肝硬化患者医学应对方式的调查分析

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目的探讨肝硬化患者的医学应对能力现状以及相关影响因素。方法采用随机抽样的方法,选取北京佑安医院住院的138例肝硬化患者。应用医学应对问卷(MCMQ)进行调查。结果回收有效问卷131份,有效率94.9%。与常模得分比较,肝硬化患者的面对因子得分低于常模[(16.90±2.22)vs.(19.48±3.81),P=0.003)],回避因子和屈服因子得分高于常模[分别为(15.51±2.08)vs.(14.44±2.97),P=0.000;(13.59±1.51)vs.(8.81±3.17),P=0.000]。单因素分析显示,文化程度对应对方式中回避因子有影响(P=0.005),收入状况对应对方式中回避因子有影响(P=0.013),年龄对应对方式中的屈服因子有影响(P=0.017)。多元回归分析结果显示,文化程度和收入状况对回避因子的影响有统计学意义(r=0.09,P=0.016;r=0.04,P=0.030)。年龄对屈服因子的影响有统计学意义(回归系数=0.24,P=0.020)。结论肝硬化患者更易于采取消极的应对方式,尤其是文化程度较低及收入水平较差的患者,提示临床护理人员应积极采取个性化认知行为干预,纠正患者消极应对方式,提高疾病的自我管理能力。 Objective To investigate the status of medical coping ability in patients with cirrhosis and related factors. Methods Randomized sampling method was used to select 138 patients with cirrhosis who were hospitalized in Beijing You’an Hospital. The Medical Response Questionnaire (MCMQ) was investigated. Results 131 valid questionnaires were collected, with an effective rate of 94.9%. The scores of face-to-face scores of patients with cirrhosis were lower than those of patients with normotensive [(16.90 ± 2.22) vs. (19.48 ± 3.81, P = 0.003)], and the scores of avoidance and yield were higher than those of norm (15.51 ± 2.08) vs. (14.44 ± 2.97), P = 0.000; (13.59 ± 1.51) vs. (8.81 ± 3.17), P = 0.000]. Univariate analysis showed that the educational level had an effect on the avoidance factor (P = 0.005) and the income status affected the avoidance factor (P = 0.013), and the age had an impact on the yield factor in the coping style (P = 0.017). Multiple regression analysis showed that educational level and income status had a significant effect on the avoidance factors (r = 0.09, P = 0.016; r = 0.04, P = 0.030). The effect of age on yield factors was statistically significant (regression coefficient = 0.24, P = 0.020). Conclusions Patients with liver cirrhosis are more likely to take a negative coping style, especially in patients with low education level and poor income level, suggesting that clinical nurses should actively adopt personalized cognitive behavioral interventions to correct the negative coping style and improve the disease self Management skills.
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