目的:尽管癌症患者的支持性治疗越来越受到重视,那些患有结肠直肠癌(CRC)的人需要特别注意他们的身体,心理,精神,和社会需求。然而,在满足CRC造口幸存者的支持性护理需求方面缺乏重大进展.为了弥合这个差距,我们进行了一项前瞻性纵向研究,以追踪有造口的CRC幸存者的支持性治疗需求趋势,并确定6个月内的任何预测因素.
方法:在大连大学附属新华医院伤口和造口门诊进行前瞻性纵向研究,重点关注有造口的CRC幸存者。共有143名参与者完成了34项简短形式支持护理需求调查(SCNS-SF34-C(普通话))和造口并发症的自我报告问卷,第三,手术后第六个月。采用重复测量的方差分析来评估支持性护理需求的过程,将广义估计方程(GEE)应用于识别SCNS的预测因子。
结果:三个时间点的支持性护理需求和5个维度得分均有统计学意义(P<0.05)。首先对患者的评级,第三,术后第6个月,患者护理和支持得分呈下降趋势,心理需求,身体和日常生活的需要,以及卫生系统和信息需求。然而,性需求得分呈增加趋势。较高水平的支持性护理需求通常与造口术后的短时间有关,高收入水平,居民医疗保险,配偶照顾者,其他慢性疾病,和造口并发症。
结论:术后6个月后,幸存者的支持治疗需求呈现动态趋势。通过三轮,主要需求是卫生系统和信息需求。建议整合跨学科的卫生专业人员,并建立全面的支持和护理系统,以有效满足不同阶段的多样化需求。在手术后的第一个月和第三个月,应优先考虑造口术的个人,特别是那些收入水平较高的人,员工医疗保险,配偶照顾者,其他慢性疾病,和造口并发症。
OBJECTIVE: Although there is a growing emphasis on supportive care for cancer patients, those with colorectal cancer (CRC) who have ostomies require special attention in terms of their physical, psychological, spiritual, and social needs. However, there has been a lack of significant progress in meeting the supportive care needs of CRC survivors with ostomies. To bridge this gap, we conducted a prospective longitudinal
study to track the trends in supportive care needs among CRC survivors with ostomies and identify any predictors over 6-month period.
METHODS: A prospective longitudinal
study was conducted at the wound and
stoma clinic of Dalian University Affiliated Xinhua Hospital, focusing on CRC survivors with ostomies. A total of 143 participants completed self-report questionnaires on the 34-item Short-Form Supportive Care Needs Survey (SCNS-SF34-C (Mandarin)) and
stoma complications at the first, third, and sixth month after surgery. ANOVA with repeated measure was utilized to assess the course of supportive care needs, with Generalized Estimating Equation (GEE) applied to identify predictors of SCNS.
RESULTS: The supportive care needs and five dimensions scores were statistically significant at three time points (P < 0.05). The ratings of patients at the first, third, and sixth month after surgery revealed a decreasing trend in the scores for patient care and support, psychological needs, physical and daily living needs, and health system and information needs. However, the score for sexual needs showed an increased tendency. Higher levels supportive care needs were generally connected with a short duration after ostomy, high income level, resident medical insurance, spouse caregiver, other chronic disease, and
stoma complications.
CONCLUSIONS: Survivors\' supportive care needs showed a dynamic trend over 6 months after surgery. Through three rounds, the primary needs were health system and information needs. It is recommended to integrate interdisciplinary health professionals and establish a comprehensive support and care system to effectively meet the diverse needs at different stages. Priority should be given to individuals with ostomies during the first and third month after surgery, particularly those with higher income levels, employee medical insurance, spouse caregivers, other chronic diseases, and
stoma complications.