目的性反刍思维在化疗期肺癌患者自我表露与创伤后成长间的中介效应

Mediating effect of purposed rumination on self-disclosure and posttraumatic growth in lung cancer patients under chemotherapy

目的探讨目的性反刍思维在化疗期肺癌患者自我表露与创伤后成长间的中介效应,以便为促进其积极心理提升提供依据。方法采用便利抽样法,选取2019年11月—2020年12月本市某三级甲等综合医院呼吸科住院的229例化疗期肺癌患者为研究对象,使用一般资料问卷、痛苦表露指数量表修订版(the distress disclosure index,DDI)、疾病多维度反刍思维量表(multidimensional rumination in illness scale,MRIS)、创伤后成长评定量表(posttraumatic growth inventory,PTGI)进行调查。运用Pearson相关性分析法分析化疗期肺癌患者自我表露、反刍思维及其各维度与创伤后成长间的相关性;采用AMOS23.0建立反刍思维在自我表露与创伤后成长间的中介结构方程模型,并用Bootstrap置信区间评估法验证中介效应模型。结果共有220例研究对象完成了研究。相关分析显示,反刍思维及其各维度得分与自我表露、创伤后成长呈正相关关系(均P<0.01);自我表露对目的性反刍思维、创伤后成长均有直接正向效应(β=0.788,β=0.583,P<0.01),并通过目的性反刍思维的部分中介作用间接影响创伤后成长,效应值为0.170,占总效应的22.58%。结论化疗期肺癌患者目的性反刍思维是自我表露及创伤后成长的中介变量,临床医护人员应关注患者在经历疾病后积极的心理方面改变,并通过提高患者的自我表露水平,促进其采用目的性反刍思维方式思考疾病相关问题,从而促进其创伤后成长。

Objective To investigate the mediating effect of purposed rumination on self-disclosure and posttraumatic growth in lung cancer patients who are undergoing chemotherapy,and to provide evidence for promoting the positive mentality of patients.Methods Convenience sampling method was used to select 229 lung cancer patients undergoing chemotherapy from the respiratory ward of a general hospital from November 2019 to December 2020.General information questionnaire,Distress Disclosure Index Revision(DDI),Disease Multidimensional Rumination Scale(MRIS)and Post Traumatic Growth Rating Scale(PTGI)were used for the survey.Pearson correlation method was used to analyse the correlation between self-disclosure rumination and posttraumatic growth.AMOS23.0 was employed to establish the model of mediating structural equation of rumination between self-disclosure and posttraumatic growth.Bootstrap confidence interval was applied to verify the effect of mediating model.Results A total of 220 patients completed the survey.Of the correlation analysis,the scores of rumination and its dimensions were positively correlated with the self-disclosure and posttraumatic growth(all P<0.01).Self-disclosure had a direct positive effect on purposed rumination and posttraumatic growth(β=0.788,β=0.583,P<0.01),but it indirectly affected the posttraumatic growth through the partial mediating effect of purposed rumination,with an effect value of 0.170,which accounted for 22.58% of the total effect.Conclusions Purposed rumination is a mediator between self-disclosure and post-traumatic growth in lung cancer patients during chemotherapy.Medical staff should pay attention to the positive psychological changes of the patients after experiencing the disease,and guide the patient with a correct rumination mode to the disease by improving the level of self-disclosure,therefore to promote the post-traumatic growth of the patients.