胃癌患者症状体验与恐惧疾病进展的现状及症状严重程度的中介效应

Correlation study between symptom experience and fear of progression in patients with stomach cancer

目的了解胃癌患者症状体验及恐惧疾病进展的现状,分析二者间的相关性,为提供科学的症状管理方案提供参考。方法便利抽样选取某三甲医院收治的174例门诊胃癌患者为研究对象,采用安德森症状评估量表胃肠道肿瘤特异性模块(MDASI-GI)及恐惧疾病进展简化量表(FoP-Q-SF)对患者进行调查;采用Spearman秩相关分析,探讨胃癌患者症状体验和恐惧疾病进展的相关性;应用结构方程模型,分析症状严重程度在恐惧疾病进展与症状困扰程度之间的中介作用。结果胃癌患者症状严重程度[M(IQR)]为1.30(2.42)分,症状困扰程度[M(IQR)]为1.67(3.04)分,恐惧疾病进展均分为(29.35±9.34)分;胃癌患者恐惧疾病进展水平与症状体验各维度呈正相关(r=0.471~0.675,P<0.01)。路径分析显示,恐惧疾病进展对症状严重程度及症状困扰程度呈显著正向影响(β=0.603、0.215,P<0.05);恐惧疾病进展通过症状严重程度对症状困扰程度产生的间接效应为0.415,总效应为0.630,中介效应为65.87%。结论胃癌患者存在不同程度的症状体验,与恐惧疾病进展心理密切相关,建议根据患者的恐惧疾病进展水平及治疗阶段制定个性化的症状管理方案,从而改善患者的症状体验。

Objective To describe the symptom experience and fear of progression in patients with gastric carcinoma and analyze the correlation between between symptom experience and fear of progression.Methods A total of 174 outpatients with gastric carcinoma from February to September 2021 were selected from our hospital by convenient sampling.The M.D.Anderson Symptom Inventory Gastrointestinal Cancer Module(MDASI-GI)and Fear of Progression Questionnaire Short Form(FoP-Q-SF)were used to assess the patients.The relationship between symptom experience and fear of progression of gastric carcinoma patients was analyzed by Spearman correlation analysis.The structural equation modeling was constructed to test the mediating effect of symptom severity on the fear of progression and symptoms distress.Results The score of symptoms severity and symptoms distress was 1.30(2.42)and 1.67(3.04)[M(IQR)];the average score of fear of progression was(29.35±9.34).There was a positive correlation between the score of symptoms experience and fear of progression(r=0.471~0.675,P<0.01).Path analysis showed that fear of progression had a positive impact on symptom severity(β=0.603,P<0.05)and symptoms distress(β=0.215,P<0.05).Fear of progression was the mediator variable between symptom severity and symptom distress.The mediating effect was 0.415 and the total effect was 0.630.Mediation effect accounted for 65.87%.Conclusions Patients with gastric carcinoma had different levels of symptom experience,which was corrected with different psychological status.Medical stuffs should formulate the symptom management project on the basis of patients’level of fear of progression to relieve symptom experience.