【摘要】 目的 了解肿瘤复发患者希望水平及其影响因素。 方法 2010年10-12月采用Herth希望量表和自制的一般情况调查表,对302例肿瘤复发患者进行问卷调查,并对相关影响因素进行分析。 结果 肿瘤复发患者希望总体均分为（31.14±5.56）分,7.95%（24例）的患者希望评分为低等水平,74.50%（225例）的患者希望评分为中等水平,17.55%（53例）的患者希望评分为高等水平。肿瘤复发患者希望水平得分的主要影响因素有:婚姻状况、工作状况、医疗费用支付情况、肿瘤类型以及无瘤生存时间。其中,与未婚患者相比,离异患者希望水平较低；与在职患者相比,退休患者希望水平较高；在医疗费用的支付方式上,自费所占的比例越大,患者希望水平越低；与其他肿瘤类型相比,以乳腺癌患者希望水平最低；此外,患者无瘤生存时间越长,其希望水平就越低。 结论 尽管肿瘤复发患者希望水平受多种因素的影响,但多数患者仍对现状和未来充满希望,其希望仍维持在较高水平。【Abstract】 Objective To explore the level of hope and the influential factors of hope in patient with tumor recurrence. Methods A total of 302 patients with tumor recurrence were enrolled. The patients were investigated by Herth Hope Scale and self-designed questionnaire. Results The average level of hope in patients with tumor recurrence was 31.14±5.56; of the total patients，7.95% (24 patients) had low level, 74.50% (225 patients) had media level and 17.55% (53 patients) had high level of hope. Parts of demographic characteristics had significant influences on level of hope and specifically: patient devoiced had lower level of hope than patients married (F=-1.868，Plt;0.05); patients retired had higher level of hope than patients on job (F=2.004，Plt;0.005); patients with greater own proportion of medical expense had lower level of hope than patients with smaller own proportion of medical expense (F=-0.937，Plt;0.05); patients with breast cancer had lower level of hope than patients with other type of cancer (F=-10.824，Plt;0.001); and finally, patients with longer free survival time had lower level of hope than patients with shorter free survival time (F=-1.930，Plt;0.001). Conclusion Parts of demographic characteristics have significant influences on level of hope in patients with tumor recurrence, but most patients still have high level of hope.
ObjectiveTo explore the level of hope of patients with tumor recurrence and its affecting factors. MethodsPatients with tumor recurrence admitted in West China Hospital from March 2014 to March 2015 were included in this study. Questionnaire survey was conducted to collect the general information of the patients and the information on their coping style, level of hope and social support. The structural equation model was used to analyze the factors that affect the level of hope in patients with tumor recurrence. ResultsA total of 431 patients were included. The average score of hope in patients with tumor recurrence was 32.88±5.83. Among these patients, 27 (6.26%) had low level of hope, 277 (64.27%) had medium level of hope and 127 (29.47%) had high level of hope. The result of univariate analysis showed that, the level of hope in different genders, marital status, education levels, income levels and types of tumors had significant differences (all P values＜0.05). The result of structural equation model showed that gender (r=-0.322, P<0.001), marital status (r=-0.243, P<0.001), education level (r=-0.219, P<0.001), income (r=0.116, P=0.021) and coping style (r=0.182, P=0.029) had direct effect on the level of hope in patients with tumor recurrence. Social support (r=0.255, P=0.027) and income (r=0.224, P=0.019) could indirectly affect patients’ coping style and therefore the level of hope. ConclusionMost patients with tumor recurrence have medium to high level of hope. Gender, marital status, education level, income and coping style have influence on the level of hope. More attention should be given to patients with low level of hope, and measures should be taken to improve the level of hope basing on the individual situations of patients with tumor recurrence.
ObjectiveTo explore the correlation between the level of hope and coping style in patients with tumor recurrence. MethodsPatients with tumor recurrence admitted to West China Hospital between March 2014 and March 2015 were enrolled as the research subjects. Questionnaire survey was used to collect general information of patients and their level of hope and coping style. ResultsFour hundred and thirty-one patients were enrolled in the study. The score of hope in patients with tumor recurrence was 32.88±5.83. Out of 431 patients, 27 (6.26%) had low level of hope, 277 (64.27%) medium level of hope and 127 (29.47%) high level of hope. Multivariate analysis showed that the coping styles and income could enhance the level of hope, whereas being female, poor marital status, low educational level and long term of complete remission could suppress the level of hope in patients with tumor recurrence. Various coping styles were adopted by patients to cope with the tumor recurrence. Amongst all coping styles, optimism was adopted most frequently by patients, which had the highest score 2.94±0.44. The other coping styles adopted by patients ranked from high to low were conservation 2.88±0.53, self-reliance 2.75±0.56, confrontation 2.73±0.55, fatalism 2.45±0.66, support 2.41±0.52, escape 2.15±0.42 and emotion 2.12±0.59, respectively. The level of hope had a positive correlation with the overall score of coping styles (r=0.112), as well as optimism (r=0.170), confrontation (r=0.166) and self-reliance (r=0.210) (P < 0.05). However, the study showed that the level of hope had no correlation with emotion, escape, conservation, support and fatalism. ConclusionsMost of the patients with tumor recurrence have medium and high level of hope. The coping styles of optimism, confrontation and self-reliance can enhance the level of hope in patients with tumor recurrence. Patients should be encouraged and guided by medical staff to adopt the above-mentioned coping styles to enhance the level of hope, through which to improve the quality of life of the patients with tumor recurrence.
Objective To study the catheter-related infection (CRI) in cancer patients treated with central venous catheterization. Methods A prospective study with 196 cancer patients was conducted to analyze the types of catheter-related infection and pathogen, as well as the relationship between CRI and the following factors: insert location, gender, age, remained time, or bone marrow suppression. Results Of the total 196 cases, 16 cases were diagnosed as CRI and the CRI rate was 8.2%. The types of CRI were five cases of pathogen colonization, four cases of insert location infection and seven cases of catheter-related bloodstream infection. Of the total 244 specimens, 20 were positive including 7 pathogenic bacteria in either Gram positive or Gram negative types, the dominating pathogens were staphylococcus aureus, staphylococcus epidermidis, acinetobacter baumannii and klebsiella pneumoniae. CRI was related to both insert location and age which were both the independent risk factors. Conclusion The concept of prevention should be set up, and the comprehensive measures should be taken to reduce CRI, such as choosing an appropriate insert location and complying with a strict catheter insert standard.