with advanced cancer during chemotherapy who regularly visited or hospitalized at Shanghai Ninth People's Hospital,Wusong Hospital and Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine from December 2021 to March 2022 were selected as the study subjects.Based on previous relevant questionnaires,government specifications and interview results,the final version of the demand for community health services of partial patients with advanced cancer during chemotherapy in Shanghai was formed,with a total of 3 demand dimensions(psychological,medical care,social support)and 38 demand items.The contents include patients'general information(demographic and sociological information:gender,age,religious beliefs,education level,marital status,source of medical expenses,disposable monthly household income,whether to participate in a patient group;tumor diagnosis:type and time of diagnosis,pain score,combining with other diseases),6 items of psychological and psychological demand,24 items of medical care demand,and 8 items of social support demand.A 3-point scale was adopted:1 was unnecessary,2 was necessary,and 3 was ve

关 键 词：肿瘤 晚期肿瘤 化疗患者 社区卫生服务 卫生服务需求 横断面研究 影响因素分析 

分 类 号：R739.9[医药卫生—肿瘤]