| Objective1.To investigate the level of perceived control of the middle-aged and elderly patients with non-small cell lung cancer undergoing chemotherapy in zhengzhou and analyze its influencing factors.2.To explore the influence of group intervention based on system-based model of stress on perceived control and quality of life of the middle-aged and elderly patients with non-small cell lung cancer undergoing chemotherapy.MethodsThis study was divided into two parts.1.Stage of investigative study: 206 lung cancer patients who met the inclusion and exclusion standards were recruited from two hospital in zhengzhou,they were pleased to sign the general date questionnaire,Social Support Rating Scale(SSRS),Medical Coping Modes Questionnaire(MCMQ),Cancer Experience and Efficacy Scale(CEES).The date was analyzed by SPSS21.0,and the statistical methods included descriptive statistic,t-test,one-way analysis of variance,Pearson correlation and multiple stepwise regression analysis.2.Stage of intervention study: 94 participants who met the inclusion and exclusion standards from one hospital in zhengzhou were selected,they were divided into intervention group(47cases)and control group(47cases)by coin tossing.The control group received conventional nursing,including group education and telephone follow-up once a month.The intervention group received group intervention based on system-based model of stress and conventional nursing,including 6 times group intervention,telephone follow-up and WeChat group message-push twice a week.The intervention lasted for 4 months.Cancer Experience and Efficacy Scale(CEES),Functional Assessment of Lung Cancer therapy(FACT-L)were measured before intervention,1 month and 3 months after intervention.The statistical method used in data analysis included descriptive statistic,t test,chi-square test,Mann-Whitney-U rank sum test and generalized estimation equation.Results1.Stage of investigative study:(1)The scores of cancer experience and control efficacy were(63.84±7.94)and(42.74±6.93),respectively,suggesting that the level of patients’ perceived control was moderate.(2)Using one-way analysis of variance,Pearson correlation and multiple stepwise regression analysis to explore the influencing factor of patients’ perceived control.The results showed that the elderly,monthly income,stage Ⅳ,length of disease diagnosis,confrontation,acceptance-resignation and objective support were the influencing factors of cancer experience in the middle-aged and elderly patients with non-small cell lung cancer undergoing chemotherapy,which could explain 44.3% of the total variation.The elderly,junior high school,senior high school or technical secondary school,stage Ⅳ,length of disease diagnosis,confrontation,acceptance-resignation and social support were the influencing factors of control efficacy in the middle-aged and elderly patients with non-small cell lung cancer undergoing chemotherapy,which could explain 51.1% of the total variation.2.Stage of investigative study: There are 87 patients completed the whole research,including 44 patients in control group,43 patients in intervention group.(1)After intervention,the total score of cancer experience,personal strain and emotional strain in the intervention group were lower than those in the control group,and the difference was statistically significant(P<0.01).There was no significant difference in socioeconomic score between the control group and the intervention group(P>0.05).After intervention,the scores of control efficacy,personal efficacy,collective efficacy and proxy efficacy in the intervention group were higher than those in the control group,and the difference was statistically significant(P<0.01).(2)The scores of control efficacy,emotional strain and collective efficacy in the intervention group were statistically significant before intervention,1 month after intervention and 3 months after intervention(P<0.01).The scores of cancer experience,personal efficacy and medical efficacy were significantly different before intervention and 1 month after intervention,before intervention and 3 months after intervention(P<0.01).There was no significant difference between 1 month after intervention and 3 months after intervention(P>0.05).(3)After intervention,the score of FACT-L,Social/Family Well-being,Emotional Well-being and Functional Well-being in the intervention group were higher than those in the control group,and the difference was statistically significant(P<0.01).There was no significant difference in physical Well-being and Lung Cancer related Symptoms between the control group and the intervention group(P>0.05).(4)The scores of social/family Well-being and functional Well-being of patients in intervention group were statistically significant before intervention,1 month after intervention and 3 months after intervention(P<0.01).There were significant differences in the score FACT-L and emotional Well-being before intervention and 1 month after intervention,before intervention and 3 months after intervention(P< 0.01).There was no significant difference between 1 month after intervention and 3 months after intervention(P>0.05).Conclusions(1)Perceived control was influenced by age,monthly income,degree of education,TNM staging,length of disease diagnosis,coping style and social support in the middle-aged and elderly patients with non-small cell lung cancer undergoing chemotherapy.(2)Group intervention based on system-based model of stress can improve perceived control and quality of life of the middle-aged and elderly patients with non-small cell lung cancer undergoing chemotherapy. |
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