A Cross-Sectional Study On The Level Of Self Care Self Efficacy Among Cancer Patients And Analysis Of Its Factors

Nowadays,self-management model has been already widely developed and applicated in chronic diseases and cancer management. Research show that this mode has good effect in promoting health behavior change, improving health condition, reducing health resource utilization and other aspects. Among them, self-efficacy is a powerful factor in self-management behavior implementation and change. High level self-efficacy of cancer patients with long-term survival will greatly improve self-management ability, promote quality of life, reduce treatment side effects and elevate degree of disease adaptability. In recent years, studies on self-efficacy in cancer field have increasingly become a popular issue.Using convenient sampling and cross-sectional survey methods to investigate cancer patients'self-care self-efficacy status, and comprehensively analyze and discuss its influencing factors, aiming to promote to make pertinence intervention strategies advice for ascending cancer patients the level of self-care self-efficacy and quality of life in clinical work and help patients transform from coping disease in negative way to self-management disease and actively participating in clinical decision-making. Meanwhile, during this study, we introduced American cancer self-care self-efficacy scale, completed the metrological test of Chinese version scale to try to contribute a new applicable tool in similar research for future.(1) By using literature content analysis systematically reviewed self-efficacy assessment tools in cancer field. Select and introduce the American self-care self-efficacy scale (Strategies Used by People to Promote Health, SUPPH) into China, complete the translation, back-translation, culture adaption, reliability and validity test of Chinese version scale of it and get the measuring tool of this study.(2) Through methods of theory study, literature review, expert consultation to determine influencing factors and measuring instruments in Section 1,including the Chinese-version SUPPH, MOS 36-item Short Form Health Survey, Social Support Revalued Scale, the Hospital Anxiety and Depression scale and demographic and disease data.. In Section 2,using the method of the convenient sampling,555 cancer patients from 6 hospitals in Shanghai, Shandong and Jiangsu Provinces were investigated the level of self-care self-efficacy, health status, psychological status and social support. Methods of one-way analysis of variance, Pearson correlation and multiple linear regressions were used to test significant variables with the self-care self-efficacy.(1)The results of item analysis (correlation efficient and discriminability analysis) demonstrated that 28 items had a good identify degree; principal component analysis with oblique rotation resulted in three factors explaining 66.65% of the variance; the three factors were separately positive attitude, making decision and stress reduction; the final scale had 28 items; Cronbach's aand Guttman split-half coefficients of the scale were 0.970 and 0.925; three factors Cronbach's a coefficients were above 0.80; The results of confirmatory were:χ2=1119.05,χ2/df=3.22, RMSEA=0.063, CFI=0.99, GFI=0.87, AGFI= 0.85, NFI=0.99 and NNFI=0.99, implied the scale had good reliability and validity.(2) The cancer patients experienced moderate levels of self-care self-efficacy (85.64±24.67), positive attitude (45.85±14.15),stress reduction (30.40±9.06) and making decision (9.38±2.90), nose, pharynx and laryngeal cancer patients'level of self-care self-efficacy was the highest; urinary tract cancer patients'level was the lowest, liver and gallbladder cancer were second lowest,(3) One-way analysis of variance found that age, work status, life styles, education levels, coping styles, stages of disease,cancer type,whether diseases had recurrence or complication and whether patients participated the health-education activity were related to self-care self-efficacy;(4)Multiple regression analysis showed that the variables of general health, depression, communication with health professionals, anxiety, vitality, objective social support and physical functioning were entered the model, accounted for 55.03% of the total variances;(1)After strict and standard scale metrological test, the Chinese-version self-care self-efficacy scale can be applied in Chinese cancer patients and provide an effective evaluation instrument for Chinese cancer self-management programs;(2)The cancer patients experienced moderate levels of self-care self-efficacy, positive attitude, stress reduction and making decision. The variables of general health, depression, communications with health professionals, anxiety, vitality, objective social support and physical functioning were entered the model. The above results could benefit for clinical professionals screening high-risk at-risk group and make more individualized and operable interventions to improve their self-care self-efficacy and self management ability, finally to elevate cancer patient's quality of life.