病耻感在青年乳腺癌患者领悟社会支持与社会疏离间的中介作用

The mediating role of disease stigma in the appreciation of young breast cancer patients regarding the relationship between social support and social alienation

目的探讨青年乳腺癌患者病耻感在领悟社会支持与社会疏离间的中介效应,为临床干预提供理论依据。方法方便抽取2022年3—4月河南省3所三级甲等医院接受治疗的乳腺癌患者225例,应用一般资料调查表、病耻感调查表、领悟社会支持量表和一般疏离感量表对其进行调查。结果青年乳腺癌患者病耻感、领悟社会支持和社会疏离感总分分别为(60.19±15.16)分、(64.67±17.89)分、(44.66±12.78)分;Pearson相关分析结果显示,青年乳腺癌患者的病耻感与社会疏离感呈显著正相关关系(r=0.324),领悟社会支持与病耻感、社会疏离感呈显著负相关关系(r=-0.331、-0.212),均P<0.01;结构方程模型结果显示,领悟社会支持对社会疏离感有直接(负向)效应(β=-0.616),病耻感对社会疏离感有直接(正向)效应(β=0.238);病耻感在领悟社会支持与社会疏离感间起部分中介作用,中介效应(β=-0.150)占总效应(β=-0.766)的19.6%。结论青年乳腺癌患者社会疏离感水平有待改善,可以通过提高其领悟社会支持水平或降低病耻感来减少患者的社会疏离感。

Objective To investigate how stigma mediates young breast cancer patients’comprehension of social support and social distancing,and to establish a theoretical foundation for clinical intervention.Methods It is convenient to select 225 breast cancer patients who underwent treatment at 3 Grade A hospitals in Henan Province during March and April 2022.These patients will be surveyed using a general data questionnaire,questionnaire of disease stigma,perceived social support scale,and general sense of isolation scale.Results The overall scores for disease stigma,perceived social support,and social alienation amongst young adults with breast cancer were(60.19±15.16)points,(64.67±17.89)points,and(44.66±12.78)points,respectively.The Pearson correlation analysis indicated a significant positive correlation between stigma and social distancing(r=0.324),and a significant negative correlation between perceived social support and both disease stigma and social distancing(r=-0.331,-0.212,P<0.01).The structural equation model indicated that perceived social support had a negative direct effect(β=-0.616)on social distancing,while the shame from disease had a positive direct effect(β=-0.238).Moreover,disease stigma partially mediated the relationship between perceived social support and social distancing(β=-0.150),accounting for 19.6%of the total effect(β=-0.766).Conclusions The social alienation level among young breast cancer patients requires improvement and can be lessened by enhancing their perceived social support or decreasing their disease stigma.