肺结节术后患者心理痛苦与知觉压力和护士关怀能力的相关性分析

Correlation analysis of psychological distress, perceived stress and nurses' caring ability in patients after pulmonary nodule surgery

目的调查了解肺结节术后患者的心理痛苦现状,并探讨知觉压力、护士关怀能力对心理痛苦的影响路径。方法于2019年10月—2021年5月采取便利抽样方法选取解放军总医院第一医学中心的415例肺结节术后患者为调查对象,采用心理痛苦温度计、关怀能力量表、知觉压力量表、一般情况调查问卷进行调查和分析。采取结构方程模型分析知觉压力对心理痛苦的影响。共发放415份纸质问卷,收回有效问卷411份,有效回收率为99.04%。结果411例肺结节术后患者的心理痛苦得分为(4.82±1.42)分,≥4分者179例(43.55%)。不同婚姻、肺结节类型、担心癌变情况、情绪自我调节能力、电子健康素养及疾病认知度的肺结节术后住院患者的心理痛苦得分比较差异有统计意义(P<0.01)。心理痛苦与护士关怀能力呈负相关(r=-0.626,P<0.01),与知觉压力呈正相关(r=0.596,P<0.01)。护士关怀能力在失控感与心理痛苦之间的中介效应值为0.132,占总效应的32.84%(0.132/0.402)。结论肺结节术后患者的心理痛苦与知觉压力、护士关怀能力具有密切的关系,护士关怀能力在失控感与心理痛苦间具有部分中介作用,提高护士关怀能力可降低肺结节术后患者的心理痛苦程度。

Objective To investigate the current situation of psychological distress in patients after pulmonary nodule surgery and to explore the effect path of perceived stress and nurses'caring ability on psychological distress.Method From October 2019 to May 2021,a total of 415 patients with pulmonary nodules after surgery in the First Medical Center of Chinese PLA General Hospital were selected as the investigation objects by the convenient sampling method.The Psychological Distress Thermometer,Caring Ability Scale,Perceived Stress Scale and General Information Questionnaire were used for investigation and analysis.Structural equation model was used to analyze the effect of perceived stress on psychological distress.A total of 415 paper questionnaires were distributed and 411 valid questionnaires were recovered,with an effective recovery rate of 99.04%.Results The psychological distress score of 411 patients with pulmonary nodules after operation was(4.82±1.42),and 179 patients(43.55%)had a score greater than or equal to 4.There were statistically significant differences in the psychological distress scores of inpatients with different marriage,pulmonary nodule types,fear of cancer,emotional self-regulation ability,e-health literacy and disease awareness after pulmonary nodule surgery(P<0.01).Psychological distress was negatively correlated with nurses'caring ability(r=-0.626,P<0.01),and positively correlated with perceived stress(r=0.596,P<0.01).The mediating effect value of nurse'caring ability between sense of loss of control and psychological pain was 0.132,accounting for 32.84%(0.132/0.402)of the total effect.Conclusions The psychological pain of patients after pulmonary nodule surgery is closely related to perceived pressure and nurses'caring ability.The nurses'caring ability has a partial mediating effect between the sense of loss of control and psychological pain.Improving nurses'caring ability can reduce the psychological distress of patients after pulmonary nodule surgery.