乳腺癌患者自我倡权体验的质性研究

目的 深入了解乳腺癌患者自我倡权的真实体验。方法 采用现象学研究方法,对20名乳腺癌患者进行半结构式访谈,并采用Colaizzi 7步分析法分析资料。结果 提炼出4个主题和11个亚主题：自我倡权意识薄弱(症状报告不主动和过度依赖医生)、自我倡权积极性受多种因素影响(存在逃避心态、信心不足、病耻感严重和害怕破坏医患关系)、自我倡权过程中面临诸多挑战(医护态度欠缺、家庭成员不支持和害怕增加经济负担)及自我倡权积极体验(增强战胜疾病的信心和提高疾病应对能力)。结论 乳腺癌患者自我倡权意识薄弱、积极性较差,在自我倡权过程中面临各种挑战,部分患者积极体验自我倡权。医务人员应多关注自我倡权意识薄弱和积极性较差的乳腺癌患者,给予其更多的帮助和鼓励,同时也应树立“以病人为中心”的服务理念,营造良好氛围促进患者自我倡权。     

乳腺癌化疗患者自我倡权能力与症状负担的相关性

目的 调查乳腺癌化疗患者自我倡权能力与症状负担现状,并探讨二者之间的相关性,为减轻乳腺癌化疗患者的症状负担提供参考。方法 采用一般资料调查表、女性癌症幸存者自我倡权量表及中文版安德森症状评估量表（M D Anderson symptom inventory,MDASI）,对湖北省某三级甲等医院260例乳腺癌化疗患者进行问卷调查,采用Pearson相关分析自我倡权能力与症状负担的相关性,采用分层回归分析自我倡权能力对症状负担的影响。结果 240例患者完成研究。乳腺癌化疗患者自我倡权能力总分（68.89±10.66）分,处于中等水平,症状负担总分（66.70±18.80）分,整体症状水平介于轻度到中度之间,各症状发生率多高于50.00%。自我倡权能力与症状负担呈负相关（r=-0.683,P<0.05）,分层回归结果显示,自我倡权能力可独立解释症状负担总变异的9.3%。结论 乳腺癌化疗患者各种不适症状发生率高,且多种症状并存,症状负担与自我倡权能力呈负相关,强化患者的自我倡权能力有助于减轻其症状负担。     

乳腺癌化疗患者自我倡权能力现状及影响因素分析

目的 调查乳腺癌化疗患者自我倡权能力水平并分析其影响因素，为临床实施针对性干预提供参考。方法 采用一般资料调查表、女性癌症幸存者自我倡权量表、社会支持评定量表、心理一致感量表对湖北省某所三级甲等医院甲乳外科240例乳腺癌化疗患者进行调查。结果 240例乳腺癌化疗患者自我倡权得分为（68.89±10.66）分，自我倡权与社会支持呈正相关（r=0.723,P<0.001），与心理一致感呈正相关（r=0.569,P<0.001）。多元线性回归分析显示，年龄、文化程度、社会支持、心理一致感是患者自我倡权能力的影响因素，解释总变异的61.4%。结论 乳腺癌化疗患者自我倡权能力处于中等水平，在自我决策、与医护人员沟通以及寻求有效支持方面皆存在一定问题，医护人员应予以重视，关注高龄及文化程度低的患者，同时帮助患者提高心理一致感以及获取、利用社会支持的能力，进而提升患者的自我倡权水平。     

231例女性癌症患者自我倡权现状及影响因素分析

目的 调查女性癌症患者自我倡权现状，并分析其影响因素。方法 于2022年1—9月采取方便抽样法选择武汉2家三级甲等医院231例女性癌症患者为研究对象。采用一般资料调查表、女性癌症患者自我倡权量表、医学应对方式问卷及自我管理效能感量表开展调查。采用多重线性回归分析女性癌症患者自我倡权的影响因素。结果 本组女性癌症患者自我倡权总分为（77.06±8.53）分。多重线性回归分析显示，年龄、本科及以上学历、妇科肿瘤、面对应对及自我管理效能感进入回归方程（P<0.05），共解释总变异的37.2%。结论 本组女性癌症患者自我倡权水平中等偏上，年龄、教育水平、肿瘤类型、医学应对方式及自我管理效能感是自我倡权的影响因素。医务人员应结合人口学特征，开展心理疏导、压力应对等措施提高女性癌症患者的自我倡权水平。     

