宫颈癌患者恐惧疾病进展现状及影响因素分析

Influencing factors analysis of fear of progression in cervical cancer patients

目的 了解宫颈癌患者恐惧疾病进展(fear of progression,FoP)现状,通过构建基于社会认知加工理论的结构方程模型,分析影响其FoP的路径。方法 采用便利抽样法,于2020年8月—10月选取在湖南省10所三级医院肿瘤科和妇科住院治疗的222对宫颈癌患者及其配偶作为调查对象。采用一般资料调查表、中文版癌症患者FoP简化量表、中文版事件影响量表修订版、社会约束量表、中文版痛苦表露指数量表对宫颈癌患者进行调查;同时采用中文版配偶FoP简化量表对其配偶进行调查。结果 宫颈癌患者FoP心理功能失调发生率为43.69%。社会约束程度、负性认知加工水平、配偶FoP水平正向影响宫颈癌患者FoP,总效应值分别为0.427、0.631、0.468;夫妻亲密度、患者自我表露水平负向影响宫颈癌患者FoP,总效应值分别为-0.279、-0.454。结论 宫颈癌患者FoP心理功能失调发生率较高,医护人员在临床中应重视社会约束、认知加工、自我表露、夫妻亲密度及配偶FoP水平对患者FoP的影响,采取针对性护理措施降低患者的FoP水平。

Objective To learn about the current situation of fear of progression(FoP) in patients with cervical cancer,and to analyze the influence path of FoP in cervical cancer patients by establishing a structural equation model based on Social Cognitive Processing Theory. Methods From August to October 2020,the convenience sampling method was adopted to investigate 222 cervical cancer patients who were hospitalized in Oncology and Gynecology Departments of 10 tertiary hospitals in Hunan province with the general information questionnaire,Fear of Progression Questionnaire-Short Form(FoP-Q-SF),Impact of Event Scale Revised(IES-R),Social Constraint Scale(SCS-15),and Distress Disclosure Index(DDI),while their spouses were surveyed by Fear of Progression Questionnaires for Partners(FoP-Q-SF/P). Results The incidence of FoP mental dysfunction in cervical cancer patients was 43.69%.Social constraint,negative cognitive processing and FoP of the spouses positively affected the FoP of cervical cancer patients with a total effect of 0.427,0.631,0.468,respectively. Marital intimacy and distress disclosure negatively affected the FoP of cervical cancer patients with a total effect of-0.279,-0.454,respectively. Conclusion The incidence of FoP psychological dysfunction in cervical cancer patients is high. In clinical practice,medical staff should pay attention to the impact of social constraints,cognitive processing,distress disclosure,marital intimacy and FoP of the spouses on the FoP in cervical cancer patients,and take targeted nursing measures to reduce the level of FoP in cervical cancer patients.