预期性悲伤对直肠癌造口患者配偶核心自我评价和心理创伤的影响研究

Analysis on the influence of anticipatory grief on spousal core self-evaluation and psychological trauma in patients with rectal cancer stomy

目的分析滇东地区直肠癌造口患者配偶的预期性悲伤与核心自我评价之间的关系,探究创伤后成长的二者间的中介作用。方法采用预期性悲伤量表、核心自我评价量表、创伤成长量表对130例直肠癌根治术患者的配偶进行问卷调查。结果直肠癌术后腹壁永久造口患者的配偶的预期性悲伤程度与核心自我评价、创伤后成长存在显著负相关,核心自我评价与创伤后成长呈显著正相关。预期性悲伤对核心自我评价有显著负面影响(P<0.001)。预期性悲伤和创伤后成长显著影响核心自我评价,预期性悲伤也显著影响创伤后成长,后者在预期性悲伤对核心自我评价的影响中起中介作用(P均<0.001)。医疗付费方式对创伤后成长的中介作用有显著调节作用(P<0.001)。结论滇东民族地区直肠癌造口患者配偶的核心自我评价影响预期性悲伤程度,该影响被创伤后成长中介,医疗付费方式在二者间起调节作用。

Objective To analyze the relationship between anticipatory grief and self-evaluation of spouses of patients with rectal cancer stomy in eastern Yunnan,and explore the mediating role between the two in post-traumatic growth.Methods The spouses of 130 patients with radical resection of rectal cancer were conducted questionnaires of Anticipatory Grief Scale,Core Self-Esteem Scale and Trauma Growth Scale.Results There was a significant negative correlation between the level of anticipatory grief,core self-assessment and post-traumatic growth in the spouses of patients with permanent abdominal wall stomy after rectal cancer surgery,and a significant positive correlation between core self-assessment and post-traumatic growth.Anticipatory grief had a significant negative effect on core self-evaluation(P<0.001).Anticipatory grief and post-traumatic growth significantly affected core self-evaluation,and anticipatory grief also significantly affected post-traumatic growth,and the latter played a mediating role in the influence of anticipatory grief on core self-evaluation(all P<0.001).Medical payment methods significantly moderated the mediating effect on post-traumatic growth(P<0.001).Conclusions The core self-evaluation of spouses of rectal cancer stomy patients in the ethnic areas of eastern Yunnan affects the level of anticipatory grief,which is mediated by post-traumatic growth and the way of medical payment.