结直肠癌肠造口患者身体意象评估及影响因素分析-现代医学

结直肠癌肠造口患者身体意象评估及影响因素分析

单位：南通大学第二附属医院伤口造口门诊, 江苏南通 226000

分类号：R473.73;R735.3

出版年·卷·期（页码）：2025·53·第四期（609-614）

摘要：

目的： 探究结直肠癌(CRC)肠造口患者身体意象水平及其影响因素。方法： 便利抽样法选择本院2021年3月至2023年5月就诊的CRC肠造口患者157例，通过一般资料调查表、身体意象量表(BIS)、中文版造口社会心理适应量表(OAI-20)等进行调查。采取多元线性回归分析CRC肠造口患者身体意象水平影响因素，相关性行Pearson分析。结果： BIS得分(13.57±3.98)分，其中75.16%的CRC肠造口患者存在明显身体意象障碍(即BIS评分≥10分)。单因素分析可见，不同性别、家庭月收入、围手术期辅助治疗、造口术后时间、造口并发症患者BIS得分差异有统计学意义(P＜0.05)，相关性可见身体意象水平与患者OAI-20总分(r=-0.362，P＜0.01)、自我效能量表(SSS)总分(r=-0.275，P＜0.01)均呈负相关，与社会影响量表(SIS)总分呈正相关(r=0.324，P＜0.01)。多元线性回归分析显示，围手术期放化疗、造口术后时间、造口并发症、OAI-20总分及SIS总分是CRC肠造口患者身体意象水平的影响因素，共同解释身体意象水平总变异的32.80%(P＜0.001)。结论： CRC肠造口患者身体意象水平较差，需重视围手术期放化疗、造口术后时间＜6个月、有造口并发症、社会心理适应水平低、病耻感水平高的患者，采取针对性措施以改善其身体意象水平。

Objective: To explore the level and influencing factors of body image in colorectal cancer(CRC) patients with enterostomy. Methods: Convenience sampling method was used to select 157 CRC patients with enterostomy in our hospital from March 2021 to May 2023. General Data Questionnaire, Body Image Scale(BIS) and Chinese version of Ostomy Adjustment inventory-20(OAI-20) were used to investigate. Multiple linear regression was used to analyze the influencing factors of body image level in CRC patients with enterostomy. Results: BIS score was(13.57±3.98) points, and 75.16% of CRC patients with enterostomy had obvious body image disorder(BIS score ≥10 points). Univariate analysis showed that there were statistically significant differences in BIS scores among patients with different gender, family monthly income, perioperative adjuvant therapy, postoperative time of enterostomy and complications(P<0.05). Body image level was negatively correlated with the total score of OAI-20(r=-0.362, P<0.01) and self-efficacy scale(SSS)(r=-0.275, P<0.01), and positively correlated with the total score of Social Impact Scale(SIS)(r=0.324, P<0.01). Multiple linear regression analysis showed that perioperative chemoradiation, postoperative time of enterostomy, complications, OAI-20 score and SIS score were influencing factors of body image level in CRC patients, which together explained 32.80% of the total variation in body image level(P<0.001). Conclusion: CRC patients with enterostomy have poor body image level. Attention should be paid to patients with perioperative radiotherapy and chemotherapy, postoperative time<6 months, complications, low level of psychosocial adaptation and high level of stigma, and targeted measures should be taken to improve their body image level.

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