北京大学医学部机构知识库
Advanced  
IR@PKUHSC  > 北京大学护理学院  > 学位论文
学科主题: 护理学
题名:
慢性伤口患者生活质量现状及影响因素分析
作者: 任辉
答辩日期: 2014-05-29
导师: 丁炎明
专业: 护理学
授予单位: 北京大学
授予地点: 北京大学护理学院
学位: 硕士
关键词: 慢性伤口 生活质量 影响因素
其他题名: Research on the quality of life and the influencial factors of patients with chronic wounds
分类号: R473.6
摘要:

目的:描述慢性伤口患者的生活质量现状,分析慢性伤口患者生活质量的影响因素,为我国慢性伤口患者的临床护理工作提供参考依据。

 

方法:本研究采取方便抽样的方法,选取北京市3家三级甲等医院伤口诊疗中心和外科换药室中自愿参加本研究的115名慢性伤口患者。采用自行设计的一般资料调查问卷调查患者的社会人口学资料和伤口资料,采用健康调查简表The MOS item short form health surveySF-36、伤口患者生活质量评价表(Cardiff Wound Impact ScheduleCWIS)测量患者的生活质量,采用社会支持测评量表(Social Support Rating ScaleSSRS)测量患者的社会支持状况,采用查尔森合并症指数评分测量患者的合并症情况,采用日常生活自理能力评价表测量患者的日常生活自理能力。采用SPSS 16.0统计学软件对数据进行录入、统计学分析。对一般资料及各量表测评得分进行描述性统计:计量资料用均数、标准差、中位数等表示,计数资料用频数、率、构成比等表示;对可能影响慢性伤口患者生活质量的因素运用相关分析等进行推断性统计。

 

结果:

1.本次共在北京市3家三级甲等医院中调查了115名慢性伤口患者,研究对象的平均年龄为55.14±18.15岁,研究对象的伤口类型以创伤性溃疡为主,占59.1%

2.SF-36测评慢性伤口患者生活质量的总分均分为47.39±27.45。其中的生理功能(32.39±34.40)、生理职能(41.78±31.57)、肌体疼痛(65.27±29.34)、总体健康(40.43±31.12)、活力(35.97±19.84)、社会功能(51.30±21.89)、情感职能(35.94±45.92)和精神健康(68.42±25.05)八个维度得分均低于一般人群(P<0.001);(2伤口患者生活质量评价表各维度得分较低,其中的躯体症状和日常生活维度(13.89±7.50),社会生活(49.62±3.46),幸福感(10.06±10.04),综合生活质量评分(6.02±2.45),综合生活质量满意度评分(6.03±2.88)得分均处于较低水平。

3.慢性伤口患者生活质量的单因素分析:(1)不同在职状况和不同日常生活自理能力的慢性伤口患者的生活质量得分具有显著性差异P<0.001,不同性别、婚姻状况、文化程度、医疗费用支付方式的慢性伤口患者生活质量的得分无显著性差异P0.05。(2)慢性伤口患者生活质量与经济负担、伤口渗液量及合并症指数成负相关(P<0.05),与社会支持成正相关(P<0.05)。

4.慢性伤口患者生活质量的多因素分析:慢性伤口患者生活质量的因素按照影响作用由大到小依次为日常生活自理能力、平时伤口疼痛、伤口渗液、在职情况、经济负担是慢性伤口患者生活质量的影响因素,5个变量共同解释了慢性伤口患者生活质量总变异的50.7%

 

结论

1.        慢性伤口患者的生活质量较差,其中生理功能、生理职能、躯体疼痛、

整体健康、活力、社会功能、情感职能和精神健康各个维度的生活质量得分均较一般人群有所下降,尤其是慢性伤口患者的生理职能、生理功能、活力、情感职能的受损较为显著。慢性伤口患者一周内的生活质量综合评价得分较低,尤其是躯体和日常生活、社会活动、幸福感三个维度的生活质量现状较差。由此可见,慢性伤口患者的生活质量较差,医护人员不仅要提供伤口处理的最佳方案,同时应注重提高患者的生活质量。

2.        日常生活自理能力、平时伤口疼痛、伤口渗液、在职情况、经济负担是

慢性伤口患者生活质量的主要影响因素。关注慢性伤口患者的生活质量及影响因素,特别是对患者的日常生活自理能力、伤口渗液以及平时伤口疼痛程度等主要影响因素进行评估,并遵循科学性、个体化的原则管理慢性伤口患者,将有利于提高慢性伤口患者的生活质量。

    3. 关注我国慢性伤口患者的生活质量及影响因素,是现阶段提高我国伤口护理工作质量,促进伤口护理专业发展的重要工作。

 

 

英文摘要:

Objectives: To evaluate the quality of life of patients with chronic wounds and to explore the influential factors that affected their quality of life in order to provide evidence for nurses to improve chronic wound nursing care.

