中国接受化疗的乳腺癌患者的不确定性、自我效能感和自我护理行为
Uncertainty, Self-efficacy, and Self-care Behavior in Patients With Breast Cancer Undergoing Chemotherapy in China.
作者信息
Zhang Yingzi, Kwekkeboom Kristine, Petrini Marcia
机构信息
Author Affiliations: School of Nursing, Wuhan University, Wuhan, Hubei, China (Ms Zhang and Dr Petrini); and School of Nursing, University of Wisconsin-Madison (Ms Zhang and Dr Kwekkeboom).
出版信息
Cancer Nurs. 2015 May-Jun;38(3):E19-26. doi: 10.1097/NCC.0000000000000165.
BACKGROUND
Treatment for breast cancer causes uncertainty in the face of new and distressing experiences and often results in the need for self-care. Identifying how uncertainty influences self-care behavior is essential to design interventions that enhance self-care capacity and improve patient outcomes.
OBJECTIVES
The aims of this study were to describe the levels of uncertainty, self-efficacy, and self-care behavior in Chinese women receiving chemotherapy for breast cancer and to determine if self-efficacy mediates the relationship between uncertainty and self-care behavior.
METHODS
A cross-sectional descriptive correlational design was used. Ninety-seven participants completed the Generalized Self-efficacy Scale, the Mishel Uncertainty in Illness Scale, and the Appraisal of Self-care Agency Scale-Revised. Descriptive statistics were used to analyze the levels of uncertainty, self-efficacy, and self-care behaviors in the sample. Multiple regression was used to test the mediating effect of self-efficacy in the relationship between uncertainty and self-care behavior.
RESULTS
Mean ratings of uncertainty (76.70), self-efficacy (27.15), and self-care behavior (53.96) all fell in the moderate range. Both uncertainty and self-efficacy independently predicted self-care behavior, explaining 18.2% of the variance, but self-efficacy did not mediate the relationship between uncertainty and self-care behavior.
CONCLUSIONS
Research is needed to further evaluate the proposed relationships using instruments specific to/related to cancer and evaluate change over time. Self-care interventions that have been efficacious in Western populations could be revised to assist Chinese women to reduce uncertainty and enhance self-efficacy in coping with breast cancer.
IMPLICATIONS FOR PRACTICE
Self-care intervention programs should include strategies to reduce uncertainty and enhance self-efficacy in coping with breast cancer treatment.
背景
乳腺癌治疗会在面对新的痛苦经历时引发不确定性，且常常导致自我护理的需求。明确不确定性如何影响自我护理行为对于设计增强自我护理能力并改善患者预后的干预措施至关重要。
目的
本研究旨在描述接受乳腺癌化疗的中国女性的不确定性、自我效能感和自我护理行为水平，并确定自我效能感是否介导不确定性与自我护理行为之间的关系。
方法
采用横断面描述性相关性设计。97名参与者完成了一般自我效能感量表、米舍尔疾病不确定性量表和修订后的自我护理能力评估量表。描述性统计用于分析样本中的不确定性、自我效能感和自我护理行为水平。多元回归用于检验自我效能感在不确定性与自我护理行为关系中的中介作用。
结果
不确定性（76.70）、自我效能感（27.15）和自我护理行为（53.96）的平均评分均处于中等范围。不确定性和自我效能感均独立预测自我护理行为，解释了18.2%的方差，但自我效能感并未介导不确定性与自我护理行为之间的关系。
结论
需要开展研究，使用特定于/与癌症相关的工具进一步评估所提出的关系，并评估随时间的变化。在西方人群中有效的自我护理干预措施可进行修订，以帮助中国女性减少不确定性并增强应对乳腺癌的自我效能感。
对实践的启示
自我护理干预项目应包括减少不确定性和增强应对乳腺癌治疗的自我效能感的策略。
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