恐惧疾病进展在肺癌患者配偶希望水平与生活质量间的中介效应

Mediating effect of fear of disease progression between lung cancer patients’spousal hope level and quality of life

目的探讨恐惧疾病进展在肺癌患者配偶希望水平与生活质量间的中介作用。方法采取方便抽样法,选取2019年11月—2021年1月新疆某三级甲等肿瘤专科医院165例肺癌患者配偶作为研究对象,采用Herth希望指数量表(Herth Hope Index,HHI)、癌症患者恐惧疾病进展简化量表(Fear ofProgression Questionnaire-Short Form,FoP-Q-SF)、生活质量核心量表(European Organization for Research and Treatment of Cancer Quality of Life Questionnaire,QLQ-C30)进行问卷调查,运用Pearson相关性分析肺癌患者配偶恐惧疾病进展、希望水平、生活质量之间的相关性;采用AMOS23.0软件建立结构方程模型,并用偏差校正的非参数百分位Bootstrap程序对模型进行检验。结果共有162例肺癌患者配偶完成研究,HHI总分为(26.28±2.90)分,FoP-Q-SF总分为(43.74±4.68)分,QLQ-C30总分为(55.29±14.26)分。相关分析显示,肺癌患者配偶生活质量与希望水平呈正相关(r=0.541,P<0.001)与恐惧疾病进展呈负相关(r=-0.469,P<0.001);希望水平与恐惧疾病进展呈负相关(r=-0.574,P<0.001)。希望水平对生活质量有显著正向效应(β=0.428,P<0.001),并通过恐惧疾病进展的部分中介作用间接影响其生活质量,中介效应占总效应的33.12%。结论希望水平对肺癌患者配偶生活质量有直接预测作用,恐惧疾病进展在希望水平与生活质量之间起到部分中介作用。

Objective To explore the mediating effect of fear of disease progression between hope level and quality of life in spouses of lung cancer patients.Methods A convenient sampling method was used to select spouses of 165 lung cancer patients from a third-grade class-A tumor-specialized hospital in Xinjiang from November 2019 to January 2021 to serve as the research subjects.A questionnaire survey was conducted by using Herth Hope Index(HHI),Fear of Progression Questionnaire-Short Form(FoP-Q-SF)for cancer patients and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(QLQ-30).Pearson correlation analysis was performed to analyze the correlation of fear of disease progression with hope level and quality of life in spouses of the lung cancer patients.AMOS23.0 was employed to establish the structural equation model,and Bootstrap confidence interval evaluation method was applied to verifying the mediation effect model.Results A total of 162 spouses of the lung cancer patients completed the study.The total scores of HHI,FOP-Q-SF and QLQ-C30 were(26.28±2.90),(43.74±4.68)and(55.29±14.26),respectively.Correlation analysis showed that quality of life in 162 spouses of the lung cancer patients was positively correlated with hope level(r=0.541,P<0.001),but negatively correlated with fear of disease progression(r=-0.469,P<0.001).Hope level was negatively correlated with fear of disease progression(r=-0.574,P<0.001).Hope level had a significant positive effect on quality of life(β=0.428,P<0.001),and indirectly affected quality of life through the partial mediating effect of fear of disease progression,accounting for 33.12%of the total effect.Conclusion Hope level can directly predict quality of life of the spouses of the lung cancer patients,and fear of disease progression can partially mediate the relationship between hope level and quality of life.