摘要
目的了解由随访转手术治疗的甲状腺微小乳头状癌(PTMC)患者医师信任现状,并分析其影响因素。方法选取由随访转手术治疗的PTMC患者140例进行研究。患者住院前曾确诊为PTMC,经监测符合疾病进展标准并行手术治疗,术后病理检查证实为甲状腺乳头状癌。采用维克森林医师信任量表(WF-PTS)评价患者对医师的信任水平。采用问卷调查收集患者的一般社会人口学资料、治疗相关资料、患者对疾病进展的恐惧心理程度[中文版恐惧疾病进展简化量表(FoP-Q-SF)]、患者治疗决策冲突情况[中文版治疗决策冲突量表(DCS)]。采用多元线性回归分析医师信任水平的影响因素。结果本组患者WF-PTS评分为(29.36±5.16)分,处于中等水平。单因素分析结果显示,以往住院经历、术前随访时间、是否有淋巴结转移、手术方式、术后有无并发症是影响医师信任水平的因素(P均<0.05)。由随访转手术治疗的PTMC患者医师信任水平与恐惧疾病进展程度及治疗决策冲突水平呈负相关(r分别为-0.718、-0.710,P均<0.05)。以WF-PTS评分为因变量,以以往住院经历、术前随访时间、是否有淋巴结转移、手术方式、术后有无并发症、FoP-Q-SF评分及DCS评分为自变量,采用逐步法进行多元线性回归分析,结果显示,FoP-Q-SF评分、DCS评分、是否有淋巴结转移及术后有无并发症是由随访转手术治疗的PTMC患者医师信任水平的独立影响因素(P均<0.05)。结论由随访转手术治疗的PTMC患者医师信任水平有待进一步改善;FoP-Q-SF评分、DCS评分、是否有淋巴结转移及术后有无并发症是由随访转手术治疗的PTMC患者医师信任水平的独立影响因素。
Objective To understand the current status of physician trust among patients with papillary thyroid microcarcinoma(PTMC)who were converted from follow-up to surgical treatment,and to analyze its influencing factors.Methods A total of 140 patients with PTMC who were converted from follow-up to surgical treatment were selected for the study.These patients were diagnosed with PTMC before hospitalization,and met the disease progression criteria during monitoring and underwent surgical treatment.The postoperative pathology confirmed papillary thyroid carcinoma.The Wake Forest Physician Trust Scale(WF-PTS)was used to evaluate the patients'trust in their physicians.Questionnaires were used to collect patients'general sociodemographic data,treatment-related information,the degree of fear of disease progression[Chinese version of the Fear of Progression Questionnaire-Short Form(FoP-Q-SF)],and the situation of treatment decision-making conflicts[Chinese version of the Decision Conflict Scale(DCS)].Multiple linear regression analysis was conducted to analyze the influencing factors of the level of trust in physicians.Results The WF-PTS score of this group of patients was(29.36±5.16)points,which was at a medium level.The results of univariate analysis showed that previous hospitalization experience,preoperative follow-up time,presence or absence of lymph node metastasis,surgical method,and postoperative complications were factors influencing the level of trust in physicians(all P<0.05).The level of trust in physicians of PTMC patients who were converted from follow-up to surgery was negatively correlated with the degree of fear of disease progression and the level of treatment decision conflict(r=−0.718 and−0.710,respectively;all P<0.05).Taking the WF-PTS score as the dependent variable and previous hospitalization experience,preoperative followup time,presence or absence of lymph node metastasis,surgical method,postoperative complications,FoP-Q-SF score,and DCS score as independent variables,multiple linear regression analysis was conducted using the stepwise method.The results showed that FoP-Q-SF score,DCS score,presence or absence of lymph node metastasis,and postoperative complications were independent influencing factors of the level of trust in physicians of PTMC patients who were converted from follow-up to surgery(all P<0.05).Conclusions The physician trust level of PTMC patients converted from followup to surgical treatment needs further improvement.The FoP-Q-SF score,DCS score,presence or absence of lymph node metastasis,and whether there are postoperative complications are independent influencing factors of physician trust in PTMC patients converted from follow-up to surgical treatment.
作者
刘洁
韩鹏
隋芳
闫金凤
周翠萍
LIU Jie;HAN Peng;SUI Fang;YAN Jinfeng;ZHOU Cuiping(Department of Otolaryngology Head and Neck Surgery,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)
出处
《山东医药》
2025年第12期76-80,共5页
Shandong Medical Journal
基金
陕西省自然科学基础研究基金项目(2022JQ-834)。
关键词
随访转手术治疗
甲状腺微小乳头状癌
甲状腺乳头状癌
维克森林医师信任量表
恐惧疾病进展简化量表
治疗决策冲突量表
淋巴结转移
手术并发症
conversion from follow-up to surgical treatment
papillary thyroid microcarcinoma
papillary thyroid carcinoma
Wake Forest Physician Trust Scale
Fear of Progression Questionnaire-Short Form
Decision Conflict Scale
lymph node metastasis
surgical complications
