[1]汪红姣,王颖,吴梅利洋,等.膀胱癌患者尿流改道术式决策冲突现状及影响因素分析[J].军事护理,2023,40(09):60-64.[doi:10.3969/j.issn.2097-1826.2023.09.015]
　WANG Hongjiao,WANG Ying,WU Meiliyang,et al.Status Quo of Decision Conflicts Among Bladder Cancer Patients with Urinary Diversion and Its Influencing Factors[J].Nursing Journal Of Chinese People's Laberation Army,2023,40(09):60-64.[doi:10.3969/j.issn.2097-1826.2023.09.015]
点击复制

膀胱癌患者尿流改道术式决策冲突现状及影响因素分析
分享到：

《军事护理》[ISSN:2097-1826/CN:31-3186/R]

卷:
40
期数:
2023年09期
页码:
60-64
栏目:
论著
出版日期:
2023-09-15

文章信息/Info

Title:
Status Quo of Decision Conflicts Among Bladder Cancer Patients with Urinary Diversion and Its Influencing Factors
文章编号:
2097-1826(2023)09-0060-05
作者:
汪红姣; 王颖; 吴梅利洋; 何梅; 鲁志卉; 秦秋霞
(华中科技大学同济医学院附属同济医院 泌尿外科,湖北 武汉 430030)
Author(s):
WANG Hongjiao; WANG Ying; WU Meiliyang; HE Mei; LU Zhihui; QIN Qiuxia
(Department of Urology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei Province,China)
关键词:
膀胱癌;  根治性膀胱切除术;  尿流改道;  决策冲突;  决策自我效能
Keywords:
bladder cancer;  radical cystectomy;  urinary diversion;  decision conflict;  decision self-efficacy
分类号:
R473.58
DOI:
10.3969/j.issn.2097-1826.2023.09.015
文献标志码:
A
摘要:
目的 调查膀胱癌患者尿流改道术式决策冲突现状并分析其影响因素,为构建决策辅助方案提供依据。方法 2021年7月至2022年4月,采用便利抽样法,选取在某三级甲等医院就诊的120例膀胱癌患者为研究对象,使用一般资料调查表、决策冲突量表、决策自我效能量表对其进行调查。结果 膀胱癌患者决策冲突量表得分为(51.51±16.66)分,92.5%的患者存在决策冲突,其中高水平冲突高达77.5%。决策自我效能量表得分为(56.67±9.13)分,与患者决策冲突水平呈负相关(r=-0.554,P<0.001)。多元线性回归分析结果显示,年龄、文化程度、家庭月收入、肿瘤分期、决策自我效能是决策冲突的影响因素(均P<0.001),解释总变异的63.5%。结论 膀胱癌患者尿流改道术式决策冲突较高,且受多种因素影响。医务人员应早期识别患者的决策冲突,为患者提供信息支持及心理支持,引导其采取积极的应对方式,提升决策自我效能以减低患者决策冲突,优化决策质量。
Abstract:
Objective To explore the decision conflicts in patients with bladder cancer undergoing urinary diversion and analyze its influencing factors,so as to provide a reference for a decision aid program.Methods From July 2021 to April 2022,120 patients with bladder cancer in a tertiary A hospital were selected by the convenience sampling method and surveyed using the General Information Questionnaire,the Decision Conflict Scale and the Decision Self-Efficacy Scale.Results The decision conflict score of bladder cancer patients was(51.51±16.66).92.5% of the selected patients had experienced decision conflicts,and the high level conflict accounted for 77.5%.The score of Decision Self-Efficacy Scale was(56.67±9.13),which was negatively correlated with the level of decision conflict(r=-0.554,P<0.001).Multiple linear regression analysis showed that age,education,monthly household income,tumor stage,and decision-making self-efficacy were the influential factors for decision-making conflict(all P<0.001),explaining 63.5% of the total variance.Conclusions Decision conflicts for urinary diversion in patients with bladder cancer are high and influenced by multiple factors.Medical staff should identify the conflicts in the early stage,provide patients with information support and psychological support,guide them to adopt positive coping methods,and enhance decision self-efficacy,so as to reduce the decision conflicts and optimize decision quality.

参考文献/References:

