恶性肿瘤住院患者癌因性疲乏与心理弹性的关系

Relationship Between Cancer Related Fatigue and Psychological Resilience in Inpatients with Malignant Tumors

目的：探讨恶性肿瘤住院患者心理弹性在积极应对方式与癌因性疲乏（CRF）之间的中介作用。方法：选取2015年3月-2017年6月在本院住院的恶性肿瘤患者为研究对象,共发放问卷380份,回收345份。采用一般资料调查表、CRF量表、心理弹性量表以及应对方式量表进行调查。结果：本研究345例患者中有284例（82.32%）患者伴有疲乏,年龄≤60岁患者CRF评分显著低于年龄〉60岁患者（t=-3.010,P=0.003）,不同疾病类型患者CRF评分差异显著（F=3.145,P=0.012）;恶性肿瘤住院患者心理弹性平均得分为（26.47±8.24）分,积极应对平均得分为（23.18±7.32）分,性别、文化程度、家庭月收入不同的患者心理弹性评分差异显著（t=2.638,P=0.009;F=4.764,P=0.007;F=4.532,P=0.008）,文化程度、家庭月收入不同的患者积极应对评分差异显著（F=4.727,5.217;P〈0.01）;经Person相关性分析显示,恶性肿瘤患者CRF总分与心理弹性和积极应对评分呈负相关（r=-0.414,-0.358,P〈0.05）,心理弹性评分与积极应对评分呈正相关（r=0.613,P〈0.05）;心理弹性和积极应对可负向预测CRF评分,心理弹性在积极应对和CRF评分中起完全中介作用（t=-4.504,P=0.000）。结论：心理弹性在积极应对方式与CRF间发挥中介作用,较高的心理弹性水平有助于改善患者CRF症状。

Objective：To explore the mediating role of psychological resilience between the positive coping styles and cancer related fatigue（ CRF） of inpatients with malignant tumors.Methods：Patients hospitalized in our hospital from March2015 to June 2017 were selected for the study.A total of 380 questionnaires were issued,and 345 were recovered.The general data questionnaire,CRF scale,Connor Davision Resilience Scale（ CD-RISC） and coping styles scale were used for the investigation.Results：In this study,there were 284 cases（ 82.32%） with fatigue among 345 patients,and the CRF score in patients≤60 years old was significantly lower than that in patients60 years old（ t =-3.010,P〈0.01）,and there were significant differences in the CRF score among patients with different disease types（ F = 3.145,P〈0.05）. The mean score of psychological resilience was（ 26.47±8.24） points and the mean positive coping score was（ 23.18±7.32） points in inpatients with malignant tumors,and there were significant differences in the psychological resilience score among patients with different genders,educational level and family monthly income（ t = 2. 638; F = 4. 764,4. 532; P〈0. 01）,and there were significant differences in the positive coping score among patients with different educational level and family monthly income（ F = 4.727,5.217;P〈0.01）. Pearson correlation analysis showed that the total CRF score of malignant tumors patients was negatively correlated with the psychological resilience score and positive coping score（ r =-0.414,-0.358;P〈0.05）,and the psychological resilience score was positively correlated with positive coping score（ r = 0.613,P〈0.05）. Psychological resilience and positive coping could negatively predict the CRF score,and psychological resilience played a complete mediating role in the positive coping styles and the CRF score（ t =-4.504,P〈0.001）. Conclusion：Psychological resilience plays a mediating role between the positive coping styles and CRF,and a higher level of psychological resilience can help to improve the CRF symptoms of patients.