肺癌患者化疗期间出院准备度和恐惧疾病进展及家庭功能对生命质量的影响

Pathway analysis on the effects of discharge readiness,fear of disease progression and family function on the quality of life in patients with lung cancer during chemotherapy

目的分析肺癌患者化疗期间出院准备度、恐惧疾病进展、家庭功能和生命质量的现状,通过构建结构方程模型探讨出院准备度、恐惧疾病进展和家庭功能对其生命质量的影响.方法采用肺癌治疗功能评定量表(FACT-L)、恐惧疾病进展简化量表(FoP-Q-SF)、出院准备度量表(RHDS)和家庭关怀度指数量表(APGAR),对2023年2-4月在中国医学科学院肿瘤医院就诊的393例肺癌化疗患者进行问卷调查.结果肺癌化疗患者FACT-L总分、FoP-Q-SF总分、RHDS总分和APGAR总分分别为(96.90±16.63)分、(25.63±9.01)分、(99.22±14.73)分和(9.21±1.85)分.结构模型显示,出院准备度和恐惧疾病进展均对生命质量有直接预测作用,直接效应分别为0.315、-0.699(均P<0.001);恐惧疾病进展通过出院准备度的中介作用对生命质量有间接负向预测作用(β=-0.093,P<0.001),家庭功能、生命质量与出院准备度的回归分析显示该路径不成立(P>0.05),家庭功能无法直接影响生命质量,也无法通过出院准备度的中介作用间接影响患者的生命质量.结论肺癌患者化疗期间恐惧疾病进展和出院准备度是生命质量的重要影响因素,恐惧疾病进展亦可以通过出院准备度间接影响生命质量.

ObjectivessTo analyze the status of discharge readiness,fear of disease progression,family function and quality of life in patients with lung cancer during chemotherapy,and to explore the effects of discharge readiness,fear of disease progression and family function on the quality of life by constructing structural equation model.Methods Functional assessment of cancer therapy-lung cancer(FACT-L),fear of progression questionnaire-short form(FoP-Q-SF),readiness for hospital discharge scale(RHDS)and family APGAR index(APGAR)were used to survey 393 patients with lung cancer receiving chemotherapy in Cancer Hospital of Chinese Academy of Medical Sciences from February 2023 to April 2023.Results The total score ofFACT-L,FoP-Q-SF,RHDS and APGAR in patients with lung cancer receiving chemotherapy was(96.90±16.63),(25.63±9.01),(99.22±14.73)and(9.21±1.85),respectively.The structural model showed that both discharge readiness and fear of disease progression had direct predictive effects on the quality of life,and the direct effects was 0.315 and-0.699,respectively(P<0.001).The fear of disease progression had an indirect negative predictive effect on the quality of life through the mediating effect of discharge readiness(β=-0.093,P<0.001).Regression analysis of the quality of life on family function and discharge readiness showed that this pathway was not established(P>0.05),and family function could neither directly affect the quality of life or indirectly affect the quality of life by the mediating effect of discharge readiness.Conclusions Fear of disease progression and discharge readiness in patients with lung cancer during chemotherapy are important influential factors on their quality of life,and fear of disease progression can also indirectly affect their quality of life through discharge readiness.