造口患者社会心理适应水平与自我效能的关系及影响因素研究

摘要

目的 调查造口术后患者的社会心理适应水平和自我效能现况,并分析两者的相关性以及社会心理适应水平的影响因素.方法 采用方便抽样法,选取2016年3 —7月南京地区5家三级甲等医院的148例造口术后患者,采用中文版造口者社会心理适应量表、造口自我效能问卷和自行设计的一般情况调查表对其进行问卷调查,并采用Pearson相关分析其社会心理适应水平与自我效能的关系,单因素分析法和多元逐步回归模型分析其社会心理适应水平的影响因素.结果 造口患者的社会心理适应水平为(44.86±9.69)分,仅有6.8%的患者为高适应水平;自我效能为(66.36±17.29)分,仅有1.4%的患者为高效能;且两者间存在正相关关系(r=0.797,P<0.01).多元逐步线性回归分析结果显示,自我效能、造口并发症、性别和造口类型为造口患者社会心理适应水平的影响因素(β'值分别为0.740、-0.177、0.100、-0.128;P<0.05).结论 造口术后患者的社会心理适应水平有待提高,女性、有造口并发症的患者需重点关注,可通过针对性的干预与随访指导,提高其自我效能,使患者尽快适应造口,回归家庭和社会.%Objective To investigate the status quo of social-psychological adjustment and self-efficacy in patients after ostomy and to analyze the correlation between them as well as the influencing factors of social-psychological adjustment. Methods Totally 148 patients who received ostomy from 5 Class Ⅲ Grade A hospitals in Nanjing between March and July 2016 were selected by convenient sampling. The Chinese version of Ostomates' Adjustment Inventory, Self-Efficacy Questionnaire for Stoma and the Self-Designed General Information Questionnaire were used to investigate the patients. The Pearson correlation analysis was used to analyze the relationship between the level of social-psychological adjustment and self-efficacy, single factor analysis and the multivariate stepwise regression analysis were used to analyze the factors influencing the level of social-psychological adjustment. Results The level of social-psychological adjustment in patients with stoma was (44.86±9.69), with only 6.8% of the patients being highly adaptive. The self-efficacy was (66.36±17.29)and only 1.4% of the patients showed high efficacy. There was a positive correlation between them (r=0.797, P<0.01). The multivariate stepwise linear regression analysis showed that self-efficacy, stoma complications, sex and stoma types were the influencing factors of social-psychological adjustment (β'=0.740,-0.177,0.100,-0.128;P< 0.05). Conclusions The patients after ostomy need to improve their social-psychological adjustment. Women and patients with stoma complications should gain more attention. Their self-efficacy may be improved with targeted intervention and follow-up instruction which can help them get adapted to stoma and return to theiry home and community as soon as possible.