老年消化系统恶性肿瘤患者应对方式在疼痛信念与生活质量间的中介效应

Mediating effect of coping styles on pain belief and quality of life of patients with digestive system malignant tumors

目的探讨应对方式在老年消化系统恶性肿瘤患者疼痛信念与生活质量间的中介作用。方法采用方便取样法对2018年1月-2019年12月在我院住院的200例老年恶性肿瘤患者,应用一般资料调查表、美国疼痛协会患者结局问卷修订版、医学应对方式问卷和中国癌症患者化学生物治疗生活质量量表进行调查,并使用AMOS 21.0建立结构方程模型进行验证分析。结果患者疼痛信念得分为(17.46±1.77)分,应对方式总得分为(48.87±2.11)分,生活质量总得分为(105.11±15.35)分。患者疼痛信念总分与应对方式总分及各维度得分均呈负相关(r=-0.680~-0.485,P<0.05);应对方式总分及各维度得分与生活质量总分及各维度得分均呈正相关(r=0.455~0.576,P<0.05);生活质量总分及各维度得分与疼痛信念得分均呈负相关(r=-0.652~-0.480,P<0.05)。应对方式作为中介变量,疼痛信念对生活质量的预测关系从0.519下降到0.277。结构方程模型再次分析结果显示,应对方式是疼痛信念和生活质量的中介变量,模型拟合指标良好。结论应对方式作为消化系统恶性肿瘤患者疼痛信念与生活质量间的中介变量,使疼痛信念对生活质量的预测效应下降。提示应提高患者的应对方式,促进其身心健康,提高疼痛信念,进而提高患者的生活质量。

Objective To explore the mediating effect of coping styles on pain beliefs and quality of life of patients with digestive system malignant tumors.Methods A cross-sectional study was used to select 200 malignant tumor inpatients from January 2018 to December 2019 in our hospital.The revised American pain association patient outcome questionnaire,Medical coping style questionnaire(MCMQ)and Chinese cancer patients'quality of life scale for chemo-biotherapy(QLQ-CCC)were used to conduct questionnaire survey.SPSS21.0 and AMOS21.0 were used for statistical analysis.Results The pain belief score was(17.46±1.77),coping style score was(48.87±2.11)and quality of life score was(105.11±15.35).Pearson correlation analysis showed that the total score of patients'pain beliefs was negatively correlated with the total score of coping styles and dimensions(r=-0.680~-0.485,P<0.05):the total score of coping styles and dimensions were positively correlated with the total score of quality of life and dimensions(r=0.455~0.576,P<0.05);The total score and dimensions of quality of life were negatively correlated with pain beliefs(r=-0.652~-0.480,P<0.05).Coping style as a mediator variable,the predictive relationship between pain belief and quality of life decreased from 0.519 to 0.277.The results of structural equation model analysis show that coping style is an intermediate variable of pain belief and quality of life,and the fitting index of the model is good.Conclusion Coping style is an intermediate variable between pain belief and quality of life in patients with digestive system malignant tumors,which reduces the predictive effect of pain belief on quality of life.Therefore,the coping style of patients should be improved,physical and mental health should be promoted,pain belief should be improved,and the quality of life of patients should be improved.