青年女性乳腺癌患者自我倡权现状及影响因素分析

目的了解青年女性乳腺癌患者自我倡权水平并分析其影响因素, 为临床干预提供参考。方法采用便利抽样法于2021年5月至2022年6月选取濮阳市人民医院、濮阳市油田总医院的250例青年女性乳腺癌患者作为研究对象。采用一般资料调查表、女性癌症幸存者自我倡权量表、青年癌症患者心理痛苦量表及家庭复原力评定量表进行横断面调查。采用多元逐步线性回归分析青年女性乳腺癌患者自我倡权影响因素。结果共235例青年女性乳腺癌患者完成调查, 其自我倡权总分为(77.04 ± 12.76)分, 心理痛苦总分为(108.25 ± 18.36)分, 家庭复原力总分为(112.93 ± 25.20)分, 患者自我倡权与心理痛苦呈负相关(r=-0.548, P<0.001), 与家庭复原力呈正相关(r=0.596, P<0.001)。文化程度、性格类型、家庭月收入、自觉经济压力、工作现况、生育意愿、亲密关系、确诊时长、心理痛苦及家庭复原力为青年女性乳腺癌患者自我倡权水平的影响因素(R2=0.595, F=35.31, P<0.01)。结论青年女性乳腺癌患者自我倡权水平有待进一步提高。医护人员应根据影响因素...     

癌症幸存者自我倡权的研究进展

自我倡权可以改善癌症幸存者症状负担、生活质量, 提升幸福感, 在促进癌症幸存者参与医疗决策和自我管理方面也起着举足轻重的作用。本文基于国内外研究, 介绍了癌症幸存者自我倡权的概念及其在癌症幸存者中的作用, 阐述了影响自我倡权的相关因素, 重点分析了评估工具和干预方法的应用现状及局限, 为今后国内开展癌症幸存者自我倡权的相关研究提出了展望, 以期在自我倡权这一新视域下推动国内癌症幸存者医疗决策参与度及自我管理质量的提升。     

自我倡权在女性乳腺癌幸存者创伤后成长和社会疏离间的中介效应

目的分析自我倡权在女性乳腺癌幸存者创伤后成长和社会疏离间的中介效应, 为制订针对社会疏离感的护理干预策略提供依据。方法本研究为随机抽样调查。便利选取2021年5—12月天津市肿瘤医院空港医院就诊的220例女性乳腺癌幸存者作为研究对象, 利用一般资料调查表、一般疏离感量表、创伤后成长评定量表、女性癌症幸存者自我倡权量表对患者进行调查。结果共回收有效问卷203份。女性乳腺癌幸存者创伤后成长得分为(60.91 ± 12.04)分, 自我倡权得分为(59.56 ± 12.19)分, 社会疏离得分为(36.52 ± 7.79)分。创伤后成长评定量表各维度得分与女性乳腺癌幸存者自我倡权量表各维度得分均呈显著正相关(r值为0.219～0.686, 均P<0.01);一般疏离感量表各维度得分与创伤后成长评定量表、女性乳腺癌幸存者自我倡权量表各维度得分均呈显著负相关(r值为- 0.804 ～ -0.202, 均P<0.01)。女性乳腺癌幸存者创伤后成长通过自我倡权影响社会疏离, 其间接效应占总效应的32.8%。结论自我倡权在女性乳腺癌幸存者创伤后成长和社会疏离中起中介作用, 护理人员可通过提...     

宫颈癌幸存者自我倡权影响因素及其与生活质量的相关性北大核心

目的:探讨宫颈癌幸存者自我倡权水平与生活质量的关系,对其自我倡权水平进行潜在剖面分析,并探究其分组类别的影响因素。方法:选取2021年5月—2022年5月某肿瘤专科三级甲等医院进行治疗的宫颈癌病人203例为研究对象,采用一般资料调查表、中文版女性癌症幸存者自我倡权量表(FSACS)、宫颈癌治疗的生活质量评估量表(FACT-Cx)和社会支持评定量表(SSRS)进行调查。结果:宫颈癌幸存者FSACS总分为(70.11±9.44)分,FACT-Cx总分为(119.80±13.99)分,FSACS总分与FACT-Cx总分呈正相关(r=0.412,P<0.05)。潜在剖面分析结果将宫颈癌幸存者自我倡权分为高决策-低社交组和低决策-高社交组两个类别。Logistic回归显示,文化程度、治疗方式、SSRS得分是宫颈癌幸存者自我倡权潜在剖面类别分组的预测因素(均P<0.05)。结论:宫颈癌幸存者自我倡权水平与生活质量相关,自我倡权可以分为2个潜在剖面类别,医护人员可以有针对性地采取干预措施,提高宫颈癌幸存者自我倡权水平,为病人提供个性化护理,从而提高其生活质量。     

