低位直肠癌造口患者支持性照顾需求轨迹分析  

Trajectories of supportive care needs of patients having an enterostomy in place after surgical treatment of low-lying rectal cancer

作　　者：张瑶瑶 张锡锴 方洪春 陈海燕[1] 屈利娟[1] Zhang Yaoyao;Zhang Xikai;Fang Hongchun;Chen Haiyan;Qu Lijuan(Department of Gastrointestinal Surgery,The Affiliated Hospital of Qingdao University,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院胃肠外科,山东青岛266000 [2]青岛大学附属医院急诊科,山东青岛266000

出　　处：《护理学杂志》2024年第4期1-5,共5页Journal of Nursing Science

摘　　要：目的追踪低位直肠癌造口患者支持性照顾需求的变化轨迹及影响因素。方法使用癌症患者支持性照顾需求简明量表对267例低位直肠癌造口患者于术后1个月、3个月、6个月调查患者支持性照顾需求水平。使用潜类别增长模型分析患者支持性照顾需求的变化轨迹,采用多分类logistic回归分析不同轨迹的影响因素。结果完成全程随访249例患者。肠造口患者支持性照顾需求变化轨迹存在3个类别:持续高需求组、需求快速下降组、需求缓慢下降组,分别占20.5%、43.8%、35.7%。logistic回归分析显示,年龄、文化程度、家庭人均月收入、化疗经历、并发症、合并慢性病、社会心理适应影响低位直肠癌造口患者支持性照顾需求轨迹类别(均P<0.05)。结论肠造口患者在术后6个月内支持性照顾需求得分呈下降趋势,患者支持性照顾需求具有群体异质性,临床医护人员可根据预测因素早期识别患者不同阶段的支持性照顾需求,制定精准化的干预措施,以满足患者照护需求。Objective To track the trajectories of supportive care needs in rectal cancer patients at different time points,and to explore the influencing factors of the trajectories.Methods A total of 267 inpatients having an enterostomy in place after surgical treatment of low-lying rectal cancer were enrolled,and surveyed at 1(T1),3(T2),6(T3)months post-surgery.Latent class growth analysis was used to identify trajectories of enterostomal patients′supportive care needs.The influencing factors of the trajectories were analyzed by running logistic regression analysis.Results Totally,249 patients completed the whole follow-ups.Three trajectories of enterostomal patients′supportive care needs emerged:the persistently high group(20.5%),the rapidly descending group(43.8%),the slowly descending group(35.7%).Logistic regression analysis showed that age,education levels,household per capita monthly income,chemotherapy,complications,chronic diseases and ostomy adjustment scores influenced the trajectories of patients′supportive care needs.Conclusion The supportive care needs of enterostomal patients have a downward trend within 6 months post discharge.There is group-based heterogeneity in their supportive care needs.Medical staff should formulate precise intervention measures tailored to predictors of supportive care needs at different stages,striving to satisfy the supportive care needs of enterostomal patients.

关 键 词：直肠癌 肠造口 支持性照顾需求 化疗 并发症 慢性病 社会心理适应 纵向研究 

分 类 号：R473.73[医药卫生—护理学]