面对应对方式在乳腺癌术后化疗患者社会支持与希望水平间的中介效应

Mediating effects on disease coping between social support and level of hope in breast cancer patients undergoing postoperative chemotherapy

目的探讨疾病应对方式在乳腺癌术后化疗患者社会支持与希望水平间的中介效应,为提升患者希望水平提供理论依据。方法采用便利抽样法,选取2020年5月—2021年1月新疆某三级甲等肿瘤专科医院165例乳腺癌术后化疗患者为研究对象,采用Herth希望指数量表(herth hope index,HHI)、社会支持评定量表(social support revalued scale,SSRS)、医学应对方式问卷(medical coping modes questionnaire,MCMQ)进行问卷调查,运用Pearson相关性分析法分析乳腺癌术后化疗患者社会支持、疾病应对方式与希望水平间的相关性;采用AMOS23.0软件建立结构方程模型,并用Bootstrap置信区间评估法验证中介效应模型。结果共有158例患者完成研究。乳腺癌术后化疗患者HHI总分为(29.78±2.94)分,SSRS总分为(35.04±7.59)分,MCMQ总分为(46.30±4.93)分;相关分析显示,社会支持与希望水平呈正相关(P<0.01),面对应对方式与社会支持、希望水平呈正相关(均P<0.01)。社会支持对希望水平、面对应对方式有直接正向效应(β=0.441,β=0.718,均P<0.01),并通过面对应对方式的部分中介作用间接影响希望水平,其中介效应占总效应的36.45%。结论社会支持对乳腺癌术后化疗患者希望水平有直接预测作用,面对应对方式在社会支持与希望水平间起部分中介作用。临床护理工作中,可以通过为乳腺癌术后化疗患者争取来自家庭、社会支持,促使患者采取积极的面对应对方式克服疾病带来的困境,从而提升其希望水平。

Objective To explore the mediating effect on disease coping between the social support and hope level in breast cancer patients who were undergoing postoperative chemotherapy,therefore to provide theoretical basis for improving the hope level of the patients.Methods Convenience sampling method was used to select 165 patients with breast cancer after chemotherapy as the research objects from May 2020 to January 2021 in a tertiary tumour hospital in Xinjiang.Herth Hope Index(HHI),Social Support Revalued Scale(SSRS)and Medical coping modes questionnaire(MCMQ)were used in the survey.Pearson correlation analysis was used to analyse the correlation between social support,disease coping and the hope level.AMOS23.0 software was used to establish the model of structural equation,and Bootstrap confidence interval evaluation method was used to verify the model of mediation effect.Results A total of 158 patients completed the study.The total scores of HHI,SSRS and MCMQ were(29.78±2.94),(35.04±7.59)and(46.30±4.93),respectively.Correlation analysis showed that social support was positively correlated with the hope level(P<0.01),so was the coping style with social support and hope level(P<0.01).Social support had a direct positive effect on hope level and the disease coping(β=0.441,β=0.718,both P<0.01),and it indirectly affected the hope level through the partial mediating effect of coping,which accounted for 36.45%of the total effect.Conclusions The level of social support could directly predict the level of hope in breast cancer patients after chemotherapy,and the disease coping can partially mediate the relationship between social support and hope.In the work of clinical nursing,efforts shall be made to get material and emotional support for the patients from the families and societies,help the patients to adopt positive disease coping hence to overcome the difficulties from the disease and to improve the hope level.