喉癌术后患者疾病感知与创伤后成长的纵向研究

doi:10.3761/j.issn.1672-9234.2020.10.013

摘要/Abstract

摘要：

目的描述喉癌术后患者出院后不同阶段疾病感知和创伤后成长的动态变化,并探讨其相关性。方法采用便利抽样法,使用一般资料调查表、简易版疾病感知问卷、创伤后成长量表对93例喉癌术后患者进行问卷调查。结果患者出院后1个月、出院后3个月、出院后6个月疾病感知均处于中等偏上水平,分别为（51.65±6.77）分、（45.09±8.73）分、（41.62±9.69）分,且呈逐渐下降趋势（F=188.272,P<0.001）;创伤后成长得分均处于中等水平,分别为（60.27±8.40）分、（67.69±9.53）分、（70.25±10.07）分,且呈逐渐上升趋势（F=144.187,P<0.001）。相关分析显示,疾病感知总分与创伤后成长总分在出院后3个月、出院后6个月呈中度负相关（r=-0.468,P<0.001;r=-0.418,P<0.001）。结论喉癌术后患者不同时间点的疾病感知与创伤后成长呈动态变化,患者负性感知越少,越有利于患者创伤后成长。

关键词: 喉肿瘤, 问卷调查, 纵向研究, 创伤后成长, 疾病感知

Abstract:

Objective To describes the dynamic changes of illness perception and post-traumatic growth and to explore their correlation in postoperative patients with laryngeal cancer at different stages after discharge. Methods A total of 93 postoperative patients with laryngeal cancer were investigated by the Brief Illness Perception Questionnaire and the Post-Traumatic Growth Inventory. Results The scores of illness perception were above the middle level at one month,three months and six months after discharge,which were（51.65±6.77）,（45.09±8.73）,（41.62±9.69）and showed a gradually downward trend（（F=188.272,P<0.001）. The scores of post-traumatic growth were all in the middle level,which were（60.27±8.40）,（67.69±9.53）,（70.25±10.07）and in a gradually increase tendency（F=144.187,P<0.001）. Analysis of partial correlation showed that,there was a moderately negative correlation between the total score of illness perception and the total score of post-traumatic growth at three months and six months after discharge（r=-0.468,P<0.001;r=-0.418,P<0.001）. Conclusion The illness perception and post-traumatic growth of postoperative patients with laryngeal cancer show dynamic changes. The less negative perception of patients,the more conducive to the occurrence of post-traumatic growth.

Key words: Laryngeal Neoplasms, Questionnaires, Longitudinal Studies, Post-traumatic growth, Illness perception

陈红涛,陈紫航,苏香华,李力,宋小花. 喉癌术后患者疾病感知与创伤后成长的纵向研究[J]. 中华护理教育, 2020, 17(10): 928-931.

CHEN Hong-tao,CHEN Zi-hang,SU Xiang-hua,LI Li,SONG Xiao-hua. Illness perception and post-traumatic growth in postoperative patients with laryngeal cancer：a longitudinal study[J]. Chinese Journal of Nursing Education, 2020, 17(10): 928-931.

