基于Andersen行为模型的晚期弥漫大B细胞淋巴瘤病人预立医疗照护计划接受度影响因素  

Influencing factors of ACP acceptance in advanced DLBCL patients based on Andersen behavior model

作　　者：周海燕 张飞彦 ZHOU Haiyan;ZHANG Feiyan(The First Affiliated Hospital with Nanjing Medical University,Jiangsu 210000 China)

机构地区：[1]南京医科大学第一附属医院,江苏210000

出　　处：《护理研究》2023年第17期3071-3082,共12页Chinese Nursing Research

摘　　要：目的:基于Andersen行为模型分析晚期弥漫大B细胞淋巴瘤(DLBCL)病人对预立医疗照护计划(ACP)接受度的影响因素,为提升其ACP接受度提供理论参考。方法:选取2019年1月—2022年4月我院收治的晚期DLBCL病人531例为调查对象,按照倾向性因素、促成性因素、需求性因素、健康行为4部分分析晚期DLBCL病人对ACP接受度的影响因素。结果:531例晚期DLBCL病人ACP接受度得分为(62.24±12.34)分;倾向性因素中学历、与家人同居、与朋友或同事同居、有无宗教信仰,促成性因素中有无伴有其他慢性病、癌症分期、D型人格、生命质量、社会支持、家庭韧性、自然接受及死亡逃避,需求性因素中综合需求、未满足需求,健康行为中口服化疗药物依从性和自我管理均为晚期DLBCL病人ACP接受度的影响因素(P<0.05)。通过比较Andersen行为模型各维度,倾向性因素对晚期DLBCL病人ACP接受度影响最大,其次为健康行为,需求性因素影响最小。结论:晚期DLBCL病人对ACP接受度受到人口学特征、疾病情况、心理特质和健康行为等因素的影响,医护人员应为其提供全面且个性化ACP服务方案,提高其对ACP的认知度和ACP的执行成功率。Objective:To analyze the influencing factors of acceptance of ACP in advanced DLBCL patients based on Andersen behavior model,and to provide theoretical references for improving their acceptance of ACP.Methods:531 advanced DLBCL patients admitted to our hospital from January 2019 to April 2022 were selected as the subjects.The influencing factors of ACP acceptance of advanced DLBCL patients were analyzed according to four parts:tendency factors,contributing factors,demand factors and health behavior.Results:The ACP acceptance score of advanced DLBCL patients was(62.24±12.34).The predisposing factors included educational background,cohabitation with family,cohabitation with friends or colleagues,religious belief,whether there were other chronic diseases,cancer stages,type D personality,quality of life,social support,family resilience,natural acceptance and death avoidance in the contributing factors,and the comprehensive needs and unmet needs in the demand factors,compliance with oral chemotherapy drugs and self⁃management in health behavior were significant influencing factors on ACP acceptance in patients with advanced DLBCL(P<0.05).By comparing the dimensions of Andersen behavior model,the tendency factor had the greatest impact on the acceptance of ACP in patients with advanced DLBCL,followed by health behavior,and the lowest was the demand factor.Conclusion:The acceptance of ACP in patients with advanced DLBCL is affected by demographic characteristics,disease conditions,psychological characteristics and healthy behaviors.Medical staff should provide them with comprehensive and personalized ACP service programs to improve their awareness of ACP and implementing success rate of ACP.

关 键 词：弥漫大B细胞淋巴瘤 Andersen行为模型 预立医疗照护计划 接受度 影响因素 

分 类 号：R473.73[医药卫生—护理学]