| Objective To analyze the risk factors of demoralization syndrome in breast cancer patients,and provide basic basis for prevention of demoralization syndrome and early clinical nursing intervention.Methods In this non-matched case-control study,inpatients diagnosed with breast cancer in the Department of Tumor Surgery,Affiliated Hospital of North China University of Science and Technology,Tangshan and Tangshan People’s Hospital from August 2020 to August 2021 were selected in an equal proportion as research subjects.When the patients’ condition was stable,With Demoralization Scale,172 breast cancer patients with scores >30 were selected as the case group,and 172 patients with scores ≤30 were selected as the control group.The stress and coping theoretical model was used to construct risk factors.The investigation content included general factors,disease and treatment factors,physiological factors,psychological factors,social support factors,cognitive and behavioral factors,and the risk factors of demoralization syndrome in breast cancer patients in the two groups were compared and analyzed.Excel software was used to establish the database,SPSS22.0 software package was used for data analysis,descriptive analysis of general demographic data,chi-square test was used for univariate analysis of the two groups of patients,and binary Logistic regression analysis was used for multivariate analysis.Results 1 A univariate analysis of the influence of demoralization syndrome in breast cancer patients Results show that the place of residence,level of education,occupation,family income,marital status,the main caregivers,personality type,subjective sleep quality,regular exercise after illness,disease stage,whether cancer metastasis and recurrence,complicated with cardiovascular disease,complicated with diabetes mellitus,surgery way,number of chemotherapy,whether radiotherapy,limb lymphedema,fatigue degree,the degree of pain,limb numbness,limb movement restriction,nausea/vomiting,skin/nail blackening,hair loss,self-perceived burden,psychological resilience,social support,self-image evaluation,Spouse and relatives’ evaluation of her image,coping style and self-management were associated with demoralization syndrome in breast cancer patients,and the differences were statistically significant(P<0.05).2 Multivariate Logistic regression analysis showed that the risk of demoralization syndrome in breast cancer patients living in rural areas was 8.326 times higher than that in urban areas(95%CI:2.074～33.406).The risk of demoralization syndrome in breast cancer patients whose primary caregivers were parents or children was 3.494 times higher than that of their spouse(95%CI:1.001～10.994).The risk of demoralization syndrome in breast cancer patients with introversion was 6.606 times higher than that in extroversion(95%CI:1.444～30.219).The risk of demoralization syndrome was 7.895 times higher in breast cancer patients undergoing breast resection than in those undergoing breast preservation(95%CI:1.840～33.883).The risk of demoralization syndrome in breast cancer patients with more than 4 times of chemotherapy was 9.977 times higher than that in patients with 0 times of chemotherapy(95%CI:1.798～55.370).The risk of demoralization syndrome in breast cancer patients with moderate fatigue was 4.315 times higher than that in patients without fatigue or with mild fatigue(95%CI:1.205～15.449).The risk of demoralization syndrome in breast cancer patients with severe fatigue was 7.042 times higher than that in patients without fatigue or with mild fatigue(95%CI:1.503～32.990).The risk of demoralization syndrome in breast cancer patients with limb lymphedema was17.487 times higher than that in patients without limb lymphedema(95%CI:4.483～68.212).The risk of demoralization syndrome in breast cancer patients with severe pain was 9.582 times higher than that in patients without pain(95%CI:1.701～53.968).The risk of demoralization syndrome in breast cancer patients with moderate self-perceived burden was 7.418 times higher than that in patients without self-perceived burden(95%CI:1.852～40.892).The risk of demoralization syndrome in breast cancer patients with severe self-perceived burden was 17.195 times higher than that in patients without selfperceived burden(95%CI:5.140～66.339).The risk of demoralization syndrome in breast cancer patients with negative coping style was 3.450 times higher than that in patients with positive coping style(95%CI:1.331～8.942).The risk of demoralization syndrome in breast cancer patients with regular exercise after disease was 0.088 times higher than that in patients without disease(95%CI:0.030～0.264).The risk of demoralization syndrome was0.110 times higher in breast cancer patients with high level of social support than in those with low level of social support(95%CI:0.024～0.510).Conclusion The risk factors of demoralization syndrome in breast cancer patients were living in rural areas,the main caregivers were parents or children,introversion of personality type,the operation mode is mastectomy,more than 4 times of chemotherapy,moderate and severe fatigue,lymphedema of affected limb,severe pain,self-perceived burden is moderate and severe,and negative coping.The protective factors of demoralization syndrome in breast cancer patients were regular exercise and high level of social support.Figure 1;Table 10;Reference 158... |
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