摘要目的 探讨肝动脉化疗栓塞术后不同年龄层次的肝癌患者自我管理效能感的现状以及影响因素,为临床医务人员进行个体化的护理干预提供依据.方法 方便抽取2013年11月至2014年6月153例住院的行肝动脉化疗栓塞术后的肝癌患者,采用一般资料调查表、中文版自我管理效能感量表、肝癌患者生活质量量表、记忆症状评估量表和社会支持量表进行生理、心理和社会方面的全面评估,并将患者分为青年组、中年组和老年组分别进行单因素的筛选和多元逐步回归分析,比较各年龄组肝癌患者自我管理效能感的现状及其影响因素.结果 患者的心理功能、婚姻状况和血甲胎蛋白值是青年组TACE术后肝癌患者自我管理效能感的影响因素,可解释青年组患者自我管理效能感水平50.6％的变异;生理症状、对支持的利用度和介入治疗次数是中年组TACE术后肝癌患者自我管理效能感的影响因素,可以解释中年组患者自我管理效能感水平47.8％的变异;症状困扰指数、文化程度和心理功能是老年组TACE术后肝癌患者自我管理效能感的影响因素,可以解释老年组患者自我管理效能感水平42.4％的变异.结论 各年龄段肝动脉化疗栓塞术后肝癌患者的自我管理效能感普遍处于中低水平,其发生与多种不同的因素有关,医护人员应重视不同年龄患者的自我管理效能状况,进行有效地评估,从而制订并进行有针对性的个性化干预措施.

abstractsObjective The objective of this study was to explore the difference factors for PHC patients by transcatheter arterial chemoembolization of different age groups of senior people in China and support reference for individualized intervention by clinical medical workers.Methods 153 cases of PHC patients by TACE were selected by convenience sampling method from October 2013 to June 2014.The data were collected using general data questionnaire,Health Promotion Strategy Scale,QOL-LC,Memorial Symptom Assessment Scales and Social Support Scale to evaluate the physical,psychological and social aspects of the PHC patients.We divided the patients into young,middle-aged and elderly groups.Single factor and multiple factors regression analysis were used to compare the status and influencing factors.Results Psychological function,value of blood AFP,marital status entered the model and were self-care efficacy and correlated factors of young-aged patients,which could explain 50.6％ of the total varience.Physical symptoms,exploitation degree of support and intervention treatment times entered the model and were self-care efficacy and correlated factors of middle-aged patients,which could explain 47.8％ of the total varience.Symptom distress,degree of cuhural and psychological function entered the model and were self-care efficacy and correlated factors of elderly-aged patients,which could explain 42.4％ of the total varience.Conclusions The self-care efficacy were low in all ages of PHC patients by TACE,it is associated with a variety of factors.Doctors and nurses should pay more attention to the self-care efficacy for PHC patients by transcatheter arterial chemoembolization with different age groups.Also we should evaluate and make well-targeted policies and personalized inter-ventions to promote self-management self-efficacy.