鼻咽癌患者自我效能、生命意义、心理弹性和工作与社会适应障碍的关系

The relationship between self-efficacy,meaning of life,resilience,and work and social adjustment in patients with nasopharyngeal carcinoma

目的探讨鼻咽癌患者自我效能、生命意义和工作与社会适应障碍(WSA)之间的关系,并分析心理弹性的中介作用,为提高鼻咽癌患者心理健康水平及制定鼻咽癌患者心理健康相关的干预策略提供理论依据。方法采用一般自我效能量表(GSES)、心理弹性量表(CD-RISC10)、生命意义感量表(MLQ)、工作与社会适应量表(WSAS)以及社会人口学问卷对广州市的鼻咽癌患者进行调查。结果本研究共纳入773例鼻咽癌患者,男性535人占69.2%,平均年龄为(47.16±11.54)岁。单因素分析结果显示,教育水平、家庭平均月收入和是否复发是WSA的影响因素。相关性分析结果显示,WSA得分和自我效能(r=-0.238,P<0.001)、生命意义(r=-0.256,P<0.001)、心理弹性(r=-0.270,P<0.001)均呈负相关。控制了显著背景变量后,中介效应模型结果显示,心理弹性是生命意义和自我效能与WSA关系的中介变量:在生命意义与WSA的关系中,总效应值为-1.931(95%CI:-2.487,-1.375),直接效应值为-1.525(95%CI:-2.088,-0.961),间接效应值为-0.407(95%CI:-0.616,-0.229),中介效应值为21.1%;在自我效能和WSA的关系中,总效应值为-0.347(95%CI:-0.460,-0.235),直接效应值为-0.191(95%CI:-0.320,-0.061),间接效应值为-0.157(95%CI:-0.233,-0.086),中介效应值为44.1%。结论心理弹性部分中介了自我效能、生命意义对工作与社会适应障碍的作用。

Objective The purpose of this study was to investigate the relationship between self-efficacy,meaning of life and work and social adjustment(WSA)in patients with nasopharyngeal carcinoma(NPC)and analyze the mediating role of resilience.Methods The general self-efficacy scale(GSES),the 10-item connor-davidson resilience scale(CD-RISC10),the meaning of life questionnaire(MLQ),and the work and social adjustment scale(WSAS)were used to assess these psychological variables include self-efficacy,resilience,meaning of life and work and social adjustment.Psychological scales and sociodemographic questionnaires were used to survey NPC patients in Guangzhou,China.Results A total of 773 patients with NPC,69.2%men and 30.8%women,with a mean age of 47.16 years,were included in this study.The results of the univariate analysis showed that education level,average monthly household income and the presence of recurrences were the influencing factors for WSA.The results of correlation analysis showed that WSA scores were negatively correlated with self-efficacy(r=-0.238,P<0.001),meaning of life(r=-0.256,P<0.001),and psychological resilience(r=-0.270,P<0.001).After controlling for significant background variables,the mediation analysis showed that resilience played significant mediation role in the relationship between meaning of life and WSA,which accounted for21.1%of the total effect.The total effect was-1.931(95%CI:-2.487,-1.375),the direct effect was-1.525(95%CI:-2.088,-0.961),and the indirect effect was-0.407(95%CI:-0.616,-0.229).Resilience was also a significant mediating variable in the relationship between self-efficacy and WSA,accounting for 44.1%of the total effect.The total effect was-0.347(95%CI:-0.460,-0.235),the direct effect was-0.191(95%CI:-0.320,-0.061),and the indirect effect was-0.157(95%CI:-0.233,-0.086).Conclusion Resilience was a mediator of self-efficacy,meaning of life,and work and social adjustment.