| Objectives:It aims to understand self-esteem of Terminally ill cancer patients, the meaning of life,quality of life and the relationship between the current situation and further exploration of the impact on their life review.Methods:In March 2015 to June 2015 in a medical university affiliated tumor hospital nursing,it adopts the method of cluster sampling, a questionnaire survey was conducted on 130 cases of advanced cancer patients all registered. By using the method of convenient sampling, it makes standard intervention on 6 patients with advanced cancer cases.1.Status quo of the research. It adopts the Ning-raise social work service demonstration projects to do questionnaire by compiling of demographic questionnaire,self-esteem questionnaire, life meaning and quality of life questionnaire investigation in patients with advanced cancer. It also does further understanding of advanced cancer patients self-esteem, quality of life and present characteristics of the meaning of life and their relationships.2.Case intervention study. It uses life review method to meet the inclusion criteria of 6patients with advanced cancer of intervention in the case study, It understands life review effectiveness of self-esteem, the meaning of life, quality of life in patients with advanced cancer, which prove that life review is an effective method of improve self-esteem,the meaning of life and quality of life in patients with advanced cancer. It can better help patients with advanced cancer to achieve end well, parting well and live well.Findings:Findings of research on the status quo are as follows:(1)In this study, the cronbach alpha coefficient of self-esteem, life meaning and thequality of life, as well as the total survey scale are respectively 0.798, 0.896, 0.863, 0.931.The questionnaire are evaluated after a number of experts at the same time. In the aspect of criterion validity, self-esteem and self-esteem, life meaning and quality of life scores are significantly correlated(p<0.05). The meaning of life is significantly correlated with the scores of self-esteem, life meaning and life quality(p<0.05). The quality of life is significantly related to self-esteem, life meaning and quality of life(p<0.05). This shows that the questionnaire has high reliability and validity.(2)The scores of self-esteem, life meaning and quality of life of patients with advanced cancer are: 22.28±7.39、70.38±19.93、66.88±18.93, all of which are close to the average.(3)Different gender of patients in self-esteem(t=-2.295,p<0.05), the meaning of life(t=-3.851,p<0.001), the quality of life(t=-3.731,p<0.001) are of significant difference,women were significantly higher than men. Patients with different levels of education in self-esteem(F=5.247, p<0.01), the meaning of life(F=3.547, p<0.05), the quality of life(F=3.525,p<0.05) exist significant difference, and the higher degree was significantly higher than that of medium and low. Different marital status of patients in self-esteem(t=3.113, p<0.01), the meaning of life(t=2.299, p<0.05), the quality of life(t=2.121, p<0.05) exist significant difference, and having a spouse is significantly higher than mateless. Different understanding of the disease degree of patients in self-esteem(F=4.650,p<0.05), the meaning of life(F=10.855,p<0.001) and quality of life(F=6.843,p<0.01) exist significant differences, and fully understand the diagnosis and prognosis is significantly higher than the understanding of the diagnosis is not clear and complete without understanding of the prognosis and prognosis. But patients, who has no religious beliefs, with self-esteem(t=0.253,p>0.05), the meaning of life(t=-0.656,p>0.05),quality of life(t=-0.590,p>0.05) have no significant difference.(4)There are significant differences in the scores of life meaning(F=28.160, p<0.001)and quality of life(F=22.702, p<0.001) in Terminally ill cancer patients of different self esteem groups.(5)Terminally ill cancer patients with self-esteem and the meaning of life has a significant positive correlation(r=0.653, p<0.01). Gender(t=3.190, p<0.01), the degree of understanding of state of illness(t=3.063, p<0.01) and self esteem(t=8.000, p<0.001), can explain the variation of 50.0% patients’, with advanced cancer, life significance for.(6)Terminally ill cancer patients with self-esteem and quality of life is a significant positive correlation(r=0.611, p<0.01). Gender(t=3.108, p<0.01), the degree of understanding of state of illness(t=2.069, p<0.05) and self esteem(t=6.821, p<0.001) can explain the variation of 42.6% of the quality of life of patients with advanced cancer.Case intervention results(1)Self-esteem, life meaning and quality of life scores of case f1, m2, f3, m4, m5, tend to rise. The changes before and after the intervention are obvious. m6 self-esteem, life meaning and quality of life scores before intervention(t1 and t2), in addition to the life quality score(t2 = 69 points), are below average. Intervention in the medium-term changes significantly, the late intervention effect is not obvious.(2)Cases before and after intervention, the m2, m4, m5 self-esteem level is obviously rising. The intervention effect is remarkable, scores before and after the intervention of case f1, f3 overall self-esteem are on the low side, but is tending to rise. Self-esteem level of case m6 are going down after rising first. One month before the intervention effect is remarkable. A month after the intervention it declines sharply. The later intervention effect is invalid.(3)Before and after the intervention, the meaning of life scores of case m4 shows a clear upward trend. The intervention effect is remarkable. The meaning of life scores of case m2 and m5 show a rising trend. Intervention effects much better, Case f1, f3 of the meaning of life scores increases. But which is only slightly higher than average level. The effect of intervention is not obvious. The meaning of life scores of case m6 increases firstly and is then lower than pre-intervention minimum score(t4=50). The intervention effect is of invalid.(4)Before and after the intervention, the scores of quality of life of case m4 shows a clear upward trend. The intervention effect is significantly higher than other subjects.Quality of life score of case f1, m2, f3, m5 shows a rising trend. Quality of life score case f1, m5 is higher than scores of case m2, f3. The scores of quality of life of case m6 increases firstly and then decreases intervention effect.(5)The level of Terminally ill cancer patients self-esteem(t=-5.898), life meaning(t=-4.385), quality of life(t=-5.931) before and after intervention are significantly different(p<0.01). The intervention effect is significant.Conclusion:1. Self-esteem, life meaning, quality of life of Terminally ill cancer patients are close to the average. At the same time, the patient’s gender, educational level, marital status,the degree of understanding of the disease is an important factor affecting the 3 indicators.2. The different level of self-esteem is an important factor affecting the life meaning and quality of life. Therefore, improving the level of self-esteem of patients with advanced cancer has important practical significance and application of enhancing their sense of the meaning of life and improving their quality of life.3. The life review is an effective way to improve the late cancer patients’ self-esteem,life meaning and quality of life. Travel notes is an application tool of life review which is very worthy of promotion. But because it takes a certain amount of time, it should be take patients’ =actual situation into consideration in the practical application. |
PDF Full Text Request