Lien Chin-Yen, Lin Hung-Ru, Kuo Ing-Tiau, Chen Mei-Ling
Department of Nursing, Taipei Veterans General Hospital, 365 Ming Te Rd, Pei Tou, Taipei, Taiwan.
J Clin Nurs. 2009 Aug;18(16):2311-9. doi: 10.1111/j.1365-2702.2008.02549.x. Epub 2009 Jan 15.
The purpose of this longitudinal correlative study was to explore the degree, compare the differences and to detect the relationships of uncertainty, social support and psychological adjustment for older cancer patients who were undergoing surgery.
While the number of the older cancer patients has been increasing, there has been little research exploring their needs with respect to psychological adjustment during cancer treatment.
The study used a pre-/postdescriptive design.
Purposive sampling was used to recruit 43 patients aged 65-84 from six surgery wards in a medical centre in northern Taiwan from January 2005-May 2005. Participants were interviewed one to two days prior to surgery and interviewed again one to two days before hospital discharge. Demographic data, Mishel's Uncertainty Illness Scale, Hospital Anxiety and Depression Scale and the Interpersonal Support Evaluation List were used to collect data.
Uncertainty varied with cancer stage. At the time of surgery, the patients had moderate levels of uncertainty. There was a significant decrease in uncertainty at the second data collection period before hospital discharge. In these participants, anxiety was significantly associated with past medical history. The participants obtained social support from family members, physicians, nurses, relatives and other patients. Married patients had higher levels of social support than those without a spouse. Significant relationships were found among uncertainty and anxiety and depression. Interestingly, a positive relationship between anxiety and social support after surgery was also identified.
Increasing levels of social support could ameliorate the degree of uncertainty, anxiety and depression in older cancer patients. Nurses should provide resources to establish an effective social network to older cancer patients who were being treated surgically.
These findings can assist nurses in understanding the psychological adjustment needs among older cancer patients who were undergoing surgery and provide appropriate intervention in nursing care.
本纵向相关性研究旨在探讨接受手术治疗的老年癌症患者的不确定性、社会支持和心理调适的程度，比较差异并检测它们之间的关系。
虽然老年癌症患者的数量一直在增加，但很少有研究探讨他们在癌症治疗期间的心理调适需求。
本研究采用术前/术后描述性设计。
采用目的抽样法，于2005年1月至2005年5月从台湾北部某医疗中心的六个外科病房招募了43名年龄在65 - 84岁之间的患者。在手术前一至两天对参与者进行访谈，并在出院前一至两天再次进行访谈。使用人口统计学数据、米舍尔疾病不确定感量表、医院焦虑抑郁量表和人际支持评估量表收集数据。
不确定性因癌症分期而异。手术时，患者的不确定性处于中等水平。在出院前的第二次数据收集期间，不确定性显著降低。在这些参与者中，焦虑与既往病史显著相关。参与者从家庭成员、医生、护士、亲属和其他患者那里获得社会支持。已婚患者的社会支持水平高于无配偶者。在不确定性与焦虑和抑郁之间发现了显著关系。有趣的是，还发现了术后焦虑与社会支持之间的正相关关系。
增加社会支持水平可以改善老年癌症患者的不确定性、焦虑和抑郁程度。护士应为接受手术治疗的老年癌症患者提供资源，以建立有效的社会支持网络。
这些发现可帮助护士了解接受手术治疗的老年癌症患者的心理调适需求，并在护理中提供适当的干预措施。
