| Objective:The purpose of this study was to investigate the current status and influencing factors of uncertainty in illness among productive age women undergoing hysterecto-my with cervical cancer;To explore the management effects of quality control circle on the uncertainty in illness and anxiety among productive age women undergoing hysterectomy with cervical cancer during the perioperative period,and providing basis for clinical nursing intervention.Methods:One hundred and twenty-eight cases of productive age women undergoing hysterectomy with cervical cancer were selected from one third-grade class-A hospital of Jiangxi province during June of 2014 to March of 2016 by convenience sampling method.The patients were investigated using General Situation Questionnaire,Mishel's Uncertainty in Illness Scale-Adult(MUIS-A),State Anxiety Inventory(SAI),Information Preference Questionnaire for Cancer Patients(IPQCP),and Multidime-nsional Health Locus of Control Scales(MHLC),then we analysed the influence factors of productive age women undergoing hysterectomy with cervical cancer,using the single factor analysis of variance,independent sample t test,pearson correlation analysis and multiple linear regression analysis.Eighty-three cases who volunteered to participation for further research were selected from the first part study during January of 2015 to March of 2016.The patients were divided into control group(42)and intervention group(41)according to the order of admission.The control group patients were given routine nursing care of cervical cancer operation,and the intervention group patients were given standardized intervention of quality control circle based on the routine nursing care.The intervention time began from the patients admitting to hospital and ended on the day before they discharged.On the intervention study,the patients of the two groups were investigated using Mishel's Uncertainty in Illness Scale-Adult(MUIS-A)and State Anxiety Inventory(SAI)respectively on the day before surgery,the morning of surgery and the day before discharged,and the disease related knowledge of the patients were surveyed when the patients were admitted to hospital and the day before discharged.Analysis the results of the uncertainty in illness,anxiety and disease related knowledge score of the two groups by variance for repeated measurement data test and the Mann Whitney U test.Results:The score of uncertainty in illness among productive age women undergoing hysterectomy with cervical cancer was(95.25±12.02),and it was a moderate level.The single item score of every dimension ranking from high to low in order is unpredictability,inconsistency,ambiguity and complexity.The score of anxiety state was(45.78±8.34),which was statistically significant(P<0.001)compared with the domestic norm(39.91).The state anxiety were significantly positively correlated with uncertainty in illness(r=0.515,P<0.01).The score of information preference questionnaire was(43.33±6.67),and patients information need from high to low were:Diagnosis,treatment,the others,and prognosis.and it was significantly positively correlated with uncertainty in illness(r=0.515,P<0.01).The scores of every part of the patients' multidimensional health locus of control scales were that: the internal control(18.68±6.51),the power of others to control(23.34±7.81),and the chance control(21.24±7.40).the internal control and power of others to control were negatively correlated with uncertainty in illness(r=-0.457,P<0.01;r=-0.552,P<0.01),the chance control was positively correlated with uncertainty in illness(r=0.227,P<0.01).Multiple linear regression analysis showed that:The variables of primary caregivers,the scope of the patient's operation,the patient's acceptance of uterine resection,information need,and the chance control had influence on uncertainty in illness among productive age women undergoing hysterectomy with cervical cancer,which can explain 56.3% of the variance of uncertainty in illness.Before the intervention,the scores of the uncertainty in illness,anxiety state,and the patients' disease related knowledge were no statistically significant(P>0.05);After the intervention,the total scores of uncertainty in illness and anxiety state at the three time points of the intervention group were lower than that of the control group,the difference was statistically significant(P<0.01);The unpredictability dimension was no significant difference in the two groups of patients at the morning of surgery(P>0.05);At different time points,there were no significant differences of the two groups in the complexity dimension(P>0.05);After intervention,the score of disease related knowledge in the intervention group was higher than that in the control group,and the difference was statistically significant(P<0.01).Conclusion:The scores of uncertainty in illness among productive age women undergoing hysterectomy with cervical cancer were in the middle level,we should pay more attention to such patients.The patients' score of anxiety was higher score and have a greater impact on the uncertainty in illness,We should give patients with higher state of anxiety positive guidance;The primary caregivers,the scope of the patient's operation,the patients' acceptance of uterine resection,information need and the chance control were the major influencing factors of uncertainty in illness among productive age women undergoing hysterectomy with cervical cancer.It suggested that we should give the patients intervention based on the primary caregivers,the scope of the patient's operation,and the patient's acceptance of uterine resection in clinical nursing work.According to the patients' information needs,we not only give them plenty of disease information support,but also information seeking means.The intervention measures should be taken to the type of patients who was chance control.The standardization quality control circle intervention can reduce the degree of patients' uncertainty in illness and anxiety status,and can improve the patients' knowledge about their disease,which has clinical significance. |
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