การดูแลตนเองกับปัจจัยทางจิตวิทยาในคนไข้ชาวจีนที่ใช้โคลอสโตมีแบบถาวร: โมเดลสมการโครงสร้าง Self-care and Psychological Factors in Chinese Patients with Permanent Colostomy: A Structural Equation Modeling
Abstract
บทคัดย่อ วัตถุประสงค์: เพื่อทดสอบความสัมพันธ์ระหว่างการดูแลตนเองกับตัวแปรทางจิตวิทยา ได้แก่ อคติต่อโรค ความเชื่อมั่นในความสามารถแห่งตน และภาวะซึมเศร้า ในคนไข้ที่ใช้ถุงโคลอสโตมีแบบถาวร ในประเทศจีน วิธีการศึกษา: คนไข้ 250 รายที่ใช้ถุงโคลอสโตมีแบบถาวรที่รับการรักษาที่คลินิกของโรคพยาบาลในเมืองหยานเชงประเทศจีนถูกเลือกโดยวิธีสุ่มหลายขั้นตอนในช่วงตุลาคม 2565 ถึงเมษายน 2566 แล้วตอบแบบสอบถามด้านประชากรศาสตร์ ด้านผลกระทบทางสังคม ความเชื่อมั่นแห่งตนต่อการดูแลตนเอง ภาวะซึมเศร้า และ และการดูแลตนเองของคนไข้ที่ใช้ถุงโคลอสโตมี ทดสอบความสัมพันธ์ด้วยโมเดลสมการโครงสร้าง (structural equation modelling; SEM) ผลการศึกษา: โมเดลที่ดัดแปลงแล้วแสดงว่าภาวะซึมเศร้า (β = -0.66, P-value < 0.001) และความเชื่อมั่นแห่งตน (β = 0.42, P-value < 0.001) ผลอิทธิพลโดยตรงต่อการดูแลตนเอง ในขณะที่อคติต่อโรคสัมพันธ์ทางอ้อมกับการดูแลตนเอง โมเดลนี้อธิบายความแปรปรวนได้ร้อยละ 59.1 สรุป: ผลการศึกษาสามารถนำไปสนับสนุนการดูแลตนเองได้โดยการประเมินปัจจัยทางจิตวิทยา เช่น อคติต่อโรค ความเชื่อมั่นแห่งตน และภาวะซึมเศร้า Keywords: การดูแลตนเอง; ปัจจัยทางจิตวิทยา; ถุงโคลอสโตมีแบบถาวร; มะเร็งลำไส้ใหญ่ทวารหนัก; โมเดลสมการโครงสร้าง Abstract Objective: To examine the interrelations among self-care and psychological factors including disease stigma, self-efficacy, and depression in individuals with a permanent colostomy in China. Methods: With a multi-stage random sampling, 250 patients with a permanent colostomy attending the clinics of general hospitals in Yancheng, China, were recruited between October 2022 and April 2023. Participants completed the questionnaires of demographic characteristics, Social Impact Scale (SIS), Ostomy Self-care Self-efficacy Scale, Self-rating Depression Scale (SDS), and Ostomy Self-Care Index (OSCI). Associations were tested using structural equation modelling (SEM). Results: The final modified model's outcomes indicated that depression (β = -0.66, P-value < 0.001) and self-efficacy (β = 0.42, P-value < 0.001) directly influenced self-care, whereas disease stigma was indirectly correlated with self-care. This model accounted for 59.1% of the total variance. Conclusion: To enhance self-care among patients with a permanent colostomy, comprehensive interventions that address psychological factors such as disease stigma, self-efficacy, and depression are essential. Keywords: self-care; psychological factors; permanent colostomy; colorectal cancer; structural equation modellingDownloads
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