灵性健康在晚期癌症患者症状负担与生活质量间的中介作用研究

Study on the mediating effect of spiritual well-being on symptom burden and quality of life in patients with advanced cancer

目的探讨灵性健康在晚期癌症患者的症状负担与生活质量间的中介作用。方法选取天津医科大学肿瘤医院晚期癌症患者作为研究对象,应用一般资料调查量表、症状负担量表、慢性疾病治疗功能评估-灵性量表-12及癌症患者生命质量测定量表分别对患者的一般资料、症状负担、灵性健康及生活质量进行调查,并采用中介效应检验方法分析灵性健康在症状负担和生活质量之间的中介作用。结果共发放问卷230份,回收有效问卷212份,有效回收率为92.2%。灵性健康与总体生活质量呈正相关(r=0.619,P<0.01),与症状负担呈负相关(r=-0.505,P<0.01),症状负担与总体生活质量呈负相关(r=-0.590,P<0.01)。灵性健康在症状负担与总体生活质量、躯体、角色、情绪、社会功能之间存在中介作用,在认知功能方面无中介作用。结论症状负担通过灵性健康影响晚期癌症患者的生活质量,临床护士应采取有效措施关注并提升患者的灵性健康,从而提高晚期癌症患者的生活质量。

Objective To explore the mediating effect of spiritual well-being on symptom burden and quality of life(QOL)in patients with advanced cancer.Methods The patients with advanced cancer in Tianjin Medical University Cancer Institute and Hospital were selected as the subjects.The general information survey scale,Memorial Symptom Assessment Scale(MSAS),the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being(FACIT-Sp-12)scale and Quality of Life Questionnaire-Core30(EORTC QLQ-C30)were used to investigate the general information,symptom burden,spiritual well-being and quality of life,respectively.The mediating effect of spiritual well-being on symptom burden and QOL was analysed via mediator effect test method.Results A total of 230 questionnaires were distributed,and 212 valid questionnaires were returned,with an effective recovery rate of 92.2%.This study revealed that spiritual well-being was positively correlated with overall QOL(r=0.619,P<0.01),while negatively correlated with symptom burden(r=-0.505,P<0.01).There was a negative correlation between symptom burden and overall QOL(r=-0.590,P<0.01).The results of hierarchical regression analysis showed that spiritual well-being significantly mediated the relationship between symptom burden and overall QOL,body,roles,emotions,and social function,while no mediating effect of spiritual well-being was observed between symptom burden and cognitive function.Conclusion The symptom burden affects QOL of patients with advanced cancer through mediating effect of spiritual well-being.Therefore,nurses should take effective measures to pay attention to and improve the spiritual well-being of patients,which finally improves the QOL of patients with advanced cancer.