应激作用过程理论视域下乳腺癌患者生活满意度影响因素的路径分析

Path Analysis on Influencing Factors of Life Satisfaction among Breast Cancer Patients from the Perspective of Stress Processing Theory

目的基于应激作用过程理论探讨各变量对乳腺癌患者生活满意度的影响路径。方法便利选取山西省某三级甲等医院244例乳腺癌患者,采用生活满意度量表、领悟社会支持量表、乳腺癌幸存者自我效能感量表、医学应对方式问卷及健康认知评价量表进行调查。结果领悟社会支持、自我效能、面对应对方式对生活满意度有直接正向效应(β=0.381、0.194、0.262,均P<0.001),负性认知评价对生活满意度有直接负性效应(β=-0.218,P<0.001);领悟社会支持、自我效能感、负性认知评价对生活满意度的间接作用显著(均P<0.001),中介效应值分别为0.250、0.109、-0.075。结论应激作用过程理论中各变量对乳腺癌患者生活满意度有多条作用路径,其中最主要路径为领悟社会支持→自我效能感→生活满意度。临床护理人员应重视社会支持相对缺乏的患者,可通过制订基于自我效能的护理措施帮助其提高生活满意度。

Objective To explore the paths through which various variables influenced the life satisfaction of breast cancer patients based on the stress processing theory.Methods Convenient sampling was used to select 244 breast cancer patients from a tertiary hospital in Shanxi Province.The Life Satisfaction Scale,Perceived Social Support Scale,Breast Cancer Survivors Self-efficacy Scale,Medical Coping Modes Questionnaire and Cognitive Appraisal of Health Scale were adopted for investigation.Results Perceived social support,self-efficacy and coping mode of facing had directly positive effects on life satisfaction(β=0.381,0.194,0.262,all P<0.001),and negative cognitive appraisal had a direct and negative effect on life satisfaction(β=-0.218,P<0.001).Perceived social support,self-efficacy and negative cognitive appraisal had significantly indirect effects on life satisfaction(all P<0.001),with the mediating effect values of 0.250,0.109,-0.075,respectively.Conclusions There are multiple paths through which various variables in the stress processing theory may influence the life satisfaction of breast cancer patients.The most significant path is‘perceived social support→self-efficacy→life satisfaction’.Clinical nursing staff should pay attention to those patients who lack social support and can help to improve their life satisfaction by implementing nursing care measures based on self-efficacy.