反刍性沉思在结直肠癌患者创伤后应激症状与创伤后成长间的中介效应分析

Mediating Role of Event-related Rumination in Posttraumatic Stress Symptom and Posttraumatic Growth among Colorectal Cancer Patients

目的探讨结直肠癌患者反刍性沉思、创伤后应激症状与创伤后成长间的关系。方法2018年6-11月,便利抽样法选取泰安市某两所三级甲等医院的结直肠癌症住院患者作为研究对象,采用反刍性沉思量表(event-related rumination inventory,ERRI)、事件影响程度量表(the impact of event scale-revised,IES-R)和创伤后成长量表(post traumatic growth inventory,PTGI),对其进行横断面调查。结果结直肠癌患者创伤后成长总分为(53.89±7.448)分,反刍性沉思总分为(36.80±5.672)分,创伤后应激症状总分为(53.08±8.943)分。结直肠癌患PTGI总分与侵入性反刍性沉思呈负相关,与目的性反刍性沉思呈正相关,与总分呈正相关;PTGI总分与IES中高唤醒维度评分呈负相关,均P<0.05。路径分析表明,创伤后应激症状可以直接预测反刍性沉思和创伤后成长,反刍性沉思在创伤后应激症状与创伤后成长之间起部分中介作用。结论结直肠癌患者创伤后应激症状、反刍性沉思与创伤后成长密切相关,医护人员应关注患者创伤后应激症状及反刍性沉思水平,采用心理干预方法促进其创伤后成长。

Objective To explore the relationship among event related rumination,posttraumatic stress symptom and posttraumatic growth.Methods From June to November 2018,inpatients with colorectal cancer from two tertiary hospitals in Tai'an City were selected as the research subjects by convenience sampling method.The event-related rumination inventory(ERRI),the impact of Event Scale-Revised(IES-R)and post-traumatic growth inventory(PTGI)were used.Cross-sectional investigation was carried out.Results The patients'posttraumatic growth level was 53.89±7.448,the total score of IES-R was 36.80±5.672,and the total score of posttraumatic stress symptom was 53.08±8.943.Purposeful rumination was positively correlated with post-traumatic growth but invasive rumination was negatively correlated with post-traumatic growth.The scores of IES-R was negatively correlated with post-traumatic growth(P<0.05).Path analysis showed that posttraumatic stress symptom could directly predict event-related rumination and posttraumatic growth,event-related rumination had a mediating effect between posttraumatic stress symptom and post-traumatic growth.Conclusions The results indicated that posttraumatic stress symptom,event-related rumination and posttraumatic growth had a close relationship.Clinical medical workers need to pay more attention on posttraumatic stress symptom and event related rumination of patients,and promote the posttraumatic growth with advanced psychological intervention technique.