中华护理杂志 ›› 2020, Vol. 55 ›› Issue (8): 1206-1211.DOI: 10.3761/j.issn.0254-1769.2020.08.018

• 专科实践与研究 • 上一篇    下一篇

肝硬化住院患者及家属疾病不确定感现状及影响因素的研究

许丽(),李萌,南士英()   

  1. 250033 济南市 山东大学第二医院肝病科(许丽,南士英);中山大学附属第八医院神经内科(李萌)
  • 收稿日期:2019-09-11 出版日期:2020-08-15 发布日期:2020-08-06
  • 通讯作者: 南士英
  • 作者简介:许丽:女,硕士,主管护师,E-mail: <email>xuli25286@163.com</email>

Study on illness uncertainty and influential factors of inpatients with cirrhosis and their family caregivers

XU Li(),LI Meng,NAN Shiying()   

  • Received:2019-09-11 Online:2020-08-15 Published:2020-08-06
  • Contact: Shiying NAN

摘要:

目的 描述肝硬化住院患者及家属疾病不确定感的现状,从心理社会因素方面探究患者及家属疾病不确定感的影响因素。方法 采取便利抽样法,选取山东省济南市某三级甲等医院肝病科符合标准的肝硬化住院患者和家属作为调查对象,采用疾病不确定感成人量表和疾病不确定感家属量表分别对患者和家属进行疾病不确定感的横断面调查,通过多元线性回归,明确2个群体疾病不确定感的影响因素。结果 肝硬化住院患者和家属疾病不确定感的得分分别为(84.82±12.92)分、(92.49±12.66)分。不可预测是影响患者和家属疾病不确定感水平的重要因素。患者的疾病不确定感受自身感知的社会支持( β=-0.181,P=0.019)和家属疾病不确定感的影响( β=0.378,P<0.001)。家属的疾病不确定感受自身感知的社会支持( β=-0.202,P=0.013)和患者疾病不确定感的影响( β=0.336,P<0.001)。 结论 肝硬化住院患者及家属普遍存在疾病不确定感,两者体验到的疾病不确定感可以互相影响,医护人员应同时关注2个群体的疾病不确定感,以便及早进行综合干预。

关键词: 肝硬化患者, 家属, 疾病不确定感, 焦虑, 抑郁, 社会支持

Abstract:

Objective The study aimed to investigate current status of illness uncertainty of inpatients with cirrhosis and their family caregivers and to explore related psychosocial factors. Methods Participants were selected by convenient sampling. Cirrhotic inpatients and their family caregivers were included by 1:1 match. Mishel Uncertainty in Illness Scales for Adults and Family Members were used respectively for patients and their family caregivers to evaluate illness uncertainty. Hierarchical linear regression was adopted to explore related influencing factors. Results The average score of illness uncertainty in cirrhotic inpatients and family caregivers were(84.82±12.92) and(92.49±12.66)respectively. The most important factor affecting illness uncertainty of patients and family caregivers was the unpredictable feature of the process and prognosis of illness. Hierarchical linear regression showed that the illness uncertainty of cirrhotic inpatients was affected by patients’ social support(β=-0.269,P=0.045) and caregivers’ illness uncertainty(β=0.380,P<0.001). The illness uncertainty of family caregivers was affected by self-perceived friend support (β=-0.739,P=0.036),patients’ family support (β=-0.700,P=0.031) and the patients’ illness uncertainty (β=0.333,P<0.001). Conclusion Illness uncertainty was common among cirrhotic inpatients and their family caregivers. The illness uncertainty of cirrhotic inpatients and family caregivers can have an interactive effect on each other. More attention to illness uncertainty should be paid to both cirrhotic patients and their family caregivers in order to facilitate early comprehensive intervention.

Key words: Inpatients with Cirrhosis, Family Caregivers, Illness Uncertainty, Depression, Anxiety, Social Support