Analysis of supportive care needs trajectory and influencing factors of bladder cancer patients with urinary stoma during home care
Objective To explore the heterogeneity of supportive care needs trajectoriesin patients with urinary stoma of bladder cancer,and analyze the effects of general demography,disease-related factors,and psychosocial factors on supportive care demand trajectories.Methods From June 2021 to October 2022,patients with bladder canc-er who underwent urostomy in our hospital were selected by convenience sampling method,and the supportive care needs scale for cancer patients was used for longitudinal investigation on the day of discharge(T1),1 month after ostomy(T2),3 months after ostomy(T3),and 6 months after ostomy(T4).The latentcategory growth model was used to identify the trajectory categories of supportive care needs,and the optimal number of clusters was determined by using Akak information index,Bayesian information criterion,entropy,and population interpretability,and its in-fluencing factorswere analyzed by the disordered multi-classification logistic regression.Results A total of 174 pa-tients with bladder cancer completed the study.The total score of supportive care needs of patients showed a down-ward trend in 4 time periods,and the latent variable growth model identified 3 categories of patients'supportive care needs:High-demand slow-decline group(43％),medium-demand rapid-decline group(33％),and low-demand slow-rise group(24％).Multivariate logistic regression analysis showed that compared with the low-demand slow-rise group,patients aged ≥65 years,with high comorbidities,and high fear of disease progression were more likely to enter the high-demand slow-decline group,and patients with high school education and above and high social support were more likely to enter the medium-demand rapid-decline group;Compared with the medium-demand rapid-decline group,patients with low social support and high fear of disease progression were more likely to enter the high-de-mand slow-decline group.Conclusion The supportive care needs of bladder cancer patients with urinary stoma showed a downward trend within 6 months after surgery,and there are significant individual differences.Medical staff should pay attention to the assessment of unmet needs of patients with older age and high comorbidity index,improve the self-care skills of patients during home stay through social support,psychological and cognitive inter-ventions,and enhance confidence,thereby reducingthe emotion of fear of disease progression.
bladder cancerurinary stomasupportive care needstrajectoryinfluencing factors
万方数据
维普
