乳腺癌患者化疗期间恐惧、出院准备度和家庭功能对生命质量影响的路径分析

Path analysis of the influence of fear,discharge preparation and family function on the quality of life of breast cancer patients during chemotherapy

目的分析乳腺癌患者化疗期间恐惧、出院准备度、家庭功能、生命质量的现状,通过构建结构方程模型探讨恐惧、出院准备度和家庭功能对其生命质量的影响。方法采用乳腺癌生命质量测定量表(QLICP-BR)、恐惧疾病进展简化量表(FoP-Q-SF)、出院准备度量表(RHDS)和家庭关怀度指数量表(APGAR),对2019年1—7月山西省肿瘤医院就诊的274例乳腺癌化疗患者进行问卷调查。结果乳腺癌化疗患者生命质量总分为(137.78±21.66)分;复发恐惧总分为(34.61±12.36)分;出院准备度总分为(95.57±18.83)分;家庭功能总分为(7.53±2.66)分。结构模型显示:恐惧、家庭功能和出院准备度均对生命质量有直接预测作用,直接效应分别为-0.468、0.331和0.509(均P<0.01);恐惧通过出院准备度的中介作用对生命质量有间接负向预测作用(β值为-0.127,P<0.01),家庭功能通过出院准备度的中介作用对生命质量有间接正向预测作用(β值为0.124,P<0.01)。结论恐惧、出院准备度、家庭功能是乳腺癌化疗患者生命质量的重要影响因素,恐惧和家庭功能亦可以通过出院准备度间接影响生命质量。

Objective To analyze the current situation of fear,discharge preparation,family function and quality of life of breast cancer patients during chemotherapy,and to explore the influence of fear,discharge preparation and family function on their quality of life by constructing structural equation model.Methods A total of 274 patients with breast cancer undergoing chemotherapy in Shanxi Cancer Hospital from January to July in 2019 were investigated with Quality of Life Instruments for Cancer Patients-Breast Cancer(QLICP-BR),Fear of Progression Questionnaire-Short Form(FoP-Q-SF),Readiness for Hospital Discharge Scale(RHDS)and Family APGAR Index(APGAR).Results The total score of the quality of life was 137.78±21.66,the total score of recurrence fear was 34.61±12.36,the total score of discharge preparation was 95.57±18.83,and the total score of family function was 7.53±2.66.The structural model showed that fear,family function and discharge preparation had a direct predictive effect on quality of life,the direct effects were-0.468,0.331 and 0.509,respectively(P<0.01);fear had an indirect negative predictive effect on quality of life through the mediation of discharge readiness(βvalue was-0.127,P<0.01),and family function had an indirect positive effect on quality of life through the mediation of discharge preparation.The predictive effect was(βvalue was 0.124,P<0.01).Conclusions Fear,discharge preparation and family function are important factors affecting the quality of life of breast cancer patients undergoing chemotherapy.Fear and family function can also indirectly affect the quality of life through discharge preparation.