结直肠癌患者肠造口术后心理一致感水平及影响因素研究-现代医学

结直肠癌患者肠造口术后心理一致感水平及影响因素研究

单位：中国人民解放军陆军第七十三集团军医院普通外科, 福建厦门 361000

分类号：R473.73

出版年·卷·期（页码）：2025·53·第十二期（1884-1890）

摘要：

目的：调查结直肠癌肠造口术后患者心理一致感的现状并分析其影响因素，为制定心理干预策略提供依据。方法：采用回顾性研究方法，收集2022年2月至2025年2月期间于本院行肠造口术的102例结直肠癌患者的临床资料。采用心理一致感量表(SOC-13)评估其心理一致感水平现状，应用多重线性回归模型分析其心理一致感水平的影响因素。结果： SOC-13总评分为38～75分，平均(58.72±9.01)分。其中有意义感评分为11～24分，平均(17.37±4.58)分；可理解感评分为15～30分，平均(23.31±4.43)分；可控制感评分为12～24分，平均(18.03±4.17)分。Pearson相关分析显示，自尊量表(SES)、社会支持度(SSRS)评分均与SOC-13评分呈正相关(r=0.880、0.888，均P<0.05)；且SES与SSRS评分存在正相关关系(r=0.875，P<0.05)。线性回归模型结果显示，性别、婚姻状况(离异/丧偶)、造口术后时间(≥12个月)、造口并发症、SES评分、SSRS评分均是结直肠癌患者肠造口术后心理一致感水平的影响因素(P<0.05)。分层线性回归分析显示，在控制人口学和临床因素后，SES评分(β=0.233，P=0.001)和SSRS评分(β=0.294，P<0.001)是心理一致感的独立正向预测因素；婚姻状况为离异或丧偶、造口术后时间≥12个月以及存在造口并发症均与心理一致感显著相关。结论：结直肠癌患者肠造口术后心理一致感处于中低水平，性别、婚姻状况(离异/丧偶)、造口术后时间(≥12个月)、造口并发症、SES评分、SSRS评分均是结直肠癌患者肠造口术后心理一致感水平的影响因素。

Objective: To investigate the current status of sense of coherence and analyze its influencing factors in colorectal cancer patients after enterostomy, so as to provide a basis for formulating psychological intervention strategies. Methods: In this retrospective cross-sectional study, clinical data of 102 colorectal cancer patients who underwent enterostomy in our hospital from February 2022 to February 2025 were collected. The Sense of Coherence-13 Scale(SOC-13) was used to assess their SOC level. Multiple linear regression models were applied to analyze the influencing factors. Results: The total SOC-13 score ranged from 38 to 75, with an average of(58.72±9.01) points. The subscores were as follows: meaningfulness,(17.37±4.58) points(range: 11-24); comprehensibility,(23.31±4.43) points(range: 15-30); and manageability,(18.03±4.17) points(range: 12-24). Pearson correlation analysis revealed that both the Self-Esteem Scale(SES) score and the Social Support Rating Scale(SSRS) score were positively correlated with the SOC-13 score(r=0.880 and 0.888, respectively, both P<0.05). A positive correlation was also found between SES and SSRS score(r=0.875, P<0.05). Multiple linear regression results indicated that gender, marital status(divorced/widowed), time since stoma surgery(≥12 months), stoma complications, SES score, and SSRS score were all influencing factors for SOC level in these patients(P<0.05). Hierarchical linear regression analysis showed that, after controlling for demographic and clinical factors, SES score(β=0.233, P=0.001) and SSRS score(β=0.294, P<0.001) were independent positive predictors of SOC. Conclusion: The sense of coherence in colorectal cancer patients after enterostomy is at a low to moderate level. Gender, marital status(divorced/widowed), postoperative time(≥12 months), stoma complications, SES score, and SSRS score are all influencing factors.

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