图/表 2

参考文献 30

[1]	谭辉, 郝永丽, 王海洋, 等. 系统康复护理对喉癌患者围手术期心理状态及术后恢复的干预研究[J]. 肿瘤预防与治疗, 2018,31(2):112-116.
[2]	陈文杰, 王斌全, 高伟, 等. 喉癌流行病学特征及影响因素分析[J]. 中国当代医药, 2015,22(12):43-46.
[3]	朱倬云. 舒适护理在喉癌患者中的应用研究进展[J]. 齐鲁护理杂志, 2017,23(4):59-61.
[4]	魏炜, 张乃嵩. 喉全切除患者术后生活质量分析[J]. 中国肿瘤, 2012,21(8):615-618.
[5]	Tedeschi RG, Calhoun LG. TARGET ARTICLE:“posttraumatic growth:conceptual foundations and empirical evidence”[J]. Psychol Inq, 2004,15(1):1-18. doi: 10.1207/s15327965pli1501_01
[6]	Ben-Zur H, Cohen M, Gouzman J. Posttraumatic growth moderates the effects of posttraumatic stress symptoms on adjustment and positive affective reactions in digestive system cancer patients[J]. Psychol Health Med, 2015,20(6):685-696. doi: 10.1080/13548506.2014.969747 pmid: 25308122
[7]	Yun YH, Sim JA, Jung JY, et al. The association of self-leadership,health behaviors,and posttraumatic growth with health-related quality of life in patients with cancer[J]. Psycho-Oncology, 2014,23(12):1423-1430. doi: 10.1002/pon.3582
[8]	宋彩虹, 钟玉芳, 张世慧. 宫颈癌根治术后病人创伤后成长状况及其影响因素分析[J]. 全科护理, 2018,16(23):2820-2823.
[9]	Tang ST, Lin KC, Chen JS, et al. Threatened with death but growing:changes in and determinants of posttraumatic growth over the dying process for Taiwanese terminally ill cancer patients[J]. Psycho-Oncology, 2015,24(2):147-154. doi: 10.1002/pon.3616 pmid: 25044970
[10]	计海霞, 张蕾, 汪凯, 等. 缺血性脑卒中患者的疾病感知及相关因素分析[J/CD]. 中华临床医师杂志:电子版, 2014,8(20):3588-3592.
[11]	谭晓娟, 杨卫霞, 徐利明, 等. 头颈部肿瘤放疗患者疾病感知与生活质量的相关性分析[J]. 天津护理, 2019,27(4):401-404.
[12]	孙志飞, 徐忠, 辛力, 等. 疾病感知对急性心肌梗死患者出院后的影响[J]. 河北医科大学学报, 2018,39(9):996-1001.
[13]	钱琴, 刘敏, 马兰. 乳腺癌患者创伤后成长与乐观倾向、疾病感知的相关性研究[J]. 护理管理杂志, 2018,18(2):89-92.
[14]	李琳, 王晴, 王璇, 等. 乳腺癌术后患者疾病感知与创伤后成长的相关性研究[J]. 护士进修杂志, 2017,32(14):1312-1315.
[15]	黄琦, 尤青海, 王巾枚. 肺癌患者的疾病感知与创伤后成长[J]. 安徽医科大学学报, 2019,54(5):781-784.
[16]	Weinman J, Petrie KJ, Moss-morris R. The illness perception questionnaire:a new method for assessing the cognitive representation of illness[J]. Psychol Health, 1996,11(3):431-445. doi: 10.1080/08870449608400270
[17]	Broadbent. The illness perception questionnaire[EB/OL].[2015-12-08]. http://www.uib.no/ipq/index.html.
[18]	Moss-Morris R, Weinman J, Petrie K, et al. The Revised Illness Perception Questionnaire(IPQ-R)[J]. Psychol Health, 2002,17(1):1-16. doi: 10.1080/08870440290001494
[19]	李思嘉, 郭爱敏, 赵艳伟. 慢性阻塞性肺疾病患者疾病感知现况及其影响因素分析[J]. 中国护理管理, 2017,17(8):1112-1116.
[20]	陈依琳, 张美芬, 覃惠英, 等. 结直肠癌患者口服化疗药依从性与疾病感知相关性的纵向研究[J]. 中华护理杂志, 2017,52(1):8-13.
[21]	梅雅琪, 李惠萍, 杨娅娟, 等. 中文版疾病感知问卷简化版在女性乳腺癌患者中的信效度检验[J]. 护理学报, 2015,22(24):11-14.
[22]	Tedeschi RG, Calhoun LG. The Posttraumatic Growth Inventory:measuring the positive legacy of trauma[J]. J Trauma Stress, 1996,9(3):455-471. doi: 10.1007/BF02103658 pmid: 8827649
[23]	汪际. 创伤后成长评定量表及其意外创伤者常模的研制[D]. 上海:第二军医大学, 2011.
[24]	刘晓蓓, 李惠萍, 陈晓红, 等. 乳腺癌患者创伤后成长与认知评价和应对方式的相关研究[J]. 重庆医学, 2019,48(4):586-590.
[25]	陈红涛. 喉癌术后患者创伤后成长与生存质量的相关性研究[D]. 长沙:湖南师范大学, 2016.
[26]	唐系甜, 伍美怡. 口腔癌术后患者创伤后成长与疾病感知的相关性研究[J]. 中西医结合护理(中英文), 2019,5(9):94-97.
[27]	Kaptein AA, Yamaoka K, Snoei L, et al. Illness perceptions and quality of life in Japanese and Dutch patients with non-small-cell lung cancer[J]. Lung Cancer, 2011,72(3):384-390. doi: 10.1016/j.lungcan.2010.09.010
[28]	高冉, 史铁英. 原发性乳腺癌患者创伤后成长的纵向调查[J]. 护理学杂志, 2017,32(20):88-90.
[29]	赵雪娇, 周景, 陆旭东, 等. 正颌手术患者口腔健康相关生活质量及创伤后成长的纵向研究[J]. 护理学杂志, 2018,33(18):72-75.
[30]	陈红涛, 宋小花, 董彩梅, 等. 喉癌术后患者创伤后成长现状及影响因素分析[J]. 护理学杂志, 2017,32(6):22-25.