Objective To investigate current status and influencing factors of patient delay in patients with advanced hepatocellular carcinoma and provide a theoretical evidence for the early diagnosis of HCC. Methods All patients with a primary diagnosis of advanced HCC admitted at Department of Hepatobiliary Medicine I, Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University from January 2015 to October 2015 were investigated prospectively. The current status of patient delay was assessed by medical records and influencing factors of patient delay were analyzed by the self-designed questionnaires. Results Rate of patient delay in the patients with advanced HCC was 27.7%(53/191). The univariate analysis demonstrated that significant influencing factors for patient delay included age, education levels, economic status, place of residence, medical insurance, knowledge about follow-up examination for chronic viral hepatitis. The rate of patient delay was high in these patients with older age, lower income, less education, place of residence (countryside or small towns), new rural insurance, lack of the knowledge about follow-up examination for chronic viral hepatitis. Multivariate analysis showed that age and lack of the knowledge about follow-up examination for chronic viral hepatitis were significantly independent predictors for patient delay. Their OR (odd ratio) and 95%CI (confidence interval) were 2.770 and 1.424-5.388, 7.867 and 1.669-37.092, respectively. According to place of residence, the univariate analysis demonstrated that significant influencing factors for patient delay included marital status, age, economic status, and knowledge about follow-up examination for chronic viral hepatitis in the countryside or small towns. Multivariate analysis also further showed that age and lack of the knowledge about follow-up examination for chronic viral hepatitis were significantly independent predictors for patient delay. Their OR and 95% CI were 3.812 and 1.550-9.373, 15.400 and 1.793-132.245, respectively. Patient delay of HCC patients in county seat and city was not significantly associated with all of above mentioned influencing factors. Conclusions Patient delay of the patients with advanced HCC in countryside or small towns was comparatively common. To early find high risk factors of HCC, government should be intensified screening to chronic hepatitis B, hepatitis C in the middle and elderly population. To reduce the rate of patient delay in advanced HCC and improve results of treatment for advanced HCC, health care workers should popularize medicine-associated knowledge, especially about chronic hepatitis and its complications.

Objective:To investigate the attitude to death of oncology nurses and analysis its influencing factors,so as to provide scientific references and basis for care of the dying patients.Methods:A convenience sampling method was used to 309 nurses from Eastern Hepatobiliary Surgery Hospital,the Third Affiliated Hospital of Naval Military Medical University.The survey was conducted by filling in the electronic questionnaire which powered by sojump.com. The questionnaire was composed with a demographic survey and Chinese version Death Attitude Profile-Revised.Results:In the five dimensions of Death Attitude Profile-Revised,the highest factor score was in Approach Acceptance(3.56±0.74),the second was in Escape Acceptance(3.54±0.85) and the lowest was in Natural Acceptance(2.30±0.53).There was a statistically significant difference in the number of years of work in Nautral Acceptance( F value was 3.400, P<0.05).Parents with or without religious beliefs had statistically significant differences in Death of Avoidance( t value was 6.207, P<0.05). Consciously aware that the current physical condition was statistically different from Approach Acceptance and Escape Acceptance( F value was 3.494, 2.606, all P<0.05).Consciously the current psychological status was statistically different in Death Fear and Approach Acceptance and Escape Acceptance( F value was 3.381, 3.125, 3.911, all P<0.05).The situation of talking death in the family was statistically different between Death Fear and Death of Avoidance ( F value was 2.899, 2.762, all P<0.05).There was a statistically significant difference in Death Fear and Death of Avoidance and Death Education ( F value was 3.581, 5.336, all P<0.05). Conclusions:The attitude to death in 309 oncology nurses is relatively passive.The main influencing factors are work experience and parents with or without religious beliefs and the situation of talking death in the family physiology and psychology conditions,whether or not receive death education.