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肝癌患者经肝动脉化疗栓塞术后的韧性及其预测因素。

Resilience and Its Predictors Among Chinese Liver Cancer Patients Undergoing Transarterial Chemoembolization.

机构信息

Author Affiliations: School of nursing (Ms C. Li and Dr Lu), Fudan University; and Departments of Nursing (Mrs Qin), Intervention Therapy (Mrs X. Li), Hepatology (Mss Yu and Fang), Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.

出版信息

Cancer Nurs. 2019 Sep/Oct;42(5):E1-E9. doi: 10.1097/NCC.0000000000000640.

Abstract

BACKGROUND

Although resilience has many positive effects on cancer patients, little is known about the level of resilience and its predictors in Chinese liver cancer patients undergoing transarterial chemoembolization (TACE).

OBJECTIVE

The aims of this study were to evaluate resilience level and identify its predictors among Chinese liver cancer patients undergoing TACE.

METHODS

Two hundred fifty-one patients were recruited from a tertiary hospital in Shanghai, China. According to Kumpfer's resilience framework, participants were assessed with Connor-Davidson Resilience Scale, Demographic and Disease-Related Information, Family Apgar Scale, Social Support Rating Scale, Herth Hope Index, General Self-efficacy Scale, and Simplified Coping Style Questionnaire. Multiple regression analysis was conducted to find predictors of resilience.

RESULTS

The average score for Connor-Davidson Resilience Scale was 70.33 (11.70). Multiple regression identified that educational level, time span since diagnosis, family function, social support, hope, self-efficacy, and positive coping strategies predicted higher resilience, whereas metastasis predicted lower resilience. These predictors accounted for 61.8% of the total variance in resilience.

CONCLUSIONS

Resilience in liver cancer patients undergoing TACE needs to be further improved, which was positively predicted by educational level, time span since diagnosis, family function, social support, hope, self-efficacy, and positive coping strategies, but was negatively predicted by metastasis. Hope had the largest influence on resilience.

IMPLICATIONS FOR PRACTICE

Interventions aimed to improve hope are crucial to patients' resilience. Additional attention should be given to patients who had lower educational level or had metastasis. Family-centered interventions and strategies used to strengthen self-efficacy and positive coping strategies are also important in improving patients' resilience.

摘要

背景

尽管韧性对癌症患者有许多积极影响,但对于正在接受经动脉化疗栓塞术(TACE)的中国肝癌患者的韧性水平及其预测因素知之甚少。

目的

本研究旨在评估中国肝癌患者 TACE 后的韧性水平,并确定其预测因素。

方法

从中国上海的一家三级医院招募了 251 名患者。根据 Kumpfer 的韧性框架,使用 Connor-Davidson 韧性量表、人口统计学和疾病相关信息、家庭 Apgar 量表、社会支持评定量表、Herth 希望指数、一般自我效能感量表和简化应对方式问卷对参与者进行评估。采用多元回归分析来寻找韧性的预测因素。

结果

Connor-Davidson 韧性量表的平均得分为 70.33(11.70)。多元回归分析确定,教育水平、诊断后时间跨度、家庭功能、社会支持、希望、自我效能和积极应对策略预测韧性较高,而转移预测韧性较低。这些预测因素解释了韧性总方差的 61.8%。

结论

正在接受 TACE 的肝癌患者的韧性需要进一步提高,教育水平、诊断后时间跨度、家庭功能、社会支持、希望、自我效能和积极应对策略呈正相关,而转移呈负相关。希望对韧性的影响最大。

意义

旨在提高希望的干预措施对患者的韧性至关重要。应特别关注教育水平较低或有转移的患者。以家庭为中心的干预措施和加强自我效能和积极应对策略的策略对于提高患者的韧性也很重要。

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