| BackgroundEsophageal carcinoma is a common digestive tract tumor.The early symptoms are often not obvious.Its typical symptom in the middle and late stage is progressive dysphagia.Comprehensive surgical treatment is one important method to cure EC.Owing to some symptoms after radical esophagectomy,combined with the disease itself and surgery to patients with psychological stress,the subjective well-being of patients after the operation will have a serious impact.Confronce is a process,by which oneself is able to adapt or get rid of a difficult situation.Hope is a kind of motivation and energy,both of which can effectively help individuals to overcome difficulties,and to encourage patients to achieve their life goals.They can also improve their physiological and psychological health condition,thereby affecting their subjective well-being.ObjectiveThis project is aim to understand the status of subjective well-being of patients after radical esophagectomy and analyze the relationship among their subjective well-being and their hope level and coping style,to explore the influencing factors of their subjective well-being,so as to provide theoretical basis for improving their subjective well-being.Methods221 reexamed patients who with radical esophagectomy(>1month)from a department of Thoracic Surgery in two tertiary hospitals in Henan Province were selected as subjects during October 2016 to September 2017.The research tools include four parts:(1)The General Information Questionnaire: mainly includes the sociodemographic data such as sex,age,place of residence,marital status and clinical data such as postoperative time,basic diseases and pathological types;(2)Herth Hope Scale(HHI): The scale consists of three dimensions: the temporality and future,positive readiness and expectancy,interconnectedness and 12 items;(3)Medical Coping Modes Questionnaire(MCMQ): The scale consists of three dimensions: confronce,avoidance,resignation and 20 items;(4)General Well-Being Schedule(GWB): The scale consists of six factors: satisfaction and interest in life,energy,health concerns,melancholy or happy mood,relaxation and tension,and 18 items.The investigators distributed the questionnaires to the patients.After completing the questionnaires,the questionnaires were completed and collected.The data were statistically analyzed by SPSS 19.0 software and Excel 2010 software.Statistical methods included single-sample t-test,independent sample t-test,analysis of variance,pearson correlation analysis and step-wise multiple linear regression analysis.Results1.The status of subjective well-being of patients after radical esophagectomy The score of subjective well-being of patients after radical esophagectomy was(74.09±7.04),while the data in male patients(75.54±6.33)was lower than that in normal subjects(42.5%),while that in female patients(70.82±7.48)was lower than that in normal subjects(45.6%).There was no significant difference between male patients and norm or female patients and norm(P>0.05).The scores in six dimensions of satisfaction or interest in life,energy,health concerns,melancholy or happy mood,relaxation and tension,and emotional and behavioral control were(7.04±1.64),(17.44±2.84),(5.83±1.47),(15.02± 2.32),(16.90±2.29)and(11.86±1.45)respectively.2.The score of hope level of patients after radical esophagectomy The total score of hope for patients after esophagectomy is(38.08±3.62),and the overall level is at a medium high level.Among them,low hope level is 0.5%,medium hope level is 20.4%,high hope level is 79.2%.The scores of 3 dimensions of attitude dimension,action dimension and relationship dimension were(12.36±1.75),(12.69±1.27)and(13.03±1.59)respectively.3.The score of coping style of patients after radical esophagectomy The score of three dimensions which were confronce,avoidance and resignation with patients after radical esophagectomy were(17.01±3.03),(14.67±2.40)and(8.47±2.20)respectively.The score of confronce and resignation dimensions are lower than the norm,and the difference was significant(P<0.05);There was no significant difference between avoidance dimension and norm(P>0.05).4.The relationship among subjective well-being,hope level and coping style of the patients after radical esophagectomy There was a significant positive correlation between the level of hope and the subjective well-being in patients after radical esophagectomy(r=0.618,P<0.01);The three dimensions of attitude,action and relationship were positively correlated with subjective well-being(r=0.498,r=0.326,r=0.599,P<0.01).There was a significant negative correlation between subjective well-being and the dimension of confronce in coping style(r=-0.533,P<0.01);There was no significant correlation between subjective well-being and the two dimensions of confronce and avoidance(r=0.074,r=-0.084,P>0.05).5.Factors affecting subjective well-being of patients after radical esophagectomy The single factor analysis of variance showed that the subjective well-being of patients after radical esophagectomy had different effects on the subjective well-being of patients with different sex,age,educational level,percapita monthly income,and with or without radiation therapy,and the difference was statistically significant(P<0.05).The step-wise multiple linear regression analysis showed that the hope level,the dimension of resignation,sex and age entered the regression equation which with subjective well-being as dependent variables,and a total of 51.2% of the variation in subjective well-being was explained(P<0.05).Conclusions1.The subjective well-being of patients who have undergone radical esophagectomy is not ideal.The main factors affecting their subjective well-being are hope level,the dimension of resignation,sex and age.2.The hope level of patients who have undergone radical esophagectomyis at a medium high level,and it can improve their subjective well-being.3.The coping style of patients who have undergone radical esophagectomy should be improved,and choosing active coping style can improve their subjective well-being. |
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