前列腺癌患者经济负担现状及影响因素分析

doi:10.3761/j.issn.0254-1769.2022.08.004

摘要/Abstract

摘要：

目的了解前列腺癌患者经济负担（financial toxicity,FT）现状及影响因素,为降低前列腺癌患者FT水平提供依据。方法采用便利抽样法,选取2020年1月—2021年8月入住上海市某三级甲等医院的281例前列腺癌患者为调查对象,采用一般资料调查表、癌症患者报告结局的经济毒性量表、医学应对方式问卷和一般自我效能感量表进行横断面调查。采用多元线性回归分析FT的影响因素。结果前列腺癌患者的经济负担得分为22.0（17.0,24.0）分。多元线性回归分析显示,疾病诊断是否影响其退休年龄、家庭人均月收入（元）、最近3个月以来治疗费用、医学应对方式屈服维度得分及自我效能感水平是影响其FT的主要因素（P<0.001）,解释总变异的45.6%。结论前列腺癌患者FT处于中下水平,临床医务人员可通过实施有效的干预措施帮助其重返工作,评估患者经济状况选择个体化的治疗方案,鼓励其寻求更多的社会支持,引导其采取积极的应对方式和提升其自我效能水平以降低FT水平,提升其生活质量。

关键词: 前列腺癌, 经济负担, 应对方式, 自我效能, 影响因素分析, 护理

Abstract:

Objective The purpose of this study is to investigate the status and influencing factors of financial toxicity（FT） in patients with prostate cancer,and to provide a basic theory for reducing FT levels in prostate cancer patients. Methods With the convenience sampling method,a total of 281 prostate cancer patients were recruited from a hospital in Shanghai from January 2020 to August 2021. A cross-sectional study was conducted by the general data questionnaire,the Comprehensive Scores for Financial Toxicity based on the Patient-Reported Outcome Measures（COST-PROM）,the Medical Coping Modes Questionnaire（MCMQ） and the General Self-Efficacy Scale（GSES）. Besides,multiple linear regression was used to identify predictors of FT in patients with prostate cancer. Results The total score of COST-PROM was 22.0 （17.0,24.0）. Multiple linear regression analysis showed that the factors of the diagnosis of prostate cancer affecting the retirement age,the average income per person in family,the treatment cost in the last 3 months,the dimension of surrender in medical coping style and the level of self-efficacy were the main influencing factors of FT（P<0.001）,which accounted for 45.6% of total variation. Conclusion The FT of patients with prostate cancer is in the middle and low level. Clinical staff should use the effective intervention measures to help patients go back to work,estimate their economic conditions for choosing individualized treatment,help them seek more social supports and resources,and guide them to manage problems in positive ways and enhance the level of self-efficacy,in order to reduce the level of FT and improve the quality of their life.

Key words: Prostate Cancer, Financial Toxicity, Coping Style, Self-Efficacy, Root Cause Analysis, Nursing Care

袁方, 林梦月, 刘永珍, 施琳琳, 居海岭, 杨斌, 袁静. 前列腺癌患者经济负担现状及影响因素分析[J]. 中华护理杂志, 2022, 57(8): 918-924.

YUAN Fang, LIN Mengyue, LIU Yongzhen, SHI Linlin, JU Hailing, YANG Bin, YUAN Jing. The analysis of the financial toxicity and its influencing factors in prostate cancer patients[J]. Chinese Journal of Nursing, 2022, 57(8): 918-924.

图/表 5

表1 前列腺癌患者经济负担的单因素分析（n=281）

Table 1 The univariate analysis of FT in prostate cancer patients（n=281）

表2 前列腺癌患者的经济负担、医学应对方式及自我效能感得分[n=281,分,M（P25,P75）]

Table 2 The scores of COST-PROM,MCMQ and GSES

表3 前列腺癌患者的医学应对方式、自我效能感与经济负担的相关分析（r,n=281）

Table 3 Correlation between COST-PROM,MCMQ and GSES（r,n=281）

表4 自变量赋值方式

Table 4 Variables assignment table

表5 前列腺癌患者经济负担影响因素的多元线性回归分析

Table 5 Multiple regression analysis of predictors of FT in prostate cancer patients

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