乳腺癌化疗患者自我效能、社会支持及应对方式对心理弹性影响的路径分析

Effects of self-efficacy, social support and coping style on resilience in breast cancer patients undergoingchemotherapy

目的探讨自我效能、社会支持及应对方式对乳腺癌化疗患者心理弹性的影响及作用路径。方法采用便利抽样法选取2015年1月-2017年1月在哈尔滨医科大学附属肿瘤医院内三科进行化疗的乳腺癌患者376例作为研究对象，应用心理弹性量表、自我效能量表、社会支持量表以及简易应对方式量表评价患者自我效能、社会支持、应对方式、心理弹性水平，通过Pearson相关分析、多元逐步回归分析、路径分析了解自我效能、社会支持及应对方式对乳腺癌化疗患者心理弹性的影响及作用路径。结果乳腺癌化疗患者心理弹性得分总分为（56．72±12．47）分，坚韧维度得分为（29．25±7．15）分，自强维度得分为（19．35±4．61）分，乐观维度得分为（8．12±2．14）分；相关分析显示，乳腺癌化疗患者心理弹性与自我效能、社会支持及积极应对均呈正相关关系（尸〈0．05）；回归分析结果显示，乳腺癌化疗患者心理弹性水平受到患者自我效能、主观支持、积极应对方式影响，其中决定系数R2=O．622，F=7．664，P〈0．001。路径分析结果显示，乳腺癌化疗患者的自我效能、主观支持对心理弹性既存在直接影响也存在间接影响，而乳腺癌化疗患者的积极应对方式对心理弹性存在直接影响。结论乳腺癌化疗患者心理弹性水平处于较低状态；患者自我效能、主观支持、积极应对方式是影响乳腺癌化疗患者心理弹性的重要因素。

Objective To explore the effect of self-efficacy, social support and coping style on resilience of breast cancer patients undergoing chemotherapy. Methods From January 2015 to January 2017, a total of 376 breast cancer patients undergoing chemotherapy in the Third Internal Medicine Department of Harbin Medical University Cancer Hospital were selected as the research objects. Patients＇ self-efficacy, social support, coping style and the level of resilience were evaluated with the Connor-Davidson resilience scale （CD-RISC）, general self-efficacy scale （GSES）, social support questionnaire （SSQ） and simplified coping style questionnaire （SCSQ）. The effects and function route of self-efficacy, social support and coping style on resilience of breast cancer patients were analyzed by Pearson correlation analysis and multiple regression analysis and path analysis. Results The total resilience score of patients with breast cancer chemotherapy was （56.72 ±12.47）, the score of tenacity dimension was （29.25 ± 7.15）, the score of strength dimension was （19.35 ± 4.61）, and the score of optimism dimension was （8.12±2.14）. Correlation analysis showed a positive correlation between the resilience of patients and self-efficacy, social support and positive coping style （P〈 0.05）. The result of regression analysis suggested that patients＇resilience was influenced by multiple factors, including self-efficacy, subjective support and positive coping style, with the coefficients of determination R2=0.622, F=7.664, P 〈 0.001. Path analysis showed that self-efficacy and subjective support of breast cancer patients had both direct and indirect effects on resilience, while breast cancer patients with positive coping style had a direct impact on resilience. Conclusions The resilience level of breast cancer patients is in a low state. The patients＇self-efficacy, subjective support and positive coping style are important factors that influencing the resilience of breast cancer patients undergoing chemotherapy.