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目的探究肿瘤复发患者的希望水平和相关影响因素。方法选择2014年3月至2015年3月在四川大学华西医院收治的肿瘤复发患者,调查患者的一般情况、希望水平、应对方式和社会支持情况,并采用结构方程模型分析肿瘤复发患者希望水平的影响因素。结果共纳入431例患者,希望水平评分为32.88±5.83分,其中低希望水平患者27例(6.26%),中希望水平患者277例(64.27%),高希望水平患者127例(29.47%)。单因素分析结果显示,不同性别、婚姻状态、文化程度、年收入及肿瘤类型的患者之间希望水平不同,差异均有统计学意义(P<0.05)。结构方程模型结果显示,性别(r=–0.322,P<0.001)、婚姻状况(r=–0.243,P<0.001)、文化程度(r=–0.219,P<0.001)、年收入(r=0.116,P=0.021)及对应方式(r=0.182,P=0.029)对患者希望水平有直接影响;社会支持(r=0.255,P=0.027)和年收入(r=0.224,P=0.019)可以通过对应方式间接对患者希望水平产生影响。结论大多数肿瘤复发患者希望水平处于中等和高等水平,性别、婚姻状况、文化程度、年收入及对应方式对希望水平具有影响作用。临床医务人员应对低希望水平患者给予更多关注,并针对患者的不同情况有计划地采取干预措施以提高肿瘤复发患者的希望水平。
Objective To explore the hope of patients with tumor recurrence and related factors. Methods The patients with tumor recurrence who were treated in West China Hospital of Sichuan University from March 2014 to March 2015 were selected to investigate the general condition, level of hope, coping style and social support. Structural equation modeling was used to analyze the patients’ recurrence rate Influencing factors. Results A total of 431 patients were enrolled. The expected level was 32.88 ± 5.83, of which 27 patients (6.26%) had low hope level, 277 (64.27%) had hope level, and 127 patients (29.47%) had high hope level. Univariate analysis showed that there was a significant difference in the level of hope among patients of different genders, marital status, educational level, annual income, and tumor type (P <0.05). The results of structural equation modeling showed that there were significant differences in marital status (r = -0.243, P <0.001), education level (r = -0.219, P <0.001) , P = 0.021) and corresponding patterns (r = 0.182, P = 0.029) had a direct effect on the patients’ hope level. Social support (r = 0.255, P = 0.027) and annual income The corresponding way indirectly affect the level of hope of patients. Conclusions Most patients with recurrent tumor hope that the level of hope is medium and high level. Sex, marital status, educational level, annual income and corresponding mode have an impact on the level of hope. Clinicians should pay more attention to patients with low hope level, and plan the intervention according to patients’ different situations so as to raise hope level of tumor recurrence patients.