甲状腺癌患者手术方式决策困境现状及影响因素分析  

Analysis of the current situation and influencing factors of decision-making dilemmas in surgical methods for patients with thyroid cancer

作　　者：田霞[1] 李志远 于方 王伟[1] 杨学荣[1] TIAN Xia;LI Zhiyuan;YU Fang;WANG Wei;YANG Xuerong(Department of Breast and Thyroid Surgery,Jining First People's Hospital,Jining,Shandong 272oo0,China)

机构地区：[1]济宁市第一人民医院乳甲外科,山东济宁272000

出　　处：《社区医学杂志》2024年第17期601-605,共5页Journal Of Community Medicine

摘　　要：目的了解甲状腺癌患者手术方式决策困境现状及影响因素,为下一步制定甲状腺癌患者手术方式决策辅助提供参考依据。方法选择2023-06-01-10-31济宁市第一人民医院拟行手术治疗的86例甲状腺癌患者作为研究对象,调查患者一般资料、决策困境水平、焦虑抑郁程度。根据有无决策困境,分为有决策困境组(n=76例)和无决策困境组(n=10例),采用二元logistic回归分析患者决策困境的影响因素。结果86例甲状腺癌患者手术方式决策困境总均分为(24.53±8.67)分,换算为百分制后为(38.34±13.55)分;无决策困境(<25分)占11.63%,有决策困境(≥25分)占88.37%。焦虑评分的中位数为9分。二元logistic回归分析结果显示,收入水平(β=2.228,OR=9.280,95%CI为1.929~44.652)、焦虑(β=0.317,OR=1.373,95%CI为1.109~1.698)是决策困境的影响因素。结论甲状腺癌患者在手术方式选择时存在一定的决策困境,临床医护人员应根据患者的不同特征及焦虑程度,制定详细的决策辅助,从而降低患者的决策困境。Objective To explore the current situation and influencing factors of decision-making dilemmas in surgical methods for thyroid cancer patients,and to provide a reference for the next step in formulating decision-making assistance for surgical methods in thyroid cancer patients.Methods A total of 86 thyroid cancer patients who were scheduled to undergo surgical treatment at the First People's Hospital of Jining City from June 1 to October 31,2023 were selected as the research subjects.General information,decision-making dilemma level,and degree of anxiety and depression of the patients were investigated.According to the presence or absence of decision-making dilemma level,patients were divided into a group with decision-making dilemmas(n=76 cases)and a group without decision-making dilemmas(n=10 cases),and binary logistic regression analysis was used to analyze the influencing factors of patients decision-making dilemmas.Results The overall average score for decision-making dilemmas in surgical methods for 86 patients with thyroid cancer was(24.53±8.67)points,converted to a percentage scale of(38.34±13.55)points.There were 11.63%of patients had no decision-making dilemmas(<25 points),while 88.37%had decision-making dilemmas(≥25 points).The median anxiety score was 9 points.The results of binary logistic regression analysis showed that income level(β=2.228,OR=9.280,95%CI was 1.929-44.652)and anxiety(β=0.317,OR=1.373,95%CI was 1.109-1.698)were the main influencing factors of decision-making dilemmas.Conclusions Patients with thyroid cancer have certain decision-making dilemmas when choosing surgical methods.Clinical medical staff should make detailed decision-making assistance based on the different characteristics and anxiety levels of patients,in order to reduce their decision-making dilemmas.

关 键 词：甲状腺癌 手术方式 决策困境 焦虑抑郁 决策辅助 

分 类 号：R736.1[医药卫生—肿瘤]