目的探讨行肝癌射频消融(RFA)治疗依从性状况和影响因素,及其与社会支持的关系。方法采用自制治疗依从性问卷和社会支持评定量表(SSRS)对2009年5月至2011年5月拟行RFA治疗的75例肝癌患者进行调查。结果肝癌RFA患者治疗依从性总得分为(25.57±4.95)分,其中定期复查的依从性相对较好,得分为(9.62±0.89)分,生活方式和RFA治疗依从性较差,得分分别为(8.93±0.57)分、(7.02±0.73)分;肝癌RFA患者社会支持总得分为(39.29±7.19)分,其中主观支持、客观支持和对支持利用度得分分别为(24.58±3.38)分、(10.52±3.38)分、(7.19±2.16)分;对影响治疗依从性的原因进行单因素分析和多因素Logistic回归分析,其中经济状况、文化程度、RFA治疗效果及社会支持是依从性的影响因素(x2=11.350,P=0.000,R2=0.347),社会支持与治疗依从性呈显著正相关(r=0.384,P〈0.01)。结论行RFA治疗的肝癌患者总的治疗依从性不佳,获得的社会支持较高,但对支持利用度较低,护士应关注患者的治疗依从性以及心理、社会因素对依从性的影响,使护理干预措施更加系统化,以帮助患者提高临床疗效。
Objective To study the compliance situation of patients with hepatic cancer and its influencing factors and explore the correlation between compliance and social support. Methods A total of 75 hepatic cancer patients who planed to receive radiofrequency ablation (RFA) between May 2009 and May 2011 in Shenzhen Hospital were recruited and investigated with the serf-designed therapeutic compliance questionnaire and social support Rating Scale. Results The average score of therapeutic compliance of periodic patient was (25.57 ± 4.95 ), with the highest score of periodic visit examination ( 9.62 ± 0. 89 ), and the score of RFA compliance ( 7.02 ± 0.73 ) and living style (8.93 ±0. 57 ) was lower. The total score of social support was (39.29 ± 7.19 ) ,with the score of objective support (24.58 ± 3.38 ) , the subjective support score( 10.52 ± 3.38 )and the utilization support score ( 7. 19 ± 2. 16 ). The One-way ANOVA and multivariate analyses showed that the financial situation, therapy effect, educational level and social support were influencing factor for patients' compliance ( X2 = 11. 350, P = 0. 000,R2 = 0. 3470), and social support was positively correlated with compliance of patients( r = 0.384, P 〈 0.01 ). Conclusions The therapeutic compliance of RFA patients planning to undergo radiofrequency ablation is not satisfactory, and they acquire more social support but is low in availability. The nurse should pay more attention to the patients' compliance and the influencing of psychological and social factors on patients' compliance, and take more effective measures systematically to improve patients' therapeutic effect.