                                                                                                                

Methods: A descriptive, cross-sectional study was used and three hospitals in Beijing were selected by convenience sampling. A total of 115 patients with chronic wounds were recruited in this study. They were asked to complete a series of questionnaires. Self-designed questionnaire was used to collect information on demographic and wound data. The Mos 36-item Short Form Health SurveySF-36and Cardiff Wound Impact ScheduleCWISwere used to evaluate the quality of life current situation of patients with chronic wounds. Social support rating scaleSRSSwas used to evaluate social support current situation of patients with chronic wounds. Charlson weighted index of comorbidities WIC was used to evaluate complication of patients with chronic wounds. Ability of daily life scale was used to evaluate ability of daily life of patients with chronic wounds. The quantitative data were collected and analyzed by SPSS 16.0 with descriptive and inferential statistics.

 

Results:                                                                                                   

1.      There were 115 patients with chronic wounds from 3 hospitals in Beijing in this

survey. The average age of them was 55.14±18.15 years old. The main type of their wounds was traumatic ulcer.

2.      The average score of SF-36 was 47.39±27.45. Each of those eight subscales

including physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental healthin SF-36 were lower than that of general populationP<0.001. Each of the subscales of CWIS including physical symtoms13.89±7.50, social life49.62±3.46, well-being10.06±10.04had low average scores.

3.      The quality of life of patients with chronic wounds was positively related to

economic burdenability of daily lifedaily pain of wounds, wound location,working status, wound exudate .SF-36 scores in a low degreeP<0.05),negatively related to their economic burden in a high degreeP<0.05),negatively related to wound exudate. Their quality of life in a low degreeP<0.05),negatively related to complication of patients in a high degreeP<0.05),and positively related to social support in a high levelP<0.05.

4.       Results of multiple linear regression were as follows: economic burdenability of

daily lifedaily pain of wounds, wound exudation, working status were the influential factors of total scores of SF-36 and explained 50.7% of variance of quality of life current situation of patients with chronic wounds.

 

Conclusion:

1.      The quality of life in physical functioning, role limitations-physical, bodily pain,

general health perception, energy and vitality, social functioning, role limitations–emotional, mental health of SF-36 declined significantly. Especially role limitations-physical, role limitations–emotional, physical functioning, energy and vitality of patients with chronic wounds were damaged significantly.

2.      Economic burdenability of daily lifedaily pain of wounds, wound location,

working status were the main influential factors of quality of life. In order to maintain and improve the quality of life of patients with chronic wounds, it is necessary to assess their quality of life current situation and influential factors, and provide individualized instructions on both physical and mental function.

 

语种: 中文
相关网址: 查看原文
内容类型: 学位论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/108194
Appears in Collections:北京大学护理学院_学位论文

Files in This Item:

There are no files associated with this item.


作者单位: 北京大学护理学院

Recommended Citation:
任辉. 慢性伤口患者生活质量现状及影响因素分析[D]. 北京大学护理学院. 北京大学. 2014.
Service
Recommend this item
Sava as my favorate item
Show this item's statistics
Export Endnote File
Google Scholar
Similar articles in Google Scholar
[任辉]'s Articles
CSDL cross search
Similar articles in CSDL Cross Search
[任辉]‘s Articles
Related Copyright Policies
Null
Social Bookmarking
Add to CiteULike Add to Connotea Add to Del.icio.us Add to Digg Add to Reddit

Items in IR are protected by copyright, with all rights reserved, unless otherwise indicated.

 

 

Valid XHTML 1.0!
Copyright © 2007-2017  北京大学医学部 - Feedback
Powered by CSpace