广西医学

目的调查结直肠癌幸存者社会疏离现状并分析其影响因素。方法选取220例结直肠癌幸存者作为研究对象，采用一般资料调查表、结直肠癌幸存者社会疏离感量表、D型人格量表（DS14）、家庭抗逆力评定量表（FHI）及家庭功能评估量表（APGAR）对患者进行问卷调查。比较不同特征的结直肠癌幸存者社会疏离水平，采用多重线性回归模型分析结直肠癌幸存者社会疏离的影响因素。结果结直肠癌幸存者的社会疏离感量表总分为53.00（41.00，66.00）分，DS14总分为18.00（12.00，23.00）分，APGAR总分为6.00（5.00，8.00）分，FHI总分为54.00（49.00，63.00）分。不同性别、居住地、婚姻状况、肿瘤位置、放化疗情况、肠造口情况的结直肠癌幸存者的社会疏离感量表总分比较，差异有统计学意义（P<0.05）。Spearman相关性分析结果显示，结直肠癌幸存者社会疏离感量表总分与DS14总分呈正相关，与APGAR总分、FHI总分呈负相关（P<0.05）。多重线性回归分析结果显示，性别、居住地、婚姻状况、肿瘤位置、放化疗情况、肠造口情况、DS14总分、APGAR总分、FHI总分是结直肠癌幸存者社会疏离的影响因素（P<0.05）。结论结直肠癌幸存者社会疏离呈中等偏上水平，医护人员应重点关注女性、居住在农村地区、独居/离异/丧偶、病变部位在直肠、行放化疗、有肠造口、存在D型人格、家庭功能差和家庭抗逆力低的结直肠癌幸存者，制定个性化干预策略以降低其社会疏离水平。

Objective To investigate the current status of social alienation in colorectal cancer survivors, and to analyze its influencing factors. Methods A total of 220 colorectal cancer survivors were selected as the research subjects. A questionnaire survey was conducted using the general information questionnaire, the social alienation scale of colorectal cancer survivors, the Type D Personality Scale⁃14 (DS14), the Family Hardiness Index (FHI), and the Family Adaption, Partnership, Growth, Affection, and Resolve Index (APGAR). The social alienation levels of colorectal cancer survivors with different characteristics were compared, and a multiple linear regression model was adopted to analyze the influencing factors for social alienation among colorectal cancer survivors. Results The total scores of social alienation scale of colorectal cancer survivors were 53.00 (41.00, 66.00), DS14 18.00 (12.00, 23.00), APGAR 6.00 (5.00, 8.00) and FHI 54.00 (49.00, 63.00). There was a statistically significant difference in the total score of social alienation scale of colorectal cancer survivors with different gender, residence, marital status, tumor location, radiotherapy and chemotherapy conditions, and enterostomy conditions (P<0.05). The results of Spearman correlation analysis revealed that the total score of social alienation scale of colorectal cancer survivors positively correlated with the total score of DS14, whereas negatively correlated with the total scores of APGAR and FHI (P<0.05). The results of multiple linear regression analysis indicated that gender, residence, marital status, tumor location, radiotherapy and chemotherapy conditions, enterostomy conditions, DS14 total score, APGAR total score, and FHI total score were the influencing factors for social alienation of colorectal cancer survivors (P<0.05). Conclusion The social alienation of colorectal cancer survivors is above the medium level. Medical and nursing personnel should focus on colorectal cancer survivors who are female, living in rural areas, living alone/divorced/widowed, with lesions in the rectum, receiving radiotherapy and chemotherapy, with enterostomy, with type D personality, poor family function and low family resilience, and formulate personalized intervention strategies to reduce their social alienation levels.