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目的 探讨胃癌住院患者的疾病不确定感与应对方式的相关性.方法 采用中文版Mishel疾病不确定感量表(MUIS)、医学应对问卷(MCMQ)对120例胃癌住院患者进行问卷调查.结果 患者疾病不确定感总分为45～101分,平均(69.92 ±9.85)分,单题平均得分为(2.80±0.39)分,不确定性因素得分为29 ～71分,平均(45.32±8.18)分,复杂性因素得分为14～35分,平均(24.61±4.14)分.处于低程度不确定感的患者6例占5％,中等程度者108例占90％,高程度者6例占5％.术前、术后至化疗前及化疗中3个治疗阶段的胃癌住院患者的疾病不确定感总分分别为(80.12±8.31),(64.08±5.33),(64.82±4.86)分,其两因子不明确性因素得分分别为(52.83±8.31),(40.78±5.01),(41.79±3.51)分,复杂性因素得分分别为(27.29±3.72),(23.30±3.91),(23.03±3.33)分,差异均有统计学意义(F值分别为81.81,50.10,17.27;P ＜0.01)；术前、术后至化疗前及化疗中3个治疗阶段患者的应对方式水平差异均有统计学意义(P＜0.01)；疾病不确定感总分及其两因子与“面对”、“回避”应对方式呈显著负相关(P＜0.05),与“屈服”应对方式呈正相关(P＜0.05).结论 胃癌住院患者普遍存在疾病不确定感,且疾病不确定感与应对方式显著相关,需引起护理人员的足够重视,并采取相应的干预措施降低疾病不确定感.

Objective To investigate the relationship between uncertainty in illness and coping style in patients with gastric cancer.Methods The Mishel's Uncertainty in Illness Scale (MUIS) and Medical Coping Modes Questionnaire (MCMQ) were used to investigateuncertainty in illness and coping styleamong 120 patients with gastric cancer.Results The total score of patients' uncertainty in illness was 45 ～ 101,with the average score as (69.92 ± 9.85) and average score for each item as (2.80 ± 0.39).Score of uncertain factors was 29 ～71,with the average as (45.32 ±8.18).Score of complexity factors was 14 ～35,with the average as (24.61 ±4.14).There were 6 patients with low level of uncertainty,accounting for 5％,180 patients with medium level of uncertainty,accounting for 90％,and 6 patients with high level of uncertainty,accounting for 5％.Before the surgery,before chemotherapy and after surgery and during chemotherapy,the total score of uncertainty in patients was respectively (80.12 ± 8.31),(64.08 ± 5.33) and (64.82 ± 4.86),score of uncertain factors was respectively (52.83 ± 8.31),(40.78 ± 5.01)and (41.79 ± 3.51),and sore of complexity factors was respectively (27.29 ± 3.72),(23.30 ± 3.91) and (23.03 ± 3.33),with statistically significant differences (F =81.81,50.10,17.27,respectively; P ＜ 0.01).There was also statistically significant difference of coping style during three different stages (P ＜0.01).The score of uncertainty in illness as well as its two factors was negatively related to coping style such as confrontation and avoidance (P ＜ 0.05),and positively to coping style like surrender (P ＜ 0.05).Conclusions Uncertainty in illness is common in gastric cancer patients and significantly related to their coping style,which need more attention and should be reduced by corresponding intervention methods.