肠造口术后病人自我感受负担现状及影响因素研究

目的了解肠造口术后自我感受负担和自我管理行为现状，探讨相关影响因素。方法采用一般资料调查表、自我感受负担量表和自我管理行为问卷对3家上海市三甲综合医院造口门诊的170例肠造口病人进行问卷调查，并对结果进行分析。结果自我感受负担总分(27.29±0.66)分，处于轻度水平。3个维度中，身体负担得分最高(2.88±0.06)分，其次为经济负担(2.12±0.10)分，情感负担得分最低(1.92±0.06)分。自我管理行为总分(113.97±13.90)分，处于高水平，5个维度得分降序排列分别是心理(4.27±0.04)分、症状(4.11±0.05)分、信息(3.85±0.05)分、造口护理(3.72±0.06)分、日常生活(3.27±0.07)分。自我感受负担总分与自我管理行为总分、症状管理及心理管理三项呈显著负相关(P < 0.01)。自我管理行为水平、婚姻状况和照护者健康状况是肠造口病人自我感受负担的影响因素。自我管理行为水平在婚姻状况与照护者健康状况对自我感受负担的影响中无中介作用。结论医护人员应注重维护肠造口病人的心理健康，通过改善自我管理行为，减轻自我感受负担，进而提高病人的生活质量。

Study on the self-perceived burden of patients after enterostomy and its influencing factors

ObjectiveTo investigate the status quo of self-perceived burden and self-management behavior among enterostomy patients, and explore its relevant influencing factors.MethodsA total of 170 patients with enterostomy from stoma outpatient department of three tertiary grade A general hospitals in Shanghai were investigated using the general data questionnaire, self-perceived burden scale and self-management behavior questionnaire, and the results of survey were analyzed.ResultsThe total score of self-perceived burden(27.29±0.66) points was at a mild level. Among the three dimensions, the highest score was the physical burden(2.88±0.06) points, followed by economic burden(2.12±0.10) points, and the lowest score was emotional burden(1.92±0.06) points. The total score of self-management behavior(113.97±13.90) points was at a high level.The scores of the psychology, symptoms, information, ostomy nursing and daily life of five dimensions were(4.27±0.04), (4.11±0.05), (3.85±0.05), (3.72±0.06) and(3.27±0.07) points, respectively. The total score of self-perceived burden was significantly negatively correlated with the total scores of self-management behavior, symptom management and psychological management(P < 0.01). The self-management behavior, marital status and caregiver health status were the main influencing factors of self-perceived burden among enterostomy patients. The level of self-management behavior had no mediating effects on the impact of marital status and caregiver health status on self-perceived burden.ConclusionsMedical staff should pay attention to maintaining the mental health of patients with enterostomy, and improve the quality of life of patients by improving self-management behavior and reducing the self-perceived burden.