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中国造口患者的污名及其影响因素。

Stigma and its influencing factors among Chinese patients with stoma.

机构信息

The Second Clinical Medical College, Yangtze University, Jingzhou, Hubei Province, China.

School of Nursing, Sun Yat-sen University, Guangzhou, China.

出版信息

Psychooncology. 2018 Jun;27(6):1565-1571. doi: 10.1002/pon.4695. Epub 2018 Apr 19.

Abstract

BACKGROUND

Although stomas are necessary for disease treatment, they unavoidably affect patients' lives from physical, psychological, social, spiritual, and familial perspectives and contribute to feelings of embarrassment and shame. This study explored the current status and factors influencing stigma among Chinese patients with stoma.

METHODS

A total of 209 patients with stoma at the stoma clinic of a tertiary cancer centre in Guangzhou, China, were recruited and investigated by using the Social Impact Scale, the Coping Self-Efficacy Scale, the State Self-Esteem Scale, and a demographic questionnaire. Multivariate linear regression was used to identify the factors influencing stigma.

RESULTS

The mean Social Impact Scale score was 69.65 ± 13.18, which represents a moderate effect; specifically, 44% of the patients experienced high levels of stigma. Stoma patients with the following characteristics had high levels of stigma: young, low coping self-efficacy, low stoma acceptance by one's spouse or other family members, poor perceived body image, stool leakage, and no experience of participating in activities with other stoma patients.

CONCLUSIONS

Medical staff members should pay more attention to stigma in stoma patients. Coping self-efficacy, family members' acceptance of the stoma, and participation in activities with other stoma patients are influencing factors that protect these patients against stigma, whereas body image loss and stool leakage place them at higher risk for stigma. Interventions aimed at improving protective factors and decreasing risk factors should be considered to reduce the level of stigma in patients with stoma.

摘要

背景

虽然造口术是治疗疾病的必要手段,但它不可避免地会从身体、心理、社会、精神和家庭等方面影响患者的生活,导致患者感到尴尬和羞耻。本研究旨在探讨中国造口患者的耻辱感现状及其影响因素。

方法

采用社会影响量表、应对自我效能感量表、状态自尊量表和一般情况问卷,对广州某三级肿瘤中心造口门诊的 209 例造口患者进行调查。采用多元线性回归分析识别影响耻辱感的因素。

结果

社会影响量表评分为 69.65±13.18,为中等程度影响;其中 44%的患者有较高的耻辱感。具有以下特征的造口患者耻辱感水平较高:年轻、应对自我效能感低、配偶或其他家庭成员对造口的接受程度低、对自身身体形象的认知差、粪便渗漏和未参加过与其他造口患者的活动。

结论

医护人员应更加关注造口患者的耻辱感。应对自我效能感、家庭成员对造口的接受程度和参加与其他造口患者的活动是保护患者免受耻辱感的影响因素,而身体形象丧失和粪便渗漏则使患者更容易产生耻辱感。应考虑采取干预措施,增强保护因素,减少风险因素,以降低造口患者的耻辱感水平。

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