乳腺癌患者家庭癌症沟通现状及影响因素分析

目的调查分析乳腺癌患者家庭癌症沟通现状, 以期为针对性解决乳腺癌患者夫妻双方沟通问题提供参考。方法采用横断面研究方法, 将2022年4—11月对济宁医学院附属医院收治的符合纳入标准的乳腺癌患者及其配偶204对作为研究对象, 采用基本资料调查表、家庭回避癌症沟通量表(FACCS)、女性癌症幸存者自我倡权量表(FSACS)对患者展开调查;采用照顾者负担量表(ZBI)对患者配偶展开调查;使用分层回归分析对调查数据进行统计分析。结果乳腺癌患者家庭癌症沟通得分为(65.30 ± 7.63)分。分层回归分析结果显示患者家庭人均月收入、肿瘤分期、恶性肿瘤家族史、患者自我倡权水平是患者家庭癌症相关沟通的影响因素, 可解释家庭癌症沟通变异的39.1%(F=22.36, P<0.05);从患者配偶方面, 配偶照护负担的影响可解释患者家庭癌症沟通变异的14.2%(F=16.39, P<0.05)。结论乳腺癌患者家庭癌症沟通欠佳, 不同特征的乳腺癌患者家庭癌症沟通程度存在差异。患者自我倡权得分较低、既往无恶性肿瘤家族史、配偶照护负担较高、家庭人均月收入较低以及患者肿瘤分期较高的乳腺癌患者家庭癌症沟...     

青少年慢性病患者自我效能评估工具的研究现状

自我效能可以影响青少年慢性病患者应对疾病和管理的信心, 进而对其疾病管理及健康行为产生影响。本研究介绍青少年慢性病患者自我效能的概念, 并对青少年慢性病自我效能量表研制、适用范围及信效度等内容进行综述, 为临床评估青少年慢性病患者治疗期间自我效能水平和针对性制定干预方案提供参考。     

慢病护理管理中健康教育方法及策略运用进展

慢性病多见于中老人人群中,我国现已步入老龄化社会。现代社会,人患上各类慢性病的原因相对较多,但是部分慢性病患者对于患病后的护理与生活方式依旧与病前相同,这在某种程度上加快了慢性病的发展。在我国慢性病为高发的态势,现已成为威胁全社会人群健康的疾病。所以,对慢性病的护理管理就需要加强,健康教育是其中的一个重要环节。本文主要对慢性病护理管理中健康教育的方法及策略运用及其进展进行综述。     

Using advocacy to safeguard older people with learning disabilities

Older people with learning disabilities may be viewed as potentially vulnerable and therefore in need of safeguarding. Advocacy should be part of the safeguarding process and is useful to ensure the views of older people with learning disabilities are communicated. The role of nurses in advocating for individuals in their care has been made clear by the Nursing and Midwifery Council. However, advocacy is not without risks and dilemmas for nurses and at times they may need to take an indirect role by promoting self-advocacy and independent advocacy.     

Predictors of patient self-advocacy among patients with chronic heart failure

The purpose of this study was to examine predictors of self-advocacy among patients with chronic heart failure (HF) as they were unknown. A convenience sample of 80 participants recruited from one Midwestern HF clinic completed surveys related to relationship-based predictors of patient self-advocacy including trust in nurses and social support. Self-advocacy is operationalized using the three dimensions of HF knowledge, assertiveness, and intentional non-adherence. Hierarchical multiple regression was used showing that trust in nurses predicted HF knowledge (ΔR² = 0.070, F = 5.91, p < .05), social support predicted advocacy assertiveness (ΔR² = 0.068, F = 5.67, p < .05), and ethnicity predicted overall self-advocacy (ΔR² = 0.059, F = 4.89, p < .05). These findings suggest that support from family and friends can give the patient the needed encouragement to advocate for what they need. A trusting relationship with nurses impacts patient education so that patients not only understand their illness and its trajectory but also use that understanding to speak up for themselves. African American patients, who are less likely to self-advocate than their White counterparts, could benefit from nurses recognizing the impact of implicit bias so that these patients do not feel silenced in their care.     

