重庆市肺癌患者健康素养、自我效能、社会支持与生活质量的关系——一项基于结构方程模型的研究

Correlation of health literacy,self-efficacy and social support with quality of life in patients with lung cancer in Chongqing:a study based on structural equation model

目的调查肺癌患者健康素养、自我效能、社会支持及生活质量现状,并探讨四者之间的关系。方法2022年1~3月采用方便抽样对376名肺癌患者进行问卷调查,包括一般资料、健康素养、社会支持、自我效能、生命质量,并使用Amos建立结构方程模型,分析各因素之间的关系。结果肺癌患者健康素养总分为(96.34±19.57)分,社会支持总分为(41.06±9.28)分,自我效能总分(85.55±19.36)分,生活质量中总体功能、总体健康状况和总体症状得分分别为(77.08±18.27)分、(46.13±18.17)分和(24.02±17.75)分。除社会支持与总体健康状况外,健康素养、社会支持、自我效能与生活质量各维度均相关(P<0.01)。结构方程模型结果显示:自我效能对生活质量仅有直接效应(效应值为0.382,P<0.01)。健康素养可直接或通过社会支持及自我效能间接影响生活质量(直接效应为0.347,间接效应为0.135,P<0.01),影响效应最大。该模型拟合效果良好(GFI=0.940,AGFI=0.908,NFI=0.959,RFI=0.45,CFI=0.974,IFI=0.974,RMSEA=0.067)。结论肺癌患者的健康素养和自我效能对生活质量有直接效应,同时健康素养还通过社会支持及自我效能间接影响癌症患者的生活质量。

ObjectiveTo investigate the current status of health literacy,self-efficacy,social support and quality of life in patients with lung cancer,and to explore the relationship among the 4 factors.MethodsA total of 376 lung cancer patients were collected with convenience sampling and surveyed with questionnaires for general information,health literacy,social support,self-efficacy and quality of life.Amos was used to establish a structural equation model to analyze the relationship in the factors.ResultsThe total score of health literacy,social support and self-efficacy of these lung cancer patients was 96.34±19.57,41.06±9.28 and 85.55±19.36,respectively.The score of general function,general health status and general symptoms in quality of life was 77.08±18.27,46.13±18.17 and 24.02±17.75,respectively.Except social support and general health status,health literacy,social support and self-efficacy were correlated with all dimensions of quality of life(P<0.01).The structural equation model showed that self-efficacy had only a direct effect on quality of life(an effect value of 0.382,P<0.01).Health literacy directly affected quality of life or indirectly did through social support and self-efficacy(an effect value of 0.347,an indirect effect of 0.135,P<0.01),with the largest effect.The model had a good fitting effect(GFI=0.940,AGFI=0.908,NFI=0.959,RFI=0.45,CFI=0.974,IFI=0.974,RMSEA=0.067).ConclusionHealth literacy and self-efficacy exert direct effects on the quality of life of lung cancer patients,and health literacy also indirectly affects the quality of life through social support and self-efficacy.