乳腺癌患者希望水平与癌因性疲乏的关系:心理弹性的中介作用

Relationship between the level of hope and cancer-related fatigue among breast cancer patients:mediating role of resilience

背景 至少77.0%的乳腺癌患者会经历癌因性疲乏。希望水平与心理弹性是癌因性疲乏的重要影响因素,目前,大多数研究从单一的希望水平或心理弹性等因素出发,探讨其与癌因性疲乏的关系,将三者结合探讨作用机制的研究有限。目的 探讨心理弹性在乳腺癌患者希望水平与癌因性疲乏之间的中介作用,为寻找乳腺癌患者癌因性疲乏的干预靶点提供参考。方法 于2022年3月-2022年10月,选取在陕西省三家三级甲等医院住院的、病理诊断为乳腺癌、年龄>18岁的324名患者为研究对象。采用成人希望水平特质量表(ADHS)、心理弹性量表(CD-RISC-10)和癌因性疲乏量表(CFS)分别评定患者的希望水平、心理弹性和癌因性疲乏状况。运用Pearson相关分析考查ADHS评分、CD-RISC-10评分和CFS评分间的关系;采用AMOS 22.0对心理弹性在乳腺癌患者希望水平和癌因性疲乏之间的中介作用进行分析。结果 乳腺癌患者癌因性疲乏检出率为88.58%。ADHS评分、CD-RISC-10评分与CFS评分均呈负相关(r=-0.750、-0.809,P均<0.01)。ADHS评分与CD-RISC-10评分呈正相关(r=0.901,P<0.01)。心理弹性在乳腺癌患者希望水平和癌因性疲乏之间具有中介作用,中介效应值为-0.676(95%CI:-1.005~-0.347),占总效应的81.90%。结论 乳腺癌患者的希望水平可以直接影响癌因性疲乏,也可以通过心理弹性间接影响癌因性疲乏,心理弹性在希望水平和癌因性疲乏之间起部分中介作用。

Background At least 77.0%of breast cancer patients will experience cancer-related fatigue.Hope level and resilience play as two important factors that have influence on cancer-related fatigue.Currently,most studies involve one single factor,either the level of hope or resilience,and explore its relationship with the cancer-related fatigue.Only limited studies explore the action mechanism behind with all three factors put together.Objective To investigate the mediating role of resilience between hope and cancer-related fatigue in patients with breast cancer,and to provide references for finding intervention targets for cancer-related fatigue in breast cancer patients.Methods From March to October 2022,this study was conducted on the sample size of 324 hospitalized patients from three Grade-A tertiary hospitals in Shaanxi Province.These patients were over 18 years old and pathologically diagnosed as breast cancer.Hope level,resilience and cancer-related fatigue were assessed,respectively,using Adult Dispositional Hope Scale(ADHS),Connor-Davidson Resilience Scale(CD-RISC-10)and Cancer Fatigue Scale(CFS).Pearson Correlation Analysis was used to analyze the relationship between ADHS score,CD-RISC-10 score and CFS score.AMOS 22.0 was used to analyze the mediating effect of resilience between hope level and cancer-related fatigue in breast cancer patients.Results The detection rate of cancer-related fatigue in patients with breast cancer was 88.58%.Scores of ADHS and CD-RISC-10 were negatively correlated with CFS score(r=-0.750,-0.809,P<0.01).ADHS score was positively correlated with CD-RISC-10 score (r=0. 901, P<0. 01). Resilience had a mediating effect between the hope level and cancer-related fatigue. The mediating effect value was -0. 676(95% CI: -1. 005~-0. 347), accounting for 81. 90% of the total effect. Conclusion The hope level of breast cancer patients can affect cancer-related fatigue directly as well as indirectly through resilience. Resilience plays a partial mediating role between hope level and cancer-related fatigue .