基于结构方程模型的肺癌化疗患者自我管理行为影响因素分析

Analysis on Influencing Factors of Self-management Behaviors of Lung Cancer Patients Undergoing Chemotherapy Based on Structural Equation Model

目的以信息-动机-行为技巧模型为指导,探讨领悟社会支持、自我效能对肺癌化疗患者自我管理行为的影响。方法于2020年1-5月,采用便利抽样法选取南华大学附属第一医院肿瘤内科收治的462例肺癌化疗患者为调查对象,采用领悟社会支持量表、癌症患者自我管理效能问卷、肺癌化疗患者自我管理量表对其进行调查,使用Amos 23.0建立肺癌化疗患者自我管理行为结构方程模型并进行验证分析。结果肺癌化疗患者自我管理行为得分为(64.55±5.27)分,处于中等偏下水平。领悟社会支持、自我效能、自我管理行为两两均呈正相关(P<0.01)。结构方程模型显示:自我效能对自我管理行为有直接正向作用(效应值为0.94,P<0.001),领悟社会支持可直接或通过自我效能间接影响自我管理行为(效应值分别为0.53、0.66,P<0.001),模型拟合良好。结论肺癌化疗患者自我管理行为水平有待进一步提高,加强领悟社会支持和自我效能可有效提高肺癌化疗患者的自我管理行为水平。

Objective To explore the effect of perceived social support and self-efficacy on self-management behaviors of lung cancer patients undergoing chemotherapy based on the information-motivation-behavior skill model(IMB model).Methods From January to May 2020,462 lung cancer patients undergoing chemotherapy in the Department of Medical Oncology of the First Affiliated Hospital of University of South China were selected by convenience sampling.They were investigated by the Perceived Social Support Scale(PSSS),the Strategies Used by People to Promote Health(SUPPH)and the Lung Cancer Chemotherapy Patients Self-management Questionnaire.Then,a structural equation model of self-management behaviors for these patients was established for validation analysis using Amos 23.0.Results For these lung cancer patients undergoing chemotherapy,the score of self-management behaviors was(64.55±5.27)points,which was in the mid-to-low level.Perceived social support,self-efficacy,and self-management behaviors were positively correlated with each other(P<0.01).The structural equation model showed that self-efficacy had a direct positive effect on self-management behaviors(effect size:0.94,P<0.001),and perceived social support could directly or indirectly affect selfmanagement behaviors through self-efficacy(effect size:0.53 and 0.66,respectively,P<0.001).The model fitted well.Conclusion The level of self-management behaviors needs to be further improved in lung cancer patients undergoing chemotherapy by strengthening their perceived social support and self-efficacy.