自我调节的常识模型在胃癌初诊患者疾病感知中的探索研究

Exploration study on common sense model of self-regulation about illness perception in patients with newly diagnosed gastric cancer

目的基于自我调节的常识模型(CSM),探索胃癌初诊患者疾病感知在关键变量与心理困扰间的中介关系。方法选取2020年1月-2022年3月某2家医院住院预手术治疗的初诊胃癌患者236例为研究对象,采用一般情况调查表、心理困扰量表、疾病感知问卷简化版(BIPQ)、社会支持评定量表(SSRS)、躯体症状自我报告和患者教育满意度问卷进行调查。结果初诊胃癌患者的心理困扰处于中等水平,疾病感知在躯体症状与心理困扰间存在部分中介作用(β=0.07,P<0.05),中介效应占总效应的15.38%;疾病感知在社会支持度与心理困扰间存在完全中介作用(β=0.07,P>0.05),中介效应占总效应的48.85%,疾病感知在患者教育满意度与心理困扰间存在完全中介作用(β=0.08,P>0.05),中介效应占总效应的42.40%。结论本研究基于CSM模型,初步验证了初诊胃癌患者的疾病感知在躯体症状与心理困扰间的部分中介作用,在社会支持、患者教育满意度与心理困扰间的完全中介作用。提示临床医护人员不应忽视早期癌症患者的心理困扰,需密切关注患者先前症状的管理和诊断后新出现的症状的评估,给予足够疾病相关信息支持,鼓励家庭力量的充分参与。

Objective To explore the mediating relationship between key variables and psychological distress in newly diagnosed patients with gastric cancer based on the common sense model of selfregulation(CSM).Methods A total of 236 patients with newly diagnosed gastric cancer who were hospitalized for preoperative treatment from January 2020 to March 2022 were selected as the research objects.The general situation questionnaire,psychological distress scale,the bnief illness perception questionnaire(BIPQ),the social support rating scale(SSRS),self-report of physical symptoms and patient education satisfaction questionnaire were used to investigate.Results The psychological distress of patients with newly diagnosed gastric cancer was at a moderate level.Illness perception had a partial mediating effect between physical symptoms and psychological distress(β=0.07,P<0.05),and the mediating effect accounted for 15.38%of the total effect.There was a complete mediating effect between psychological distress(β=0.07,P>0.05),and the mediating effect accounts for 48.85%of the total effect.There was a complete mediating effect between patients'disease perception and psychological distress(β=0.08,P>0.05),and the mediation effect accounted for 42.40%of the total effect.Conclusion Based on the CSM model,this study preliminarily verified the partial mediation effect of disease perception in patients with newly diagnosed gastric cancer between physical symptoms and psychological distress,and the complete mediation effect between social support,patient education satisfaction,and psychological distress.It is suggested that clinical medical staff should not ignore the psychological distress of patients with early cancer,pay close attention to the management of patients'previous symptoms and the assessment of new symptoms after diagnosis,provide sufficient disease-related information support,and encourage the full participation of family forces.