目的 了解育龄期乳腺癌患者对子代健康和遗传风险担忧现状及其对癌症诊断前后生育意愿改变的影响。方法 于2019年11月—2020年9月,采用中文版癌症后生育忧虑量表(RCAC)-子女健康亚量表对广州市某三甲医院的230例育龄期乳腺癌患者进行调查,应用SPSS 26.0及PSM插件对结果进行统计分析。在进行子女健康亚量表得分低分组和中高分组患者的生育意愿改变率的比较时,应用倾向性评分匹配法控制混杂因素。结果 育龄期乳腺癌患者对子代健康和遗传风险担忧得分为(11.40±2.99)分;匹配前后不同子女健康亚量表得分分组的患者在癌症诊断前后生育意愿改变率的差异均不具有统计学意义(P>0.05)。结论 育龄期乳腺癌患者对子代健康和遗传风险的担忧虽然没有显著影响其生育意愿的改变,但其对子代健康和遗传风险担忧处于较高水平,临床医护人员应提高对这一现象的重视,可通过多渠道科普相关知识,开展遗传咨询服务以减轻患者的担忧。
Objective To explore the current status of childbearing age breast cancer patients’ concerns about their children’s health and genetic risk and its influence on the change of fertility intention before and after cancer diagnosis.Methods From November 2019 to September 2020,the Chinese version of the Reproductive Concern After Cancer Scale(RCAC)- Children’s Health Sub-scale was used to interview 230 patients with breast cancer of childbearing age in a tertiary hospital in Guangzhou,and SPSS 26.0 and PSM plug-in were used to analyze the results statistically.The propensity score matching method was used to control confounding factors when comparing the change rate of fertility intention of patients with low scores and those with medium and high scores in the children health subscale.Results The score of concern for the health and genetic risk of children in breast cancer patients of childbearing age was(11.40±2.99).There was no statistically significant difference in the change rate of fertility intention before and after cancer diagnosis among patients with different subscale scores of children’s health.Conclusions Despite not significantly impacting fertility intentions,the notably high level of concern regarding children’s health and genetic risks among childbearing-age breast cancer patients necessitates increased clinical awareness.It is recommended that healthcare professionals address this through multi-channel education and genetically focused counseling within a collaborative model to mitigate patient distress.
目的 调查老年人照护服务需求现状并分析其影响因素,为构建基于需求为导向的老年照护服务体系提供参考依据。方法 采用便利抽样法,选取广州市某三甲医院212名老年人作为调查对象,采用日常生活能力量表、Fried衰弱评估量表及自行编制的老年人需求评估问卷进行调查。结果 老年人对运动与营养(1.96±0.90分)、心理慰藉(2.63±0.85分)、安宁服务(2.73±1.07分)的需求水平较高。多因素线性回归分析结果显示养老方式、日常生活活动能力、爱好数量、性别、衰弱等级、有无主要照顾者是照护服务需求的影响因素(P均<0.05),可解释61.5%的变异量。结论 老年人的照护服务需求受多种因素的影响。应根据老年人的不同特征,构建供需匹配的多元化,多层次照护体系。
Objective To investigate the status quo of care service needs of the elderly and analyze its influencing factors,so as to provide a reference for the construction of a needs-oriented care service system for the elderly.Methods A total of 212 elderly people from a tertiary hospital in Guangzhou were selected by convenience sampling method and investigated with the Activity of Daily Living scale,Fried frailty scale and the self-designed elderly needs assessment questionnaire.Results Elderly patients had higher demands for exercise,nutrition,psychological comfort and hospice services.The results of multivariate analysis showed that the influencing factors of care service demand included pension style,activities of daily living,number of hobbies,gender,frailty level,and having main caregivers(all P<0.05),which could explain 61.5% of the variation.Conclusions The care needs of elderly patients are affected by many factors.A diversified and multi-level care system with matching supply and demand should be constructed according to the different characteristics of the elderly.