《住院胃肠道癌患者希望水平的研究》由会员分享，可在线阅读，更多相关《住院胃肠道癌患者希望水平的研究（86页珍藏版）》请在金锄头文库上搜索。
1、上海交通大学 硕士学位论文 住院胃肠道癌患者希望水平的研究 姓名：张妮娜 申请学位级别：硕士 专业：护理学 指导教师：吴蓓雯 20090401 摘 要摘 要 目的目的： （1）在文献回顾基础上，诠释“希望”和“希望理论”，为后续量性研究提供理 论基础。 （2）评价住院胃肠道癌患者希望水平，分析影响癌症患者希望水平的相关因素，并 探讨希望水平对癌症患者生活质量的影响。 方法方法： （1）运用重庆维普、清华同方、万方、Pubmed、Elsevier、EBSCO 等数据库以及 Google 搜索引擎搜索“希望”相关文献，搜索相关研究进展和最新研究成果，并对 文献进行分析。 （2）分别采用 Herth
2、 希望量表、医学应对量表、社会支持量表、及 EORTC QLQ C30 生活质量量表，对 2008.2.1 2008.12.31 收纳的 316 名住院胃肠道癌患者的希 望水平、应对方式、社会支持、及生活质量进行评价，分别采用 t 检验、方差分析， Pearson 相关分析和多元逐步回归法分析影响胃肠道癌患者希望水平的相关因素， 并探讨癌症患者希望水平对生活质量的影响。 结果：结果： （1）文献回顾提示：“希望”是一种可超越现状，并对生命产生持续性正向促 进作用的动态力量，“希望”能促进人的生理、心理和社会等多方面的健康； “Herth 希望理论”强调“希望”是一种体验的过程；一种精神性过程；
3、一种理性 思考的过程和一种相互关联的过程。 （2）胃肠道癌患者现况评价结果：希望水平为中等水平（33.553.26 分）；生 活质量总分较差(52.5321.57 分)，低于欧洲癌症治疗组织提供的参考值； 其中认知功能得分为最高，社会功能得分最低；患者以出现疲乏症状最多，普遍存 在因疾病所致的经济压力（47.9933.16 分）；主要采用的应对方式为“面对”， 其次为“回避”应对，最少采用的为“屈服”；社会支持状况总分为 43.656.78 分，高于与国内常模和高血压常模。 IV （3） 不同年龄组、 不同文化程度组、 不同经济收入组和有无宗教信仰组患者的希 望 水平间存在统计学差异（P0.0
4、5)；社会支持水平较高组患者的希望总分高于社会支 持水平较低组（P0.05）；“面对”组患者的希望水平总分高于“回避”组和“屈 服”组（P0.05）。回归分析提示影响胃肠道癌患者希望水平的因素依次为：年龄、 社会支持总分、“面对”应对总分、“屈服”应对总分、经济状况及有无宗教信仰。 （4）不同希望水平组患者整体生活质量、认知功能和经济困难方面存在统计学差异 （P0.05)，希望水平总分与患者生活质量（r=0.351,P0.05）、认知功能 （r=0.249,P0.05）呈正相关。回归分析提示影响胃肠道癌患者整体生活质量因素从 大到小依次为：经济状况、希望水平总分和文化程度。 结论结论： （1）
5、 “希望”是一种可超越现状，并对生命产生持续性正向促进作用的动态力量， 对机体健康起促进作用。 （2）胃肠道癌患者希望水平达到中等水平。人口学因素（年龄、经济状况、有无 宗教信仰）、社会支持状况和应对方式（面对/屈服）会影响胃肠道癌患者希望水平。 （3）胃肠道癌患者生活质量较差，其生活质量受患者希望水平的影响。 关键词关键词：胃肠道癌，希望，生活质量，应对方式，社会支持， V ABSTRACT Objective: (1) To describe the definition of hope and hope theory by reviewing literature for support
6、ing the quantitative research of hope. (2) To evaluate the level of hope of the patients with gastrointestinal cancer , analyze the effect factors on the level of hope, and explore the influence on quality of life of gastrointestinal cancer patients. Method: (1) A comprehensive review of publication
7、s on the subject of hope was conducted by searching the database, such as the Pubmed, Elsevier, EBSCO, etc. and the search engine Google as well. (2) Three hundred and sixteen participants，who were diagnosed as gastrointestinal cancer， were recruited from two general hospitals from February 1, 2008
8、to December 31, 2008. Instruments used for this investigation included four scales: Herth Hope Index，Medial Coping Modes Questionnaire，Social Science Research Solutions，European Organization for Research and Treatment of cancer core quality of life questionnaire-core 30(Version3.0). All the data wer
9、e put into the statistical software spss11.0, and analyzed by t-test and One-way analysis of variance (ANOVA)，Pearson correlation analysis, and stepwise regression analysis. Result: (1) Hope proposed in the health literature was described as continually unfolding and changing in response to life sit
10、uation and can improve the status of health. Herths hope theory emphasized that the hope is an experiential process, spiritual process, rational thought process. (2) The level of hope of the patient with gastrointestinal cancer was medium (score: 33.553.26). The level of quality of life of the patie
11、nt with gastrointestinal cancer was medium (score: 52.5321.57), and even lower than the reference value of European Organization for Research and Treatment of cancer. The score of cognition function was the highest. The score of social function was the lowest. The common VI used coping styles by the
12、 patients with gastrointestinal cancer were as follows: confrontation, avoidance, acceptance-resignation. The level of social support of gastrointestinal cancer patients was higher than the level of general population and hypertension patient (score:43.656.78). (3) There was statistically significan
13、t difference on the level of hope of the gastrointestinal cancer patients, in different ages, educational levels, and level of income (P0.05).The level of hope in patients with higher level of social support was higher than those with the lower level of social support (P0.05).The level of hope of th
14、e patients with the confrontation coping style was higher than that of patients using the two other coping styles (P0.05). The Stepwise regression analysis revealed that the major factors which influence the level of hope of gastrointestinal cancer patients were: age, level of social support, confro
15、ntation coping style, acceptance-resignation coping style, income level, religious belief. (4) There was statistically significant difference on general quality of life, cognition function, financial difficulties among the patient with the different level of hope (P0.05).There were significant posit
16、ive relationships between the level of hope and general quality of life (r=0.351, P0.05), cognition function (r=0.246, P0.05). The major factors influencing level of quality of life of gastrointestinal cancer patients were: income level, level of hope, educational level by Stepwise regression analysis. Conclusions: (1)Hope is described as continually unfolding and changing in response to life situation .Hope can improve the health of gastrointestinal cancer patients. (2)