Is the sexuality of people with a learning disability being denied?

This article explores how the nursing profession has become more liberal in its attitudes towards sexuality as a consequence of and a response to HIV/AIDS. This liberal attitude has, however, failed to be generalized towards people with a learning disability. The continued use of labelling terms for people with a learning disability serves as an excuse to either justify the control of people's sexuality and fertility, or a rationale to argue that people with a learning disability do not have a sexual identity. Developments in the self-advocacy and advocacy movement provide opportunities for people with a learning disability to have a say in the development of sexuality policies to guide the practice and philosophy within an organization.     

石河子市老年人健康状况和护理需求现状调查

目的了解新疆石河子市老年人的健康状况及护理服务需求,为老年人的健康保健及医疗服务提供参考依据。方法采用自制问卷对500名社区老年人的一般人口学资料、健康状况、个人健康行为和护理服务需求等进行调查。结果老年人慢性病患病率为72．60％,其中46．60％的老年人患有2种及以上的慢性病;近2周患病率为49．40％;前10位慢性病依次为高血压、冠心病、风湿性关节炎、糖尿病、骨质增生、慢性支气管炎、胆道疾病、脑梗塞、胃肠疾病、前列腺疾病。老年人中有吸烟史者占28．20％,有饮酒史者占18．20％;62．80％的老年人从未体检;老年人所需的保健知识依次为安全用药、慢性病、饮食指导、传染病和常见病等;老年人急需的卫生服务项目：建立健康档案（47．80％）、定期体检（46．60％）、健康指导（43．80％）、社区紧急救护（37．40％）。结论社区老年人慢性病患病率高,针对社区老年人的健康状况和护理服务需求,开展健康教育及社区卫生服务,提高社区老年人的健康水平和生活质量。     

Ethical dilemmas in the pediatric hemophilia community

How can pediatric nurses best advocate appropriately and knowledgeably for patients with hemophilia in our rapidly changing health care system. This commentary raises many questions, questions that can provide the basis for discussion among parents, providers, and payors. Children with hemophilia have benefited greatly by the creation of comprehensive care teams that support home treatment (Butler, 1998). Ongoing excellence in home care can be achieved by parents' and patients' self-advocacy. The hemophilia community's self-advocacy has been so successful as demonstrated by the move to home care, self-infusion, and the Ricky Ray legislation. This community has an ownership of its preventive care and recognizes that federally funded centers of excellence exist by the use of the family's tax dollars and the patient's patronage. Hemophilia programs are a model for further examination for preventive self-care in other chronic disease states.     

Focus groups: the lived experience of participants with multiple sclerosis.

Multiple sclerosis (MS) is a chronic disease affecting young adults. The presence of the sometimes-invisible symptoms (loss of vision, fatigue, incontinence) and the episodic nature and uncertainty of symptoms can create a constant sense of vigilance or support the use of denial. Indeed, family, friends, and even nursing support may be elusive, leaving one feeling lonely, frightened, and insecure. The purposes of this research were to investigate the lived experiences of people with MS and examine their needs from their perspectives. Two focus groups included 4 men diagnosed with MS from 2 to 15 years and 6 women diagnosed with MS from 1.5 to 15 years. Four themes were identified. The first theme resonated around feelings that "nobody listened." The second theme, symptom devastation, described the overwhelming presence of symptoms and the difficulty they caused. The third theme was "picking and choosing," or making choices to maintain some control. "Fight your own fight" with self-advocacy and taking charge was the final theme. Even though MS continuously caused challenges and changes interfering with goals, participants described creative solutions. They learned to deal with the denial, refocus their priorities, plan their activities, and choose carefully. They described a litany of being unheard, unimportant, and confused, which led to feelings of dejection, desperation, and depression. Their most poignant need was someone to listen and teach since they identified knowledge as power. The data gathered contribute to knowledge and understanding of people living with MS. Findings support nursing interventions that empower and teach self-management techniques.