Exploring Self-management Efficacy And Its Influencing Factors In Patients With Primary Liver Cancer After Hepatectomy

ObjectivesTo investigate the status and self-management efficacy in patients with primary liver cancer after hepatectomy.To analyze the difference of self-management efficacy among patients with primary liver cancer after hepatectomy with different demographic characteristics.To analyze the correlation between self-management efficacy,social support and illness uncertainty.To find out the influencing factors of self-management efficacy for patients with primary liver cancer after operation.Methods1.Using convenient sampling method,258 patients with primary hepatocellular carcinoma were treated with hepatectomy in the Department of Hepatobiliary Surgery,First Affiliated Hospital of Anhui Medical University from January 2015 to July 2017,after obtaining their informed consent,the investigators sent out general information questionnaire,Social Support Rating Scale(SSRS),Mishel Uncertainty in Illness Scale for Adult(MUIS-A)and s Strategies Used by Patients to Promote Health(SUPPH)to investigate.A total of 270 questionnaires were sent out and 266 questionnaires were recovered.Among them,258 valid questionnaires were valid(8 questionnaires with missing values of 3 items or more were excluded),and the effective recovery rate was97.0%.2.Epidata 3.1 was used for inputting data,and SPSS23.0 software was used for statistical analysis.Enumeration data were calculated by frequency and percentile.The scores of social support,illness uncertainty and self-management efficacy were described by x±s.Two independent sample t test was used for the comparison of social support score,disease uncertainty score and self-management efficacy score between the two groups.The scores of social support,disease uncertainty and self-management efficacy of patients in the three groups and above were compared by ANOVA analysis.Pearson correlation analysis was used to analyze the correlation among self-management efficacy,social support and illness uncertainty.Multivariate linear regression analysis was used to screen variables related to self-management efficacy.Results1.The total score of self-management efficacy in patients with primary liver cancer after hepatectomy was(88.06±20.51).The scores of self-decompression,self-decision and positive attitude were(31.14±7.37),(9.30±2.53),(47.62±11.59),respectively,which were in the middle level.2.The results of one-way ANOVA analysis showed that there were significant differences in self-management efficacy among patients with primary liver cancer after hepatectomy in different marital status,educational level,family location,medical insurance type,family history of liver cancer,previous history of hepatitis and tumor numbers(P<0.05).3.Correlation analysis results showed that the total score of social support and its dimensions were positively correlated with the total score and dimensions of self-management efficacy(r=0.318~0.517,P<0.05).The total score and each dimension of illness uncertainty were negatively correlated with the total score and each dimension of self-management efficacy(r=-0.312~-0.632,P<0.05).4.Multivariate regression analysis showed that the type of medical insurance,family history of liver cancer,previous history of hepatitis,number of tumors,social support and illness uncertainty were the main factors affecting self-management efficacy(F=18.001,P<0.001,R~2=0.529).These variables could explain 52.9%of the total variation of self-management efficacy.ConclusionsThe self-management efficacy of patients with primary liver cancer after hepatectomy is at a moderate level.The main influencing factors include the type of medical insurance,family history of liver cancer,previous history of hepatitis,the number of tumors,social support and the level of illness uncertainty.Medical staff can formulate personalized interventions from social,physiological and psychological aspects in view of the above results.To improve the self-management level of the patients and improve the quality of life of the patients with primary liver cancer after hepatectomy.