[1] XIA C,DONG X,LI H,et al.Cancer statistics in China and United States,2022:profiles,trends,and determinants[J].Chin Med J(Engl),2022,135(5):584-590.
[2] WITJES J A,BRUINS H M,CATHOMAS R,et al.European Association of urology guidelines on muscle-invasive and metastatic bladder cancer:summary of the 2020 guidelines[J].Eur Urol,2021,79(1):82-104.
[3] 医政医管局.膀胱癌诊疗指南(2022 年版)[EB/OL].[2023-06-20]. http://www.nhc.gov.cn/yzygj/s7659/202204/a0e67177df1f439898683e1333957c74/files/7224e506d4a24b90a9df0424888ba38a.pdf.
[4] CHECK D K,LEO M C,BANEGAS M P,et al.Decision regret related to urinary diversion choice among patients treated with cystectomy[J].J Urol,2020,203(1):159-163.
[5] HOU Y,CHEN Y,LAI S,et al.Decision regret related to urinary diversion choices after cystectomy among Chinese bladder cancer patients[J].Cancer Med,2023,12(4):4786-4793.
[6] MILLER S M,HUDSON S V,EGLESTON B L,et al.The relationships among knowledge,self-efficacy,preparedness,decisional conflict,and decisions to participate in a cancer clinical trial[J].Psychooncology,2013,22(3):481-489.
[7] 王丽萍,王慧,侯铭,等.222名颅内肿瘤患者家属决策冲突现状及影响因素分析[J].护理学报,2022,29(20):11-16.
[8] 张舵,周雁荣,刘娟,等.主动脉夹层患者术前决策现状及影响因素分析[J].护理学杂志,2022,37(5):73-76.
[9] 倪平,陈京立,刘娜.护理研究中量性研究的样本量估计[J].中华护理杂志,2010,45(4):378-380.
[10]O'CONNOR A M.Validation of a decisional conflict scale[J].Med Decis Making,1995,15(1):25-30.
[11]王露,陈英,崔金锐,等.中文版决策冲突量表在直肠癌患者术式决策中应用的信效度检验[J].护理学杂志,2019,34(3):31-35.
[12]李长娥,王君芝,李辛,等.孕妇产前筛查与诊断决策冲突现状及影响因素分析[J].护士进修杂志,2022,37(16):1453-1458.
[13]田畅,宋颖.晚期癌症患者参与治疗决策冲突的现状及影响因素分析[J].天津护理,2021,29(3):288-292.
[14]BUNN H,O'CONNOR A.Validation of client decision-making instruments in the context of psychiatry[J].Can J Nurs Res,1996,28(3):13-27.
[15]王思潼,叶志霞,李芸芸,等.中文版决策自我效能量表在原发性肝癌患者治疗决策中的信效度检验[J].解放军护理杂志,2021,38(1):37-40.
[16]PATEL H D,BALL M W,COHEN J E,et al.Morbidity of urologic surgical procedures:an analysis of rates,risk factors, and outcomes[J].Urology,2015,85(3):552-559.
[17]DUMONTIER C,LOH K P,SOTO-PEREZ-DE-CELIS E,et al.Decision Making in Older Adults With Cancer[J].J Clin Oncol,2021,39(19):2164-2174.
[18]LLOYD-WILLIAMS M,MOGAN C,HARRISON D K.Cognitive impairment in older adults with cancer[J].Curr Opin Support Palliat Care,2021,15(1):11-15.
[19]TANG H,WANG S,DONG S,et al.Surgery decision conflict and its related factors among newly diagnosed early breast cancer patients in China:A cross-sectional study[J].Nurs Open,2021,8(5):2578-2586.
[20]李玉,叶志霞,刘佩玉,等.原发性肝癌诊断知情患者参与手术决策现状及影响因素研究[J].护理学报,2016,23(18):6-11.
[21]EHLERS M,BJURLIN M,GORE J,et al.A national cross-sectional survey of financial toxicity among bladder cancer patients[J].Urol Oncol,2021,39(1):71-76.
[22]CHEN N H,LIN Y P,LIANG S Y,et al.Conflict when making decisions about dialysis modality[J].J Clin Nurs,2018,27(1-2):e138-e146.
[23]MOHAMED N,LEUNG T M,SHAH Q N,et al.Involving Patients in the Development and Evaluation of an Educational and Training Experiential Intervention(ETEI)to Improve Muscle Invasive Bladder Cancer Treatment Decision-making and Post-operative Self-care:a Mixed Methods Approach[J].J Cancer Educ,2020,35(4):808-818.
[24]查丹凤,杨艳,杨雄豪,等.终末期肾脏病患者透析决策辅助方案的制订及应用研究[J].上海护理,2021,21(10):23-28.

相似文献/References:

[1]刘玉芹,杨明莹,李丹娜,等.膀胱癌特异性患者报告结局测量工具的研究进展[J].军事护理,2021,38(06):62.[doi:10.3969/j.issn.1008-9993.2021.06.016]
[2]程文瑜,高凯霞,王静,等.膀胱癌术后患者经济毒性水平多中心调查及其机制研究[J].军事护理,2023,40(12):42.[doi:10.3969/j.issn.2097-1826.2023.12.011]
　Cheng Wenyu,Gao Kaixia,Wang Jing,et al.A Multi-centered Survey and Research into the Mechanism on Postoperative Financial Toxicity of Bladder Cancer Patients[J].Nursing Journal Of Chinese People's Laberation Army,2023,40(09):42.[doi:10.3969/j.issn.2097-1826.2023.12.011]

备注/Memo

备注/Memo:
【收稿日期】2022-11-22【修回日期】2023-08-24
【作者简介】汪红姣,硕士,主管护师,电话:027-83665308
【通信作者】王颖,电话:027-83662466
更新日期/Last Update: 2023-09-15