Study On Breast Cancer Conserving Treatment Chemotherapy Patients' Uncertainty In Illness

BackgroundBreast cancer is one of the common malignant tumors which took place in female duct epithelium. Its morbidity is increasing recently. In 1990, the International Association of Cancer Treatment held the Early Breast Cancer Symposium, formally took Breast-conserving therapy as an possible treatment to treatⅠ,Ⅱstage of breast cancer. By 2011, breast conserving surgery has accounted for more than 50% of all breast cancer surgical operations of U.S.,40% in Japan,70%～80% in Singapore,30% in Hong Kong, and, however, only some hospitals developed breast conserving surgery in mainland China.The related researches on uncertainty in illness confirmed that the uncertainty feelings widespread exist among the patients in many diseases such as cancer, heart disease and many chronic diseases. The related patients with cancer have included lung cancer, breast cancer, prostate cancer, intestinal cancer and radiation treatment cancer patients. The object of uncertainty in illness research has extended from patients to their family members, but there are few studies on uncertainty feelings about patients after breast cancer.Medical Coping Modes is an existing process that people through the sustain efforts of consciousness and behavior, to cope with special needs which surpass the individual original storage capacity from the internal and external. It is a method,mean and strategy to deal with required from internal and external environments and related emotional disturbance. Domestic and international study confirmed that Medical Coping Modes have an influence on patients'uncertainty feelings. ObjectiveTo analyze the level of uncertainty in illness, medical coping style and the influence factor through an questionnaire survey on the breast conserving postoperative chemotherapy patients. To propose relative suggestion and countermeasure in order to lower the level of uncertainty in illness, enhance the initiative respond to negative life events and maintain mental health.MethodThe samples of the study were chosen by the stratified-cluster random sampling method. Three hospitals which took breast conserving surgery from Kundulun district, Kunshan district of Baotou were chosen.191 patients have been treated by breast conserving surgery in these 3 hospitals during March 2009 to March 2011 were surveyed. Use self-designed questionnaire survey, Mishel Disease Self-rating Scale Uncertainty (MUIS-A) and Medical Coping Questionnaire (MCMQ) to collect data.The data was input into the compute after encode, established a database with Access 2003 and analyzed by SPSS 16.0.Main ResultsUnivariate analysis revealed that:the mean score of uncertainty in patients of 1) different ages 2) different education levels 3) different incomes 4) different health-insurance modes 5) the numbers of different chemotherapy 6) different types of side effects were significantly different. The younger the patients'age, the higher the education level, the more the income, have medical insurance and the more number of chemotherapy, the lower they scored. With the kind of side effects appears to increase, the higher they scored.Spearman correlation analysis showed that age and type of side effects was positively correlated with uncertainty score and its various dimensions. Education level, income, health-insurance mode and number of different chemotherapy was negatively correlated with uncertainty score and its various dimensions.Uncertainty in illness and its four dimensions was negatively correlated with facing dimension and avoiding dimension of medical coping modes, and positively correlated with yielding dimension.Conclusion1) Income, health insurance scheme and other economic factors should be concerned as an impact factors on uncertainty feeling of patients with breast conserving surgery.2) In light of the multiple side effects of chemotherapy and high uncertainty of illness in less educated people, medical staff should focus on strengthening health publicity and education.3) For patients with postoperative chemotherapy after breast conserving surgery, facing or avoiding dimensions are positive factors while yielding is a negative factor. Doctors and nurses can guide and encourage the patients to face facts to decrease uncertainty feeling. When some disease-related events happened, and the facing coping style temporarily is unable to help patients understand the significance of disease events, doctors and nurses can guide patients to temporarily take avoidance coping style in order to reduce uncertainty feelings in illness. Patients shouldn't be guided to take avoidance coping style.