肺癌同步放化疗患者自我管理行为调查及影响因素研究-现代医学

肺癌同步放化疗患者自我管理行为调查及影响因素研究

单位：1. 临沂市肿瘤医院内科二病区, 山东临沂 276034;
2. 临沂市肿瘤医院胸外科二病区, 山东临沂 276034

分类号：R734.2

出版年·卷·期（页码）：2025·53·第十期（1589-1594）

摘要：

目的：分析肺癌放化疗(CRT)患者自我管理行为(SMB)现状及有关的影响因素。方法：选取2023年1月至2024年11月诊治的150例肺癌CRT患者为研究对象。采用肺癌生存者SMB评估量表、医院焦虑抑郁量表(HADS)、中文版癌症自我管理效能感量表(C-SUPPH)、Mishel疾病不确定感量表(MUIS)、领悟社会支持量表(PSSS)分别评估患者SMB、焦虑/抑郁、自我管理效能感、疾病不确定感、社会支持水平。Pearson相关分析SMB水平与自我管理效能感、社会支持等的关系。多元线性回归分析CRT患者SMB水平的影响因素。结果：本研究有效问卷回收率为96.67%(145/150)。145例肺癌CRT患者SMB评估量表、C-SUPPH、中文版MUIS、HADS焦虑、HADS抑郁、PSSS评分分别为(164.97±17.39)分、(84.56±8.96)分、(50.20±5.80)分、(9.22±2.14)分、(8.34±1.86)分、(51.84±4.32)分。Pearson相关分析显示，肺癌CRT患者SMB水平与自我管理效能感(r=0.721)、社会支持(r=0.624)呈正相关，与疾病不确定感(r=-0.579)、焦虑(r=-0.537)、抑郁(r=-0.551)呈负相关(P＜0.05)。多元线性回归分析显示，文化水平、疾病不确定感、化疗次数、焦虑、抑郁、自我管理效能感、社会支持是肺癌CRT患者SMB水平的影响因素(P＜0.05)。结论：肺癌CRT患者SMB属于中等水平，文化水平、疾病不确定感、化疗次数、焦虑、抑郁、自我管理效能感、社会支持是肺癌CRT患者SMB水平的影响因素，临床可据此采取针对性管理策略以提高患者SMB水平。

Objective: To analyze the current status and influencing factors of self-management behavior(SMB) in lung cancer patients undergoing synchronous chemoradiotherapy(CRT). Methods: 150 patients with lung cancer CRT from January 2023 to November 2024 were selected as the study objects. SMB, anxiety/depression, self-management efficacy, disease uncertainty, and social support level were evaluated by Lung Cancer Survivors Self-management Behavior Assessment Scale, Hospital Anxiety and Depression Scale(HADS), Chinese Strategies Used by People to Promote Health(C-SUPPH), Mishel's Uncertainty in Illness Scale(MUIS), and Multidimensional Scale of Perceived Social Support(PSSS). Pearson correlation analysis was used to analyze the relationship between SMB level and self-management efficacy, social support and so on. Multiple linear regression was used to analyze the factors affecting SMB level in lung cancer CRT patients. Results: The effective questionnaire recovery rate was 96.67%(145/150). The scores of SMB Assessment Scale, C-SUPPH, MUIS, HADS anxiety, HADS depression and PSSS of 145 lung cancer CRT patients were 164.97±17.39, 84.56±8.96,50.20±5.80,9.22±2.14, 8.34±1.86 and 51.84±4.32. Pearson correlation analysis showed that SMB level in lung cancer CRT patients was positively correlated with self-management efficacy(r=0.721) and social support(r=0.624), and negatively correlated with disease uncertainty(r=-0.579), anxiety(r=-0.537) and depression(r=-0.551)(P<0.05). Multiple linear regression analysis showed that literacy level, disease uncertainty, chemotherapy frequency, anxiety, depression, self-management efficacy and social support were the influencing factors for SMB level of lung cancer CRT patients(P<0.05). Conclusion: SMB of CRT patients with lung cancer belongs to the medium level. Literacy level, disease uncertainty, times of chemotherapy, anxiety, depression, self-management efficacy, and social support are the influencing factors for SMB level of lung cancer CRT patients. Therefore, targeted management strategies can be adopted to improve SMB level of lung cancer CRT patients.

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