子宫内膜癌患者对复发风险认知与其随访依从性的相关性研究-现代医学

子宫内膜癌患者对复发风险认知与其随访依从性的相关性研究

单位：1. 南京医科大学第一附属医院/江苏省人民医院麻醉手术科, 江苏南京 210000;
2. 南京医科大学第一附属医院/江苏省人民医院妇科, 江苏南京 210000

分类号：R737.33

出版年·卷·期（页码）：2026·54·第二期（281-288）

摘要：

目的： 了解子宫内膜癌(EC)患者疾病复发风险认知和随访依从性现状，分析患者随访依从性的相关影响因素。方法： 采用横断面研究设计，便利抽样法选取2022年1月至2025年6月于我院妇科门诊随访的EC术后患者，通过一般资料调查表、EC复发风险认知量表及随访依从性量表进行问卷调查。本研究共收集纳入290例研究对象。采用单因素分析(t检验、 χ²检验)、Pearson相关分析及二元Logistic回归分析探讨变量间关系。结果： 患者复发风险认知总分的百分制得分为(58.4±12.7)分，处于中等水平，其中复发易感性感知维度得分最低[(56.8±16.4)分]。随访依从性良好率为79.3%(230/290)。单因素分析显示，复发风险认知百分制得分在不同年龄、文化程度、家庭月收入和FIGO分期患者间比较，差异均有统计学意义(均P＜0.001)；随访依从性良好率在年龄、文化程度、家庭月收入和FIGO分期分组间的比较，差异亦均有统计学意义(均P＜0.05)。复发风险认知总分与随访依从性呈显著正相关(r=0.452,P＜0.001)。二元Logistic回归分析显示，复发风险认知总分(OR=1.078,95%CI 1.048～1.109,P＜0.001)是随访依从性良好的显著相关因素。与文化程度为初中及以下患者相比，高中/中专(OR=1.682,95%CI 1.032～2.742)和大专及以上(OR=2.858,95%CI 1.618～5.049)的患者依从性良好的可能性更高(均P＜0.05)。与FIGO Ⅰ期患者相比，FIGO Ⅱ期(OR=2.411,95%CI 1.080～5.382)和FIGO Ⅲ期(OR=5.210,95%CI 1.272～21.340)的患者依从性良好的可能性也更高(均P＜0.05)。与家庭月收入<5 000元的患者相比，家庭月收入≥10 000元的患者(OR=2.509，95%CI 1.263～4.986)其依从性良好更高(P＜0.05)。年龄与随访依从性良好的关联无统计学意义(P>0.05)。结论： EC的复发风险认知处于中等水平，且是随访依从性存在最强关联。临床应优先针对低认知-低依从群体(如高龄、低文化程度患者)探索并实施以提升复发风险认知为核心的干预策略，以改善随访行为及长期预后。

Objective: To investigate the current status of disease recurrence risk cognition and follow-up compliance among patients with endometrial carcinoma(EC), and to analyze the related influencing factors of follow-up compliance. Methods: A cross-sectional study design with convenience sampling was employed. Patients who attended the gynecological outpatient clinic for follow-up after EC surgery at our hospital between January 2022 and June 2025 were enrolled. Data were collected using a general information questionnaire, a self-developed Endometrial Carcinoma Recurrence Risk Cognition Scale, and a Follow-up Compliance Scale. A total of 290 patients were included. Univariate analysis(t-test, χ² test), Pearson correlation analysis, and binary logistic regression analysis were applied to examine the relationships among variables. Results: The total percentage score for patients' recurrence risk cognition was[(58.4±12.7)score], indicating a moderate level, with the lowest score observed in the dimension of perceived susceptibility to recurrence[(56.8±16.4)score]. The rate of good follow-up adherence was 79.3%(230/290). Univariate analyses showed that recurrence risk perception scores differed significantly across age, educational level, monthly household income, and FIGO stage(all P＜0.001). Similarly, the rates of good follow-up compliance also differed significantly across these groups. Cognition scores showed significant differences among the complete compliance, partial compliance, and non-compliance groups(65.2±10.9 vs 57.6±11.2 vs 49.8±10.5,F=38.48,P＜0.001). A significant positive correlation was found between the total score of recurrence risk cognition and follow-up compliance(r=0.452,P＜0.001). Binary logistic regression analysis identified the total score of recurrence risk cognition(OR=1.078,95%CI 1.048-1.109,P＜0.001) as the factor most strongly associated with good follow-up compliance. Compared to patients with a junior high school education or below, those with a senior high school/technical secondary school education(OR=1.682,95%CI 1.032-2.742, P＜0.05) and those with a college education or above(OR=2.858,95%CI 1.618-5.049, P＜0.001) were more likely to have good compliance. Compared to patients with FIGO stage I disease, those with stage Ⅱ(OR=2.411,95%CI 1.080-5.382, P＜0.05) and stage Ⅲ(OR=5.210,95%CI 1.272-21.340,P＜0.05) were also more likely to have good compliance. A monthly household income of ≥10,000 yuan was a facilitating factor for compliance(OR=2.509,95%CI 1.263-4.986,P＜0.05), while age and a monthly household income between 5 000 and 10 000 yuan showed no statistically significant association with compliance(P>0.05). Conclusion: Recurrence risk perception among patients with endometrial cancer is at a moderate level and shows the strongest association with follow-up adherence. Clinical practice should prioritize patients with low recurrence risk perception and poor adherence—such as older patients and those with lower educational attainment—and develop targeted interventions aimed at enhancing recurrence risk perception to improve follow-up behavior and long-term outcomes.

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