乳腺癌患者归因方式对健康相关生活质量的中介作用分析

Analysis of mediating effect of attributional style on health-related quality of life in patients with breast cancer

目的探讨乳腺癌患者归因方式、心理韧性和健康相关生活质量(HRQoL)间的关系,分析归因方式在心理韧性和HRQoL间的中介作用。方法采用方便抽样法抽取西安市某三甲医院共433例乳腺癌患者。分别采用归因方式问卷(ASQ)、10条目心理韧性量表(CD-RISC-10)和中文版乳腺癌生活质量测定量表(FACT-Bv4.0)评估患者的归因方式、心理韧性和HRQoL。采用Pearson相关分析法分析归因方式、心理韧性和HRQoL间的相关性。采用Bootstrap法分析归因方式在心理韧性和HRQoL间的中介作用。结果乳腺癌患者的归因方式、心理韧性和HRQoL两两之间呈正相关(P<0.01)。归因方式在心理韧性与HRQoL之间起部分中介作用,中介效应值为0.164[95%CI(0.104,0.232)],占总效应量的25.63%。结论乳腺癌患者积极的归因方式与高水平心理韧性和HRQoL相关。积极的归因方式有助于促进高水平心理韧性对HRQoL的改善。

Objective To explore the relationship between attributional style,psychological resilience and health-related quality of life(HRQoL)in the patients with breast cancer,and to analyze the mediating effect of attributional style between psychological resilience and HRQoL.Methods A total of 433 patients with breast cancer in a tertiary hospital of Xi’an City were selected by the convenient sampling method.Attributional Style Questionnaire(ASQ),10-item Connor-Davidson Resilience Scale(CD-RISC-10)and Functional Assessment of Cancer Therapy-Breast(FACT-Bv4.0)were used to assess the attributional style,psychological resilience and HRQoL.The Pearson correlation was used to analyze the correlation among the attributional style,psychological resilience and HRQoL.The Bootstrap method was used to analyze the mediating effect of attributional style between psychological resilience and HRQoL.Results There were pairwise positive correlations among the attributional style,psychological resilience and HRQoL in the patients with breast cancer(P<0.01).The attributional style played a partial mediated role between psychological resilience and HRQoL,with a mediating effect value of 0.164[95%CI(0.104,0.232)],accounting for 25.63%of the total effect size.Conclusion The positive attributional style in the patients with breast cancer is correlated with high level of psychological resilience and HRQoL.The positive attributional style is conducive to promote the improvement of high level of psychological resilience on HRQoL.