Xu Yin, Fei Xiaoyan, Qi Qian, Chen Yingjie, Wang Zhongmin, Yang Rumei
Department of Nursing, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
BMC Psychol. 2025 Jul 11;13(1):775. doi: 10.1186/s40359-025-03085-1.
To investigate the current status of stigma, family care, and discharge readiness in patients with malignant obstructive jaundice undergoing percutaneous transhepatic cholangial drainage (PTCD) and analyze its influencing factors.
A cross-sectional survey was conducted on 399 patients with malignant obstructive jaundice who underwent PTCD using a general information questionnaire, the readiness for hospital discharge scale (RHDS), the social impact scale (SIS), and the family APGAR index.
The total average stigma score in patients with malignant obstructive jaundice who underwent PTCD was 59.1 ± 10.34, and the average scores of each dimension, from low to high, were: social exclusion, economic discrimination, intrinsic stigma, and social isolation. The overall average score of discharge readiness was 61.08 ± 17.94, and the average scores of each dimension from low to high were personal status, adaptability, and predictive support. The total score of the family care scale was 5.00 (4.00, 7.00). Patients with malignant obstructive jaundice undergoing PTCD had a negative correlation between their sense of stigma and discharge readiness, r = -0.748 (P < 0.01). There was a positive correlation between family care and discharge readiness, r = 0.904 (P < 0.01), and a negative correlation between sense of stigma and family care, r = -0.854 (P < 0.01). The results of multiple linear regression analysis showed that age, lifestyle, PTCD time, and hospitalization interval were all correlated with patients' sense of stigma, family care, and discharge readiness (P < 0.05).
Patients with malignant obstructive jaundice who underwent PTCD had a moderate level of stigma, family care, and discharge readiness. There were pairwise correlations among family care, discharge readiness, and sense of stigma. Clinical medical staff should attach importance to the quality of discharge guidance and the importance of family support, help patients establish good social support systems, and promote the safety management of patients after discharge.
探讨经皮肝穿刺胆管引流术(PTCD)治疗的恶性梗阻性黄疸患者的耻辱感、家庭关怀及出院准备情况现状,并分析其影响因素。
采用一般资料问卷、出院准备度量表(RHDS)、社会影响量表(SIS)及家庭APGAR指数,对399例行PTCD的恶性梗阻性黄疸患者进行横断面调查。
行PTCD的恶性梗阻性黄疸患者耻辱感总均分59.1±10.34,各维度均分由低到高依次为:社会排斥、经济歧视、内在耻辱感、社会隔离。出院准备总均分61.08±17.94,各维度均分由低到高依次为个人状况、适应性、预测性支持。家庭关怀量表总分为5.00(4.00,7.00)。行PTCD的恶性梗阻性黄疸患者耻辱感与出院准备呈负相关,r=-0.748(P<0.01)。家庭关怀与出院准备呈正相关,r=0.904(P<0.01),耻辱感与家庭关怀呈负相关,r=-0.854(P<0.01)。多元线性回归分析结果显示,年龄、生活方式、PTCD时间、住院间隔均与患者耻辱感、家庭关怀及出院准备相关(P<0.05)。
行PTCD的恶性梗阻性黄疸患者耻辱感、家庭关怀及出院准备处于中等水平。家庭关怀、出院准备及耻辱感之间两两相关。临床医护人员应重视出院指导质量及家庭支持的重要性,帮助患者建立良好的社会支持系统,促进患者出院后的安全管理。