直肠癌结肠造口康复期患者自我护理能力状况及影响因素

目的了解直肠癌结肠造口术后6个月以上患者的自我护理能力状况，并分析其与健康行为自我效能、社会支持的相关关系。方法采用造口自我护理能力量表、健康行为能力自评量表、领悟社会支持量表测评104例直肠癌结肠造口术后6个月以上患者的自我护理能力、健康行为自我效能、社会支持状况，同时收集患者的一般资料，并进行统计分析。结果104例患者自我护理能力总分为（57．1±7．7）分，处于较高水平自我护理意愿（37．4±5．1）分，自我护理知识（15．6±3．5）分，自我护理技能（4．1±1．1）分，健康行为自我效能总分（82．66±17．43），得分率为（73．80±15．56）％；社会支持总分（64．71±13．20），其中家庭内支持得分（24．10±3．95）分，家庭外支持（40．62±11．10）分。单因素分析发现自我护理能力与年龄（r=-0．214，P〈0．05）、文化程度（r=0．341，P〈O．01）、家庭人均月收入（r=0．271，P〈0．01）、参加造口联谊会情况（r=O．227，P〈0．05）、健康行为自我效能（r=0．422，P〈0．01）、家庭内支持（r=0．224，P〈O．05）、家庭外支持（r=0．530，P〈0．01）相关。多元逐步线性回归分析发现自我护理能力的主要影响因素是家庭外支持、健康行为自我效能（调整后R。=0．316，F=23．827，P〈0．01）。结论直肠癌结肠造口康复期患者的造口自我护理能力处于较好水平，家庭外支持和健康行为自我效能有利于患者自我护理能力的提高。

Self-care ability of rectal carcinoma patients with colostomy during recovery period and its influence factors

Objective To investigate the self-care ability of postoperative rectal carcinoma patients with colostomy, and analyze the self-efficacy of health behaviors and social support. Methods Ostomy self-care scale, self-efficacy of health behaviors scale and apperception of social support scale were used to assess the self- care ability, self-efficacy of health behaviors and social support of 104 rectal carcinoma patients who had colostomy more than 6 months. Results The total score of self-care ability of 104 patients was （57.1 ＋ 7.7 ）, which meant a relatively high level. The score of self-care desire was （ 37.4± 5.1 ） , self-care knowledge was （ 15.6±3.5）, self-care skill was （4. 1±1.1 ）. The total score of self-efficacy of health behaviors was （82.66±17.43 ）, with scoring average of （73.80±15.56） %. The total score of social support was （64.71±13.20）, in which family support was （24. 10±3.95） and outside family support was （40.62±11.10）. Univariate analysis showed that associated factors of self-care ability were age （r = -0.214 ,P 〈 0.05 ）, edueational level （ r = 0.341,P 〈 0.01 ）, family income （ r = 0.271, P 〈 0.01 ）, participations in colostomy sodality （ r = 0.227, P 〈 0.05）, self-efficacy of health behaviors（ r = 0.422, P 〈 0.01 ）, family support （ r = 0. 224, P 〈 0.05 ） and outside family support（ r = 0. 530 ,P 〈 0.01 ）. Multiple regression analysis indicated that outside family support and self-efficacy of health behaviors were the main influential factors of self-care ability （adjusted R^2 = 0. 316, F = 23. 827, P 〈 0.01 ）. Conclusions Self-care ability of the rectal carcinoma patients with colostomy during their recovery is relatively good. Outside family support and self-efficacy of health behaviors can help to improve patients＇ self-care ability.