| Objective:This essay aims to investigate levels of esophageal carcinoma patients psychological resilience, discuss factors which may influence their psychological resilience, analyze relations between patients’ psychological resilience and optimistic inclination, social support, and make intervention measures for esophageal carcinoma patients’ psychological resilience on the basis of investigation results so as to strengthen their psychological resilience, improve their psychological health, and promote patients adaptation to disease, so that they can positively cooperate with the treatment and improve the quality of life.Methods:We collect materials by combining qualitative and quantitative research. Qualitative research is done by half-structural interviews, using purpose sampling method by selecting 13 esophageal carcinoma patients for this interview, know the psychological changes and coping course after illness, using content analysis to features and relevant factors of esophageal carcinoma patients’ psychological resilience. In quantitative research, we use convenient sampling; select 225 esophageal carcinoma patients in chest radio therapy ward 1, 2, 3 and thoracic therapy ward 2 in a tertiary referral hospital in Shanxi from June 2015 to January 2016, using general material investigation table,psychological resilience scale, social support scale, optimistic inclination scale to investigate levels of esophageal carcinoma patients’ psychological resilience and influential factors, using SPSS 19.0 software to analyze data in statistic measures. Weformulate esophageal carcinoma psychological resilience intervention measures according to qualitative and quantitative investigation results and psychological resilience models, using two rounds of Delphi methods evaluation and establish intervention measures finally.Results:1. Results of qualitative research: Among 13 esophageal carcinoma patients who accepted our investigation, 9 of them can accept changes brought by illness, positively face illness and cooperate with treatment. Psychological resilience features of esophageal carcinoma patients are: face problems in a right way; be good at reflection and summarize experience; strong autonomy, do not rely on others; have strong responsibility of family.Main factors that influence psychological resilience of esophageal carcinoma patients are:(1) body factors, including adverse reactions in illness treatment and pains caused by illness;(2) family factors, including family members support to patients;(3)medical environment factors, including medical care personnel’s attitudes and limited medical resources;(4) individual psychological factors, including patients’ personality characteristics and self-adaptation ability.2. Results of quantitative research: the comprehensive score of psychological resilience of esophageal carcinoma patients is(55.86±9.32), scores of each dimension are:toughness(28.15±4.48), self-improvement(19.09±4.20), optimism(8.62±2.07); social support score is(33.19±5.26),scores of each dimension are: objective support(9.20±1.53), subjective support(17.49±3.24), utilization of support(6.49±2.06);optimistic inclination support score is(16.02±1.84), scores of two dimensions are optimistic cognition(7.95±1.46), pessimistic cognition(8.07±1.18).Single factor analysis of variance and t test indicate that: influential difference of gender, age, marital status, level of education, occupation, religious belief, per capita income of a family, residence, having complication or not, staging of disease, workingcondition, personality of patient, etc. on psychological resilience have statistical significance(P<0.05).Pearson correlation analysis indicates that: the social support score is positively relevant to psychological resilience score and scores of each dimension(P<0.01),correlation coefficients are r=0.60, 0.56, 0.50 and 0.46 respectively. Optimistic inclination score is also positively relevant to psychological resilience score and scores of each dimension(P<0.01), correlation coefficients are r=0.63, 0.59, 0.58 and 0.40 respectively.Multiple regression analysis indicates that: optimistic cognition factor of optimistic inclination, subjective support factor of social support and level of education are positive forecast factors of psychological resilience of esophageal carcinoma patients, and they can jointly interpret 59.9% of psychological resilience score influential factor(R2after adjustment).3. Expert consultation results:In the two rounds, 18 and 15 questionnaires were given out respectively, and 15 and 15 were reclaimed accordingly. Experts were highly active, effective percentages of reclamation were 83.3% and 100% respectively; experts were highly authentic, and their authentic coefficient was 0.82. Established intervention measures consist of 4 primary indexes and 28 secondary indexes.Conclusion:1. Levels of psychological resilience of esophageal carcinoma patients are on the low side. After in-depth interview, psychological resilience features of patients are:self-confidence, humor, positively facing illness and strong sense of responsibility to family. their psychological resilience are influenced by many aspects, including uncomforting of their own bodies, support from family, attitude of medical personnel and their own self-adaptation ability, etc.2. The psychological resilience of esophageal carcinoma patients are mainly influenced by individual cognition to optimism, their own levels of education andperceived social support. In demographic materials, gender, age, marital status, etc, are also influential to psychological resilience.3. After two rounds of expert consultation, direction and evaluation are given for formulated intervention measures on psychological resilience of esophageal carcinoma patients, thus final intervention measures have a easy operation for nursers. |
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