Dignity Status And Its Influencing Factors In Patients Of Bladder Cancer With Urostomy

ObjectiveTo investigate dignity of bladder cancer patients with urostomy.To analyze the influencing factors of dignity of bladder cancer patients with urostomy.which provided the basis to help the clinical nursing staff to find appropriate intervention points,to formulate personalized nursing intervention measures to reduce the damage to dignity.MethodThis study is a cross-sectional study,using convenience sampling method from January 2022 to August 2022,156 bladder cancer patients with urostomy in the urinary surgery inpatient department and outpatient department of two tertiary hospitals in Da Lian were selected as the research objects.The general information questionnaire,Patient Dignity Inventory(PDI),Mishel Uncertainty in Illness Scale for Adult(MUIS-A),Personal Mastery Scale(PMS),Hospital Anxiety and Depression Scale(HADS)and Social Support Rating Scale(SSRS)were used to investigate.The data were logged by two persons in Excel and analyzed by SPSS 26.0 software.The analysis methods included descriptive statistics,t-test(Secondary variable),univariate analysis of variance(Multiclass variable),Pearson correlation analysis(continuous variable to continuous variable)and multiple linear regression analysis,with α=0.05 included andα=0.10 excluded as the rule.Results1.The total score of dignity of bladder cancer patients with urostomy was(71.79±17.71),The scores of each dimension from high to low were: Existential Distress(18.29 ± 5.61),Symptom Distress(17.71 ± 4.69),Dependency(8.01 ± 2.52),Peace of Mind(7.76 ± 3.06),and Social Support(7.47 ± 2.79).The degree of dignity lose in 156 bladder cancer patients with urostomy,with 20 patients(12.8%)with mild dignity lose,66 patients(42.3%)with moderate dignity lose,62 patients(39.7%)with severe dignity lose and 8 patients(5.1%)with very severe dignity lose.2.The total score of uncertainty in illness in 156 bladder cancer patients with urostomy was(68.74 ± 18.80),the mark of complexity dimensionality was(25.45 ±7.49),and the mark of uncertainty dimensionality was(43.29 ± 12.52).Total score of personal mastery(21.02 ± 5.66).The total mark of anxiety and depression was(22.38 ±8.56),the score of anxiety was(11.22 ± 4.45),and the score of depression was(11.16 ±4.77).The total score of social support was(35.94±7.71),The mark of each dimensionality from high to low were: subjective support(18.09 ± 3.82),objective support(10.72 ± 2.88),and support utilization(7.13 ± 1.89).3.The results of single factor analysis showed that,the level of dignity in bladder cancer patients with urostomy with different gender,age,education level,self-perceived family financial burden,implementation time of ostomy,self-care degree of ostomy were statistically significant(P<0.05).Pearson correlation analysis exhibited that the total score of uncertainty in illness and all dimensions was positively correlated with the loss of dignity(r=0.760,P<0.001),the total score of personal mastery was negatively correlated with the loss of dignity(r=-0.784,P<0.001),the total score of anxiety and depression and all dimensions was positively correlated with the loss of dignity(r=0.776,P<0.001),and social support and all dimensions were negatively correlated with the loss of dignity(r=-0.845,P<0.001).4.The results of multivariate analysis showed that age,time after ostomy,self-care degree,uncertainty in illness,personal mastery,anxiety and depression and social support of bladder cancer patients with urostomy entered the regression equation,which interpreted 86.5% of the total variance.Conclusion1.The dignity of bladder cancer patients with urostomy was at the moderate level,with the highest level of existential distress.2.The level of uncertainty in illness,personal mastery,anxiety and depression of bladder cancer patients with urostomy was moderate;The level of social support was moderate,the support degree of subjective was the highest,while objective support and support utilization was low.Uncertainty in illness,anxiety and depression have a positive predictive effect on the degree of dignity impairment,while personal mastery and social support have a negative predictive effect on the degree of dignity impairment.Therefore,improving the level of personal mastery and social support of bladder cancer patients with urostomy,and reducing the level of uncertainty in illness,anxiety and depression of patients will alleviate the degree of dignity impairment of patients.3.The main influencing factors of the level of dignity include age,time of ostomy,self-care degree,uncertainty in illness,personal mastery,anxiety and depression and social support of bladder cancer patients with urostomy.