【摘要】：目的:了解永久性結腸造口患者的造口接受度現(xiàn)狀,分析造口接受度的影響因素,探討造口接受度與認知情緒調節(jié)方式的關系,為提高永久性結腸造口患者造口接受度提供參考依據(jù)。方法:采用方便抽樣,在2016年5月~2016年12月期間對南昌市3所三甲醫(yī)院的128例永久性結腸造口患者進行問卷調查。調查工具包括:永久性結腸造口患者一般資料調查表、造口接受度量表、認知情緒調節(jié)方式量表。結果:1、永久性結腸造口患者造口接受度總分為(78.37±10.66)分,其中造口接受度處于低水平的占總調查人數(shù)10.94%,中水平81.25%,高水平7.81%。各維度得分為:對造口影響的包容(21.20±3.97)分,從對比價值到固有價值的轉變(21.89±3.56)分,造口價值范圍的擴大(24.65±3.32)分,對身體形象的從屬(10.62±1.67)分。不同文化程度、工作狀態(tài)、家庭收入、造口術后時間、造口自理程度以及有無并發(fā)癥的永久性結腸造口患者造口接受度得分差異有統(tǒng)計學意義(P0.05)。2、永久性結腸造口患者的認知情緒調節(jié)方式得分依次為:接納(13.81±1.74)、災難化(13.33±2.32)、沉思(12.46±2.01)、重新關注計劃(11.98±2.54)、理性分析(11.45±3.19)、積極重新關注(11.23±3.32)、積極重新評價(11.04±3.34)、自我責難(10.89±2.29)、責難他人(8.25±2.93)。3、永久性結腸造口患者的造口接受度及各維度與積極認知情緒調節(jié)方式正相關(P0.05),與消極認知情緒調節(jié)方式負相關(P0.05)。4、造口接受度的多元線性回歸分析顯示,災難化、理性分析、接納、術后造口時間、文化程度、家庭人均月收入是影響造口接受度的重要因素,共同解釋造口接受度總分變異的57.0%。結論:1.永久性結腸造口患者的造口接受度處于中等偏低水平,其中擴大維度得分最高,從屬維度得分最低。影響永久性結腸造口患者造口接受度的因素有:造口術后時間、文化程度、家庭人均月收入、工作狀態(tài)、造口自理程度、造口并發(fā)癥。2.在面對永久性結腸造口時,患者較多采用的認知情緒調節(jié)方式為接納、災難化、沉思,總體以消極的認知情緒調節(jié)為主。3.永久性結腸造口患者造口接受度與積極認知情緒調節(jié)方式呈正相關,與消極認知情緒調節(jié)方式呈負相關。說明使用積極認知情緒調節(jié)方式頻率越高的患者,造口接受度水平越高;使用消極認知情緒調節(jié)方式頻率越高的患者,造口接受度水平越低。4.認知情緒調節(jié)方式中的災難化、接納、理性分析是造口接受度的重要預測因子。
[Abstract]:Objective: to understand the present situation of ostomy acceptance in patients with permanent colostomy, analyze the influencing factors of ostomy acceptance, and explore the relationship between ostomy acceptance and cognitive emotion regulation. In order to improve the permanent colostomy patients ostomy acceptance to provide a reference. Methods: from May 2016 to December 2016, 128 patients with permanent colostomy in 3 third Class A hospitals in Nanchang City were investigated by convenient sampling. The survey tools include: general information questionnaire for permanent colostomy patients, oral acceptance scale and cognitive mood regulation style scale. Results the total score of ostomy acceptance was (78.37 鹵10.66) in the patients with permanent colostomy, among which the lower level was 10.94. the middle level was 81.25, and the high level was 7.81.The total score of the patients with permanent colostomy was (78.37 鹵10.66), and that of the patients with permanent colostomy was (78.37 鹵10.66). The scores of each dimension were (21.20 鹵3.97), (21.89 鹵3.56), (24.65 鹵3.32) and (10.62 鹵1.67), respectively, and the changes from comparative value to intrinsic value were (21.89 鹵3.56), (24.65 鹵3.32) and (10.62 鹵1.67), respectively. Different levels of education, working status, family income, post-orostomy time, There were significant differences in the degree of self-care and acceptance of permanent colostomy with or without complications (P0.05). The scores of cognitive emotion regulation in patients with permanent colostomy were (13.81 鹵1.74), (13.33 鹵2.32), and (13.33 鹵2.32) respectively, and those in patients with permanent colostomy were (13.81 鹵1.74), (13.33 鹵2.32), respectively. Contemplation (12.46 鹵2.01), refocus on plan (11.98 鹵2.54), rational analysis (11.45 鹵3.19), positive re-focus (11.23 鹵3.32), positive reassessment (11.04 鹵3.34), self-blame (10.89 鹵2.29), censure others (8.25 鹵2.93) .3. patients with permanent colostomy have positive oral acceptance and dimensions and positive cognitive mood regulation patterns. Correlation (P0.05), negative correlation with negative cognitive emotion regulation (P0.05). Disaster, rational analysis, acceptance, postoperative stomatal time, education level and average monthly income of the family were the important factors affecting the acceptance of the stomatitis, which explained the variation of the total score of ostomy acceptance in 57.0%. Conclusion 1. The acceptability of permanent colostomy patients was at the medium low level, with the highest score in the extended dimension and the lowest in the subordinate dimension. The factors influencing the acceptance of permanent colostomy were as follows: time after ostomy, education level, average monthly income of family, working status, degree of care, complications of anastomosis. In the face of permanent colostomy, the most common cognitive emotion regulation methods used by patients were acceptance, disaster, meditation, and negative cognitive emotion regulation. The degree of ostomy acceptance was positively correlated with positive cognitive emotion regulation and negatively correlated with negative cognitive emotion regulation in patients with permanent colostomy. It showed that the higher the frequency of positive cognitive emotion regulation, the higher the acceptance level of ostomy, and the lower the acceptance level of ostomy was with the higher the frequency of negative cognitive emotion regulation. Disaster, acceptance and rational analysis are important predictors of acceptance.
【學位授予單位】：南昌大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.73

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