晚期癌症患者死亡焦虑现状及其与家庭功能的相关性分析  

Analysis of current status of death anxiety in advanced cancer patients and its correlation with family function

作　　者：刘慧 应文娟[2] 吴晓英 罗泽槟 郭郁莲[2] 伍艳春[2] 谢蓉芝[4] Liu Hui;Ying Wenjuan;Wu Xiaoying;Luo Zebing;Guo Yulian;Wu Yanchun;Xie Rongzhi(Department of Orthopedics,Cancer Hospital of Shantou University Medical College,Shantou 515000,China;Nursing Department,the First Affiliated Hospital of Shantou University Medical College,Shantou 515000,China;Nursing Department,Shantou Central Hospital,Shantou 515000,China;Cancer Center,the Fifth Affiliated Hospital,Sun Yat-sen University,Zhuhai 519000,China)

机构地区：[1]汕头大学医学院附属肿瘤医院骨科,汕头515000 [2]汕头大学医学院第一附属医院护理部,汕头515000 [3]汕头市中心医院护理部,汕头515000 [4]中山大学附属第五医院肿瘤中心,珠海519000

出　　处：《中华现代护理杂志》2024年第34期4744-4750,共7页Chinese Journal of Modern Nursing

基　　金：汕头大学医学院2019年"冲补强"高水平大学建设计划临床医学重点建设科研立项(002-18119101);汕头市医学科技人才培育及临床技术提升计划(190917115269889);2022年汕头大学医学院院级质量工程项目大学生安宁疗护社会实践教学基地(181233131)。

摘　　要：目的探讨家庭功能及个人特征对晚期癌症患者死亡焦虑的影响,为临床寻找缓解晚期癌症患者死亡焦虑的方法和途径提供参考。方法采用便利抽样法,选取2023年3—6月中山大学附属第五医院肿瘤中心收治的182例晚期癌症患者进行横断面调查。采用中文版死亡与濒死焦虑量表、家庭关怀度指数问卷调查患者的死亡焦虑和家庭功能,采用数字评分法、卡氏功能状态评分评估患者的疼痛程度和体能状态。采用单因素分析、多重线性回归分析晚期癌症患者死亡焦虑的影响因素。结果共发放问卷182份,回收有效问卷165份,有效回收率为90.7%。晚期癌症患者的死亡焦虑得分为(22.52±15.27)分,10.3%(17/165)的患者存在中度及以上的死亡焦虑。患者家庭功能总分为(8.62±1.97)分,86.7%(143/165)的患者自我报告家庭功能良好。死亡焦虑总分与家庭功能总分呈负相关(P<0.05)。多重线性回归分析结果显示,卡氏功能状态评分、患病前就业状况、家庭功能、居住地和疼痛评分是晚期癌症患者死亡焦虑的影响因素(R 2=0.196,P<0.01)。结论本研究中的晚期癌症患者死亡焦虑水平较低,其中家庭功能为中度障碍、居住在农村、患病前在职及疼痛评分高的晚期癌症患者死亡焦虑水平偏高,而体能状态好的患者死亡焦虑水平偏低。建议临床工作者加强评估晚期癌症患者的死亡焦虑水平和家庭功能,针对相关影响因素及时采取有效措施,帮助减轻或缓解晚期癌症患者的死亡焦虑。ObjectiveTo explore the influence of family function and personal characteristics on death anxiety in patients with advanced cancer,providing reference for finding methods and approaches to alleviate death anxiety in advanced cancer patients.MethodsFrom March to June 2023,convenience sampling was used to select 182 advanced cancer patients admitted to the Cancer Center of the Fifth Affiliated Hospital of Sun Yat-sen University.The Chinese Version of Death and Dying Distress Scale and Family APGAR Index were used to investigate patients'death anxiety and family function.The Numerical Rating Scale and Kamofsky Performance Status were used to assess patients'pain and performance status.Single factor analysis and multiple linear regression were used to analyze the influencing factors of death anxiety in advanced cancer patients.ResultsA total of 182 questionnaires were distributed,and 165 valid questionnaires were collected,with a valid response rate of 90.7%.The death anxiety score of advanced cancer patients was(22.52±15.27),and 10.3%(17/165)of patients had moderate or above death anxiety.The patients'total family function score was(8.62±1.97),and 86.7%(143/165)patients self-reported good family function.The death anxiety score was negatively correlated with the family function score(P<0.05).Multiple linear regression analysis showed that Kamofsky Performance Status score,pre-illness employment,family function,place of residence,and pain score were the influencing factors of death anxiety in advanced cancer patients,and the differences were statistically significant(R 2=0.196,P<0.01).ConclusionsThe advanced cancer patients have low levels of death anxiety in our study.Advanced cancer patients with moderate family dysfunction,living in rural areas,working before illness,and high pain scores have high levels of death anxiety,while patients with good performance status have low levels of death anxiety.It is recommended that clinical workers strengthen the assessment of death anxiety and family function in patients w

关 键 词：肿瘤 死亡焦虑 疼痛 家庭功能 体能状态 影响因素 

分 类 号：R473.73[医药卫生—护理学]