| Objective: To discuss self-efficacy theory of application and effect evalua- tion in patients with nasopharyngeal carcinoma for radiotherapy and chemother- apy. To promote the level of self-efficacy in patients with nasopharyngeal carci- noma for radiotherapy and chemotherapy,so that patients can be comfortable with emerging health problems,fully mobilize the patient,s own potential and behavior,reduce poisonous side reaction and complication what disease and the treatment bring,improve the quality of life of patients.Methods: Clinical research methods about adopting comparison before and after in this study. From Jun 2009 to Sept 2010,selecting 240 patients with NPC was confirmed by histopathology who were initially cured at two radiothe- rapy ward in first affiliated hospital of guangxi medical university were ranked research object. After admission and before treatment(generally about 1 week to 2 weeks): to investigate and analyze demographic data,quality of life,self- efficacy and influencing factor in patients with 240 NPC by means of scale. From Jun 2009 to Jan 2010,120 patients with NPC who were initially cured at t- wo radiotherapy ward in first affiliated hospital of guangxi medical university were ranked control group,from Feb 2010 to Sept 2010,120 patients with NPC who were initially cured at two radiotherapy ward in first affiliated hospital of guangxi medical university were ranked experimental group. Control category: conventional nursing;Experimental category:conventional nursing and effective enhanced self-efficacy interventions(according to the survey of factors,formula- te effective enhanced self-efficacy intervention,health education,psychology interventions,behavior therapy,positive coping style,enhance social support dynamics,etal).To investigate two patients,self-efficacy,the level of depression and to observe and record the patient,s acuting poisonous side reaction in different treatment period(time interval of 1~10 day of radiotherapy,time interval of 11~20 day of radiotherapy,time interval of 20~conclusion of radiotherapy)for radiotherapy and chemotherapy.To collect relevant data with patients in the study,establish database,apply descriptive analysis,t,test,chi-sq- uare test,rank sum test,variance analysis,relevant and multi-factor regression analysis,etc.To analyze two patients, self-efficacy and influencing factor,the level of depression,the level of self-efficacy and acuting poisonous side reaction for radiotherapy and chemotherapy in different treatment time interval,quality of life around interventions.Results:1,Two patients,self-efficacy with NPC before treatment:240 patients,overall self-efficacy was low,mean was (27.51±4.43)points the average score indicators was 68.77﹪,only the 24.58﹪score indicators≥80﹪,was in higher levels,75.42﹪was in middle or low levels.2,The influencing factor analysis for the level of self-efficacy in patients with NPC:①Single factor analysis:the level of self-efficacy in patients with NPC was positively correlated with social support,positive coping style,the level of education,economical condition,but negatively with the level of depression and negative coping style(p<0.01),wasn,t correlated with age,sex, marital status,occupation and condition degree(p>0.05).②Stepwise multifact- or regression analysis:the level of self-efficacy in patients with NPC was remarkable correlated with the level of depression,positive coping style, negative coping style,social support,economical condition,the level of educati- on(p<0.01).③The correlational analysis among associated factors for patients with NPC:there was correlative among associated factors for patients with NPC(p<0.01).④Comparison between associated factors for patients with NPC(the level of depression,social support,coping style)and the norm,the degree of depression and social support higher than norm (p<0.01);positive coping lower than the norm (p<0.05);negative coping style compared with the norm,the difference was not statistically significant(p>0.05).3,Two group patients,self-efficacy grading comparison in different treatment period:①Before treatment(that is,before intervention)were not receiving chemotherapy and chemotherapy,two groups patients, level of self-efficacy scores,the difference was not statistically significant (p>0.05).②In three different time intervals during treatment,the level of self-efficacy form control group assumed the downward trend with the advance of the treatment process,while the level of self-efficacy form experimental group increased first and decreased then,and assumed increasing trend finally,two group patients,self-efficacy grading were different(p<0.01),and self-efficacy for the experime- ntal group were higher than those in the comparative group.③Two group patie- nts,self-efficacy grading were different(p>0.05).4,Two group patients,SDS grading comparison in different treatment period:①Before treatment(that is,before intervention)were not receiving che- motherapy and chemotherapy,two groups patients, SDS scores,the difference was not statistically significant (p>0.05).②In three different time intervals during treatment,two patients,SDS grading results showed that:two group patients,overall levels of depression assumed the trend of escalation during treatment period,and the great changing tendency is a time interval of 11~20 day of radiotherapy,but increasing rate of the level of SDS form experimental group compared with control group to be low during treatment period(p<0.01).③Two group patients,SDS grading were different(p>0.05).5,Two group patients,observation of poisonous side reaction:①Disgust- ing and disgorgement degree: In three different time intervals during treatment, for two group patients,disgusting and disgorgement degree,the comparison in three treatment periods of 1~10day,11~20 day and 21~conclusion of radiotherapy,result showed that:disgusting and disgorgement degree of experimental group compared with control group to be low(p<0.05).②Stomatitis or mucous membrane inflammation,and(radioactive skin-reaction) radiodermatitis:In three different time intervals during treatment,for two group patients,stomatitis or mucous membrane inflammation and radiodermatitis, result were not significant though data statistical analysis in time interval of before treatment,time interval of 1~10 day of radiotherapy(p>0.05);but the comparison in two treatment period of 11~20 day and 21~ conclusion of radiotherapy,result showed that: stomatitis or mucous membrane inflammation and radiodermatitis of experimental group compared with the control group to be low(p<0.05).6,Comparision in various domains form the quality of life in two patients with NPC around interventions:①Result were not significant though data statistical analysis in time interval of before treatment(p>0.05).②Various functional domains and global heath of experimental group compares the control group to be statistically hight(p<0.05),stomatitis or mucous membrane inflammation and radiodermatitis of experimental group compares the control group to be low(p<0.05).Conclusion:1,Two patients,overall self-efficacy was low before treatment,the level of depression,social support,positive coping style,negative coping style,the level of education,economical condition,which were influencing factors,so nurses can formulate effective enhanced self-efficacy intervention according to factors.2,Nursing ways and means of enhanced self-efficacy,including health education,psychology interventions,behavior therapy,positive coping style, enhance social support dynamics,and so on.Which can play fully the patients, potential and dynamism,improve the level of self-efficacy with patients.3,Depression in patients with nasopharyngeal carcinoma was highly correlated with its level of self-efficacy,the overall depression assumed the trend of escalation during treatment period,and the greater changing tendency is a time interval of 11~20 day of radiotherapy. In all clinical times for treatment and care,especially the time for upward greater changing depression trend, nur- ses should assess regularly the patients,depression,and implement timely enhanced self-efficacy intervention manner,reduce depression,and enhance the confidence and ability of patients to resolve health problems,promote the patient's own development of their potential,to improve treatment compliance and quality of life.4,During the treatment in patients with NPC,there will be varying degrees of acuting toxicity for radiotherapy and chemotherapy,severely reducing the level of self-efficacy in patients,increasing the patient's depression,affecting the patient's treatment compliance and quality of life. Enhanced self-efficacy intervention can effectively reduce the acuting toxicity for radiotherapy and chemotherapy,reduce depression and improve treatment compliance and quality of life.5,The role for application of self-efficacy to improve the health and quality of life in patients with nasopharyngeal carcinoma was significant,providing a new theoretical basis for the treatment and rehabilitation care in patients with nasopharyngeal carcinoma,self-efficacy should be widely applied for cancer treatment and care practice in our country.
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