陈攀 何业萍 许琼 刘敏艳

【摘要】 目的：探討肠造口患者主要照顾者的照顾负担现状及影响因素。方法：选取2016年

2月-2017年8月本院肠造口患者的主要照顾者140人为研究对象。采用Zarit照顾者负担量表（ZBI）、焦虑自评量表（SAS）和一般情况调查表对肠造口患者主要照顾者进行问卷调查。分析主要照顾者ZBI评分的影响因素。结果：共发放问卷140份，回收有效问卷126份，问卷有效率为90.0%。126人主要照顾者中，无照顾负担20人（15.9%），轻度负担80人（63.5%），中度及以上负担26人（20.6%）。平均ZBI评分为（30.35±9.83）分，平均个人负担维度为（16.13±5.54）分，平均责任负担维度为（8.74±3.79）分。126人主要照顾者中发生焦虑40人（31.7%），平均SAS评分为（49.78±5.18）分。不同年龄、与患者不同的社会关系、相处情况、患者有无肠造口并发症及有无焦虑情况下的主要照顾者ZBI评分比较，差异均有统计学意义（P<0.05）。焦虑、与患者相处情况和肠造口并发症最终进入多元线性回归方程，可以解释ZBI评分总变异的24.4%。与患者相处不好、存在肠造口并发症及有焦虑为ZBI评分升高的危险因素（P<0.05）。结论：肠造口患者主要照顾者存在轻度照顾负担。与患者相处不好、存在肠造口并发症和存在焦虑为主要照顾者的照顾负担影响因素。

【关键词】 肠造口 主要照顾者 照顾负担

The Care Burden Status of Main Caregivers and Its Influencing Factors of Enterostomy Patients/CHEN Pan， HE Yeping， XU Qiong， LIU Minyan. //Medical Innovation of China， 2020， 17（11）： -167

[Abstract] Objective： To investigate the care burden status of main caregivers and its influencing factors of patients with enterostomy. Method： A total of 140 main caregivers of enterostomy patients in our hospital from February 2016 to August 2017 were selected as the research objects. The main caregivers of enterostomy patients were investigated by Zarit caregiver burden scale （ZBI）， anxiety self-rating scale （SAS） and general condition questionnaire. The influencing factors of ZBI scores of main caregivers were analyzed. Result： A total of 140 questionnaires were issued and 126 effective questionnaires were recovered， with an effective rate of 90.0%. Among the 126 main caregivers， 20 cases （15.9%） had no care burden， 80 cases （63.5%） had mild burden and 26 cases （20.6%） with moderate or above burden. The average ZBI score was （30.35±9.83） scores， the average personal burden dimension was （16.13±5.54） scores， and the average responsibility burden dimension was （8.74±3.79） scores. Anxiety occurred in 40 cases （31.7%） of the 126 main caregivers， with an average SAS score of （49.78±5.18） scores. There were statistically significant differences in the ZBI scores of the main caregivers under different ages， different social relations with the patients， get along with the patients， whether the patients had intestinal ostomy complications and whether anxiety （P<0.05）. Anxiety， get along with the patients and the patients had intestinal ostomy complications eventually entered the multiple linear regression equation， which accounted for 24.4% of the total variation in ZBI score. Not get along with patients，patients had intestinal ostomy complications and anxiety were risk factors for increased ZBI score （P<0.05）. Conclusion： Main caregivers of enterostomy patients have mild care burden. Not get along with patients， enterostomy complications and anxiety were the influencing factors of the burden of care for main caregivers.

[Key words] Enterostomy Main caregivers Care burden

First-authors address： Xiaolan Peoples Hospital Affiliated to Southern Medical University， Zhongshan 528415， China

doi：10.3969/j.issn.1674-4985.2020.11.041

我国目前累计肠造口患者总数已超过100万例，且以每年10万例递增[1]。肠造口是指因疾病的治疗需要，如直肠癌等，需将一段肠管拉出腹腔进行造口，将肠管开口缝合于腹壁切口上以排泄粪便或尿液[2]。接受该类手术的患者，排便方式发生了改变，术后需要面对生理、心理和社会方面的各种挑战，不仅严重影响患者的生活质量，而且给家属及照顾者带来了极大的压力[3]。照顾者不仅需要照护患者，而且还承受亲人患癌症和造口的双重打击，相关研究显示照顾者会比患者承担更大的负面情绪和情感压力[4-5]。因此，肠造口患者照顾者的照顾负担及心理状态应该得到重视，但当前对此研究报道较少。……