晚期癌症患者对预立医疗照护计划的接受度及其影响因素研究  

Study on the Acceptance of Advance Care Planning and its Influencing Factors in Patients with Advanced Cancer

作　　者：陶然[1] 王石坤 杨小蕾 吴江[3] 鲁鑫 李科逸 TAO Ran;WANG Shi-kun;YANG Xiao-lei;WU Jiang;LU Xin;LI Ke-yi(Department of Medical Cadres,Yunnan Cancer Hospital,Kunming 650118,Yunnan,China;School of Continuing Education,Kunming Medical University,Kunming 650500,Yunnan,China;Department of Radiotherapy,Yunnan Cancer Hospital,Kunming 650118,Yunnan,China)

机构地区：[1]云南省肿瘤医院干部医疗科,云南昆明650118 [2]昆明医科大学继续教育学院,云南昆明650500 [3]云南省肿瘤医院放射治疗科,云南昆明650118

出　　处：《医学信息》2023年第20期40-43,47,共5页Journal of Medical Information

基　　金：云南省肿瘤医院2020年度院内护理课题(编号:2020-HL-Y-08)。

摘　　要：目的了解癌症晚期患者接受预立医疗照护计划的程度及影响因素,为预立医疗照护计划的推广与发展提供参考。方法采用便利抽样方法,于2020年1月-2021年6月对云南省某三级甲等医院104例晚期癌症住院患者采用一般资料调查表、预立医疗照护计划接受程度问卷进行调查,分析不同人群对预立医疗照护计划的接受度及其影响因素。结果晚期癌症患者对预立医疗照护计划接受度得分为(71.66±8.08)分,处于中等偏上的水平;晚期癌症患者预立医疗照护计划接受度得分高于肺癌患者、癌症患者、骨髓异常增生综合征患者、社区老年慢性病患者、心力衰竭患者、养老机构慢性病老年人、重症监护室患者、住院老年HIV/AIDS患者,差异有统计学意义(P<0.05);晚期癌症患者预立医疗照护计划接受度得分与老年患者比较,差异无统计学意义(P>0.05)。单因素分析显示,文化程度、住院次数、是否经历过抢救是晚期癌症患者预立医疗照护计划接受度得分的影响因素。多元线性回归分析显示,文化程度、住院次数、抢救经历是晚期癌症患者预立医疗照护计划接受度的独立影响因素。结论晚期癌症患者对预立医疗照护计划的接受度处在中等偏上的水平,且有不同的影响因素,医疗工作者要有针对性的进行宣教,以提升其接受程度,推动其发展。Objective To understand the acceptance of advance care planning and its influencing factors in patients with advanced cancer,and to provide reference for the promotion and development of advance care planning.Methods From January 2020 to June 2021,a convenience sampling method was used to investigate 104 hospitalized patients with advanced cancer in a tertiary hospital in Yunnan Province using a general information questionnaire and an advance care planning acceptance questionnaire.The acceptance of the advance care planning and its influencing factors were analyzed.Results The acceptance score of advance care planning for patients with advanced cancer was(71.66±8.08)scores,which was above the middle level.The acceptance score of advance care planning for patients with advanced cancer was higher than that of lung cancer patients,cancer patients,myelodysplastic syndrome patients,community elderly patients with chronic diseases,heart failure patients,elderly patients with chronic diseases in pension institutions,intensive care unit patients,hospitalized elderly patients with HIV/AIDS,the difference was statistically significant(P<0.05).There was no significant difference in the acceptance score of advance care planning between patients with advanced cancer and elderly patients(P>0.05).Univariate analysis showed that education level,number of hospitalizations,and whether they had experienced rescue were the influencing factors of the acceptance score of advance care planning for patients with advanced cancer.Multivariate linear regression analysis showed that education level,number of hospitalizations and rescue experience were independent influencing factors of acceptance of advance care planning for patients with advanced cancer.Conclusion The acceptance of advance care planning for patients with advanced cancer is at the upper-middle level,and there are different influencing factors.Medical workers should carry out targeted education to improve their acceptance and promote their development.

关 键 词：晚期癌症患者 预立医疗照护计划 接受度 

分 类 号：R197[医药卫生—卫生事业管理]