Dodd M J, Dibble S L
Department of Physiological Nursing, University of California, San Francisco.
Oncol Nurs Forum. 1993 Jul;20(6):895-901.
Despite advancements in self-care for people with cancer, a profile of individuals who perform self-care behaviors has not been determined. Without these data, interventions cannot be targeted to specific patient groups that demonstrate the most need. This study's investigators used Orem's model of self-care to determine predictors of self-care behavior. The sample consisted of 127 adults with cancer who were to receive their first dose of chemotherapy (e.g., doxorubicin, methotrexate, 5-fluorouracil, cyclophosphamide, or cisplatin, given alone or in combination). Data were collected from the subjects prior to the first cycle and at drug nadir for each of the four chemotherapy cycles. Potential predictors of self-care included demographic variables, performance status, affective state, social support, ability to manage a situation, self-care ability, and prior health-promoting activities. Self-care was measured using a 40-item behavior checklist. Multiple regression techniques were used to obtain four significant predictors of self-care, which accounted for 47% of the variance. Subjects with lower performance status, higher anxiety, less social support, and more education performed more self-care. These findings clarify Orem's model with this clinical population and provide a patient profile of self-care for practice.
尽管癌症患者自我护理方面有了进展，但尚未确定进行自我护理行为的个体特征。没有这些数据，干预措施就无法针对最有需求的特定患者群体。本研究的调查人员使用奥瑞姆自我护理模式来确定自我护理行为的预测因素。样本包括127名成年癌症患者，他们即将接受第一剂化疗（例如单独或联合使用阿霉素、甲氨蝶呤、5-氟尿嘧啶、环磷酰胺或顺铂）。在第一个化疗周期之前以及四个化疗周期中每个周期的药物最低点时，从受试者那里收集数据。自我护理的潜在预测因素包括人口统计学变量、身体状况、情感状态、社会支持、应对能力、自我护理能力以及先前的健康促进活动。使用一份包含40个项目的行为清单来衡量自我护理。采用多元回归技术获得了自我护理的四个显著预测因素，它们解释了47%的方差。身体状况较差、焦虑程度较高、社会支持较少且受教育程度较高的受试者进行了更多的自我护理。这些发现阐明了奥瑞姆模式在这一临床群体中的情况，并为实践提供了自我护理的患者特征。
