The Inlfuence Of Self-efficacy And Self-care Joint Intervention On The Quality Of Life Of Postoperation Patients With Laryngeal Carcinoma

Objective：To explore the influence of self-efficacy and self-care joint intervention onthe quality of life of postoperative patients with laryngeal carcinoma, and evaluate theprospect of clinical application based on the effect of intervention in order to draw upfeasible nursing intervention model, and improve the quality of life of patients withlaryngeal carcinoma.Methods：The research was an interventional study, and use the method of conveniencesampling to select76patients with laryngeal carcinoma conformed by pathology forsurgery who came from the ENT department of the First Affiliated Hospital of BengbuMedical College from Aug2011to Sep2012. Among those37patients with laryngealcarcinoma from Aug2011to Feb2012were ranked control group, and39patients withlaryngeal carcinoma from Mar2012to Sep2012were ranked experimental group. Thepatients in the control group received laryngeal carcinoma routine nursing, while theexperimental group was received joint nursing intervention which improved self-efficacy and self-care ability on the basis of routine nursing care. The interventionaleffect of those two groups were campared with each other, using questionnairesincluded general self-efficacy scale(GSES), the exercise of self-care agency(ESCA), theChinese quality of life instrument for cancer patients-head and neck cancer(QLICP-HN) during the following three months after the operation. The patients inexperimental group were also researched in the same way on the day before operationand the very day of discharge so that can be studied the impact of interventions forpatients with laryngeal carcinoma over time. The statistical software SPSS for windowsversion17.0was used for data analysis.Results：1.53.85%patients with laryngeal carcinoma perceived higher levels,35.90%patients perceived medium levels and10.26%patients perceived lower levels ofself-efficacy in experimental group; while18.92%patients perceived medium levels,81.08%patients perceived lower levels and none perceived higher levels in the controlgroup.79.49%patients perceived higher levels,20.51%patients perceived medium levels and none perceived lower levels of self-care ability in experimental group; while2.70%patients perceived higher levels,97.30%patients perceived medium levels, andnone perceived lower levels in the control group.2. Comparing the two groups withself-efficacy, self-care ability and quality of life, the experimental group were allsignificantly improved(P<0.01).3. The scores of self-efficacy, self-care ability andquality of life in the experimental group were improved over time(P<0.01), Thepatient’s quality of life scores were statistical differences between the preoperative,discharge and after the intervention (P<0.05).4. Self-efficacy and self-care ability andits dimension scores had a significant positive correlation (P<0.01); Self-efficacy andquality of life and its dimension scores had a significant positive correlation (P<0.01);self-care ability and quality of life and their dimension scores had a significant positivecorrelation (P<0.01).5. According to the stepwise multiple regression analysis of theinfluencing factors related to the quality of life of postoperative patients with laryngealcarcinoma were self-care ability (B=0.289, P<0.01), with pipe(B=6.439, P<0.01),operation method(B=－5.792, P<0.01), Self-care(B=0.734, P<0.01), educationallevel(B=3.124, P<0.05).Conclusion：1. The level of self-efficacy of patients in control group was low, while thelevel of that in experimental group was medium.2. The level of self-care ability incontrol group was medium, while the level of that in experimental group was high.3.Self-efficacy and Self-care joint intervention was the effective way to improveself-efficacy, self-care ability and the quality of life of postoperative patients withlaryngeal carcinoma.4. The relationship between the scores of self-efficacy, self-careability and its dimensions, and the quality of life and its dimensions presented highlypositive correlation.5. The main factors that affect the quality of life of postoperativepatients with laryngeal carcinoma were self-care ability, clinical stage, self-efficacy,among which the self-care ability was the most important factor.