食管癌术后患者支持性照护需求发展轨迹及预测因素分析  

Trajectory of supportive care needs and its predictors among postoperative esophageal cancer patients

作　　者：范艺禧 赵莉[1,2] 罗文煜 周金凤 邱琳钰 吴岫霏 Fan Yixi;Zhao Li;Luo Wenyu;Zhou Jinfeng;Qiu Linyu;Wu Xiufei(Nursing Department,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]川北医学院附属医院护理部,四川南充637000 [2]川北医学院护理学院

出　　处：《护理学杂志》2024年第22期37-42,共6页Journal of Nursing Science

基　　金：成渝双城经济圈现代护理职业教育联盟科研项目(2023CYLMY03)。

摘　　要：目的探讨食管癌术后患者支持性照护需求发展轨迹及潜在类别的预测因素。方法对156例食管癌根治术患者采用一般资料调查表、食管癌手术患者出院后支持性照护需求量表、健康信息素养量表、领悟社会支持量表,于食管癌患者出院时及出院1、3、6个月时评估其支持性照护需求水平,应用潜类别增长模型识别需求发展轨迹,并采用无序多分类logistic回归分析不同发展轨迹类别的预测因素。结果共识别出食管癌术后患者3种支持性照护需求发展轨迹:中需求快速下降组(15.4%)、中需求曲折下降组(30.8%)、高需求平缓下降组(53.8%)。logistic回归分析结果显示,性别、年龄、家庭居住地、文化程度、健康信息素养、领悟社会支持影响食管癌术后患者的支持性照护需求发展轨迹(均P<0.05)。结论食管癌术后患者出院6个月内支持性照护需求发展轨迹存在显著群体异质性,可识别出3种变化轨迹。医护人员应根据预测因素早期识别患者支持性照护需求,实施针对性、特异性的干预措施,以减少其未满足需求,改善其生活质量。Objective To explore the trajectory of supportive care needs and its predictors among postoperative esophageal cancer patients.Methods General information questionnaire,the Supportive Care Needs Scale for Esophagectomy patients after Discharge(SCNS-ED),the Health Information Literacy Scale(HILS)and the Perceived Social Support Scale(PSSS)were used to assess the level of supportive care needs of 156 patients with radical esophageal cancer at the time of discharge and 1,3,6 months after the discharge,and then the latent growth curve model was applied to identify the trajectory of their supportive care needs,and the multinomial logistic regression was used to analyze its potential category predictors.Results Three trajectories of the supportive care needs were identified among postoperative esophageal cancer patients:a rapid decline in medium need group(15.4%),a zigzag decline in medium need group(30.8%),and a flat decline in high need group(53.8%).The results of the logistic regression analysis showed that,gender,age,family residence,educational background,the scores of HILS and PSSS were predictors of the trajectory of supportive care needs in postoperative esophageal cancer patients(all P<0.05).Conclusion Significant group heterogeneity exists in the trajectories of supportive care needs development in postoperative esophageal cancer patients within 6 months after the discharge,and three trajectories of change can be identified.Medical staff should identify patients'supportive care needs early based on the predictors,and implement targeted and specific interventions to reduce their unmet needs,and improve their quality of life.

关 键 词：食管癌 术后 支持性照护需求 发展轨迹 健康信息素养 领悟社会支持 潜在类别 预测因素 

分 类 号：R473.73[医药卫生—护理学]