Objective: To study the quality of life and its influencing factors of patients with deep partial-thickness and above burns on head and face at discharge, and to guide clinical nurses to provide targeted nursing for patients. Methods: A cross-sectional survey was conducted on 42 patients with deep partial-thickness and above burns on head and face who met the inclusion criteria. The patients were hospitalized from January 2014 to November 2017 in the Department of Burns and Plastic Surgery of our hospital and were selected by adopting the convenient sampling method. On the day before discharge, the Chinese version of the Abbreviated Burn Specific Health Scale was used to assess the scores in various fields of patients' quality of life and total scores. The self-designed general situation questionnaire was used to investigate the gender, age, education level, occupation, marital status, cause of injury, and source of expenses of patients, and the scores in various fields of quality of life of patients in various general conditions and total scores were recorded. Data were processed with t test or one-way analysis of variance. The indicators with statistically significance in the total score difference in the above analysis were chosen, and multivariate linear regression analysis was performed to screen the factors influencing the quality of life of patients. Results: Totally 42 groups of questionnaires were sent out and 42 groups of valid questionnaires were retrieved. The effective recovery rate was 100%. The total score of quality of life of patients at discharge was (49±10) points. The scores of general health status (57±23) points, social relations (56±18) points, physical function (49±17) points, and mental health (41±20) points were ranked from high to low. There were statistically significant differences in the scores of physical function, mental health, and general health status among patients of different age groups (F=8.115, 14.182, 19.285, P<0.01). There were statistically significant differences in the scores of mental health, social relations, and general health status among patients with different educational levels (F=3.312, 51.176, 21.852, P<0.05 or P<0.01). There were statistically significant differences in the scores of mental health and general health status among patients with different occupations (F=3.667, 2.947, P<0.05). The scores of mental health and social relations of married patients were significantly higher than those of unmarried patients (t=27.096, 4.885, P<0.05 or P<0.01). There were statistically significant differences in the scores of physical function, mental health, social relations, general health status of patients with different causes of injury (F=3.000, 5.438, 4.005, 9.125, P<0.05 or P<0.01). There were statistically significant differences in the scores of mental health and general health status of patients with different sources of expenses (F=10.456, 3.368, P<0.05 or P<0.01). The total scores of quality of life of patients with different gender and causes of injury were similar (t=0.407, F=1.145, P>0.05); there were statistically significant differences in the total scores of quality of life of patients of different age groups, with different education levels, occupations, sources of expenses, and marital status (F=2.947, 17.064, 9.324, 4.101, t=7.225, P<0.05 or P<0.01). Multivariate linear regression analysis showed that age, education level, occupation, marital status, and source of expenses were the factors influencing the quality of life of patients at discharge (t=-2.437, 8.037, -2.994, 5.016, 3.519, P<0.05 or P<0.01). Conclusions: The quality of life of patients with deep partial-thickness and above burns on head and face is at a low level at discharge. The influencing factors include age, education level, occupation, marital status, and source of expenses. Nurses should screen the relevant items when the patient is hospitalized. Emphasis should be laid on young, with undergraduate and above education, unmarried, self-funded patients, and those engaged in occupations with high facial requirements, to minimize the negative mood of patients, encourage them to face life, choose the right career, and improve their quality of life.
目的:了解头面部深Ⅱ度及以上烧伤患者出院时生命质量及其影响因素,指导临床护士为患者提供针对性护理。 方法:采用便利抽样法,选取笔者单位烧伤整形科2014年1月—2017年11月收治的符合入选标准的42例头面部深Ⅱ度及以上烧伤住院患者,进行横断面调查。在出院前一日,采用简明烧伤专用健康量表中文版评估患者生命质量各领域得分及总分;采用自行设计的一般情况调查问卷调查患者性别、年龄、文化程度、职业、婚姻状况、受伤原因、费用来源,统计各一般情况患者生命质量各领域得分及总分,对数据行t检验或单因素方差分析。选取前述分析中总分差异有统计学意义的指标,行多元线性回归分析,筛选患者生命质量影响因素。 结果:本次共发放问卷42组,收回有效问卷42组,有效回收率为100%。本组患者出院时生命质量总分为(49±10)分,各领域得分从高到低排列依次为一般健康状况(57±23)分、社会关系(56±18)分、躯体功能(49±17)分、心理健康(41±20)分。不同年龄段患者躯体功能、心理健康、一般健康状况得分比较,差异有统计学意义(F=8.115、14.182、19.285,P<0.01);不同文化程度患者心理健康、社会关系、一般健康状况得分比较,差异有统计学意义(F=3.312、51.176、21.852,P<0.05或P<0.01);不同职业患者心理健康和一般健康状况得分比较,差异有统计学意义(F=3.667、2.947,P<0.05);已婚患者心理健康和社会关系得分明显高于未婚患者(t=27.096、4.885,P<0.05或P<0.01);不同受伤原因患者躯体功能、心理健康、社会关系、一般健康状况得分比较,差异有统计学意义(F=3.000、5.438、4.005、9.125,P<0.05或P<0.01);不同费用来源患者心理健康和一般健康状况得分比较,差异有统计学意义(F=10.456、3.368, P<0.05或P<0.01)。不同性别、受伤原因患者的生命质量总分相近(t=0.407,F=1.145,P>0.05);不同年龄段、文化程度、职业、费用来源、婚姻状况患者的生命质量总分比较,差异均有统计学意义(F=2.947、17.064、9.324、4.101,t=7.225,P<0.05或P<0.01)。多元线性回归分析显示,年龄、文化程度、职业、婚姻状况、费用来源均是患者出院时生命质量的影响因素(t=-2.437、8.037、-2.994、5.016、3.519,P<0.05或P<0.01)。 结论:头面部深Ⅱ度及以上烧伤患者出院时的生命质量处于较低水平,其影响因素包括年龄、文化程度、职业、婚姻状况、费用来源。护士应在患者住院时进行相关项目的筛查,重点关注青年、大学本科及以上学历、未婚、自费及从事对面部要求高职业的患者,将患者不良情绪降至最低,鼓励其勇敢面对生活,选择合适的职业,提高其生命质量。.
Keywords: Burns; Cross-sectional studies; Face; Head; Influencing factors; Quality of life.