目的 调查结直肠癌术后患者久坐行为现状及影响因素。方法 选取2023年3月至2025年3月淮安市第二人民医院收治的结直肠癌术后患者190例作为研究对象,使用一般资料调查、国际体力活动问卷(IPAQ)、抑郁自评量表(SDS)、焦虑自评量表(SAS)、社会支持评定量表(SSRS)、营养风险筛查2002(NRS 2002)、数字疼痛评定量表(NRS)和癌因性疲乏量表(CFS)进行调查,通过单因素及多因素Logistic回归分析患者结直肠癌患者久坐行为的影响因素。结果 本次研究发放190份问卷,回收186份(97.89%),其中存在久坐行为112例(60.22%)。Logistic回归分析结果表明无配偶(OR=2.472, 95%CI=1.503~4.067,P<0.001)、3种及以上慢性病(OR=2.440,95%CI=1.925~3.093,P<0.001)、TNM分期Ⅲ期(OR=2.680,95%CI=1.420~5.058,P=0.001)、肿瘤组织学分化程度低(OR=2.214,95%CI=1.788~2.742,P<0.01)、永久性造口(OR=2.401, 95%CI=1.748~3.299,P<0.001)、化疗(OR=2.423,95%CI=1.686~3.482,P<0.001)、有造口并发症(OR=3.080,95%CI=1.616~5.870,P<0.001)是久坐行为的独立危险因素,抑郁状态[SDS高评分(OR=2.192,95%CI=1.487~3.232,P<0.001)]、焦虑状态[SAS高评分(OR=2.230,95%CI=1.177~4.225,P<0.05)]、疼痛[NRS高评分(OR=2.044,95%CI=1.308~3.196,P<0.05)]、癌因性疲乏[CFS高评分(OR=2.512,95%CI=1.591~3.966,P<0.001)]也是久坐行为的独立危险因素;社会支持[SSRS高评分(OR=0.378, 95%CI=0.172~0.830,P<0.05)]是久坐行为的独立保护因素(P＜0.05)。结论 结直肠癌术后患者久坐行为普遍存在,患者的婚姻状况、既往慢性病、肿瘤分期和分化程度、接受化疗、造口及并发症是导致久坐行为的危险因素,抑郁、焦虑、疼痛评分及高癌因性疲乏也是患者久坐行为的独立危险因素。而较高的社会支持度则可减少久坐行为。针对以上因素制订综合干预策略,有助于减少久坐行为,改善预后。
Abstract
Objective To investigate the status of sedentary behavior and its underlying risk factors in postoperative colorectal cancer patients. Method A total of 190 postoperative colorectal cancer patients diagnosed at Huai'an Second People's Hospital between March 2023 and March 2025 were included in the present study. Data were collected using the following instruments: a general information questionnaire, the international physical activity questionnaire (IPAQ), the self-rating depression scale (SDS), the self-rating anxiety scale (SAS), the social support rating scale (SSRS), the nutritional risk screening 2002 (NRS 2002), the numeric rating scale (NRS) for pain, and the cancer fatigue scale (CFS). Logistic regression analysis was employed to identify the factors regarding sedentary behavior in these patients. Result Of the 190 questionnaires distributed, 186 were returned(97.89%). Of them, 112 (60.22%) exhibited sedentary behavior. according to the results of logistic regression analysis, it was revealed that unmarried (OR=2.472,95%CI=1.503-4.067,P<0.001), with 3 or more type of chronic diseases (OR=2.440,95%CI=1.925-3.093,P<0.001), stage Ⅲ (OR=2.680,95%CI=1.420-5.058,P=0.001), with poor differentiation tumor (OR=2.214,95%CI=1.788-2.742,P<0.01), with a permanent stoma (OR=2.401,95%CI=1.748-3.299,P<0.001), receiving chemotherapy (OR=2.423,95%CI= 1.686-3.482,P<0.001), with stoma complications (OR=3.080,95%CI=1.616-5.870,P<0.001), higher SDS score (depression) (OR=2.192,95%CI=1.487-3.232,P<0.001), higher SAS score (anxiety) (OR=2.230,95%CI=1.177-4.225,P<0.05), higher NRS score (pain) (OR=2.044,95%CI= 1.308-3.196,P<0.05), and higher CFS score (cancer-related fatigue) (OR=2.512,95%CI=1.591-3.966,P<0.001). Higher SSRS score (social support) was identified as an independent protective factor (OR=0.378,95%CI=0.172-0.830,P<0.05). Conclusion Sedentary behavior is prevalent in postoperative colorectal cancer patients. Being unmarried, chronic disease history, tumor stage and differentiation, with a permanent stoma and related complications, chemotherapy, depression, anxiety, pain, cancer-related fatigue (CFS) score are revealed as the independent risk factors for sedentary behavior. Social support is identified as the protective factor. Comprehensive intervention strategies targeting these factors could help mitigate sedentary behavior and promote prognosis in patients with postoperative colorectal cancer.
关键词
结直肠癌 /
术后 /
久坐行为 /
焦虑 /
抑郁 /
社会支持 /
癌因性疲乏 /
危险因素
Key words
Colorectal cancer /
Postoperative /
Sedentary behavior /
Anxiety /
Depression /
Social support /
Cancer fatigue scale /
Risk factors
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