中青年癌症患者预立医疗照护计划接受度现状及影响因素研究

doi:10.3761/j.issn.0254-1769.2022.07.011

摘要/Abstract

摘要：

目的了解中青年癌症患者预立医疗照护计划（advance care planning,ACP）接受度现状并分析其影响因素,为ACP的实施和推广提供依据。方法采用便利抽样的方法,于2020年9月—2021年2月采用一般资料调查表、患者ACP接受程度调查问卷、维克森林医师信任量表中文修订版和死亡态度描绘量表修订版对长春市3所三级甲等医院肿瘤科460例住院中青年癌症患者进行调查。采用多元线性逐步回归分析ACP接受度的影响因素。结果回收有效问卷426份,调查对象的ACP接受度得分为（66.30±9.32）分,宗教信仰、病程、疼痛程度、就医信任度、死亡态度是中青年癌症患者ACP接受度的影响因素（P<0.05）。结论中青年癌症患者ACP接受度处于中等偏上的水平,受多种因素影响,临床医护人员要识别ACP接受度的影响因素并采取规范化的措施帮助患者正确面对疾病与死亡,提高患者ACP接受度,建议进行ACP知识的普及宣讲,并在中青年癌症患者中试行ACP。

关键词: 中年人, 青年人, 肿瘤, 预立医疗照护计划, 接受度, 影响因素分析, 横断面研究

Abstract:

Objective To understand the status quo of acceptance of advanced care plan（ACP） for young and middle-aged cancer patients,and to analyze its influencing factors,so as to provide the basis for the implementation and promotion of ACP. Methods The convenience sampling method was adopted from September 2020 to February 2021 to investigate a total of 426 young and middle-aged cancer inpatients by a general information questionnaire,Patient’s Advance Care Planning Acceptance Questionnaire（ACPQ）,Wake Forest Physician Trust Scale（WFPTS） and Death Attitude Profile-Revised（DAP-R）. Multiple linear stepwise regression was used to analyze the influencing factors of ACP acceptance. Results The score of ACP acceptance of 426 young and middle-aged cancer patients was（66.30±9.32）. Religious belief,course of disease,degree of pain,medical trust,and death attitude were the influencing factors of ACP acceptance of this population（P<0.05）. Conclusion The acceptance of ACP in young and middle-aged cancer patients is at the upper-middle level and it is affected by many factors. Clinical medical staff should identify the relevant factors affecting the acceptance of ACP,take standardized measures to help patients correctly face the disease and death,and improve the acceptance of ACP. It is suggested to popularize ACP knowledge and try ACP for young and middle-aged cancer patients.

Key words: Middle Aged, Young Adult, Neoplasms, Advance Care Planning, Acceptance, Root Cause Analysis, Cross-Sectional Study

尹晓彤, 朱蓝玉, 王幽, 李雪, 温娜, 朱亚飞. 中青年癌症患者预立医疗照护计划接受度现状及影响因素研究[J]. 中华护理杂志, 2022, 57(7): 834-840.

YIN Xiaotong, ZHU Lanyu, WANG You, LI Xue, WEN Na, ZHU Yafei. Status quo and influencing factors of acceptance of advance care planning for young and middle-aged cancer patients[J]. Chinese Journal of Nursing, 2022, 57(7): 834-840.

图/表 4

表1 中青年癌症患者的一般资料及患者ACP接受程度调查问卷得分比较（n=426）

Table 1 Comparison of general information and Advance Care Planning Acce-ptance Questionnaire scores of young and middle-aged cancer patients（n=426）

表2 中青年癌症患者ACP接受程度调查问卷得分（分,n=426）

Table 2 Score of Advance Care Planning Acceptance Questionnaire for young and middle-aged cancer patients （score,n=426）

表3 中青年癌症患者ACP接受度与就医信任度、死亡态度的相关性分析（r 值）

Table 3 Correlation analysis between advance care planning acceptance,medical trust and death attitude of young and middle-aged cancer patients（r value）

表4 中青年癌症患者ACP接受度影响因素的多元线性逐步回归分析结果（n=426）

Table 4 Multiple linear regression analysis of influencing factors of advance care planning acceptance in young and middle-aged cancer patients（n=426）

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