二元应对在肺癌患者配偶照顾负担与生活质量间的中介作用分析

Dyadic coping mediatingcare burden and quality of life in spouse of lung cancer patient

目的:评估肺癌患者配偶二元应对、照顾负担、生活质量的现状,分析三者之间的路径作用机制。方法:采用方便抽样法,选取2022年9月至2023年4月河北省5所三级甲等医院的331例肺癌患者配偶为研究对象。采用一般资料调查表、照顾者负担量表(ZBI)、家庭照顾者生活质量量表(FAMQOL)、二元应对量表(DCI)对其进行调查,分析二元应对在肺癌患者配偶照顾负担与生活质量间的中介作用。结果:331例肺癌患者配偶照顾负担总分为(24.58±13.42)分,生活质量总分为(50.41±8.08)分,二元应对总分为(127.20±18.16)分。照顾负担与二元应对、生活质量均呈负相关(r值分别为-0.488、-0.265,均P<0.01),二元应对与生活质量呈正相关(r=0.419,P<0.01)。结构方程模型结果显示,肺癌患者配偶的照顾负担可负向预测生活质量,效应值为-0.183,二元应对在照顾负担与生活质量间起部分中介效应,占总效应的40.72%。结论:医护人员应开展以影响二元应对路径为依据的干预策略,尝试构建以夫妻为中心的疾病管理干预方案,从而降低患者配偶的照顾负担,提高其生活质量。

Objective:Assess the current status of dual coping,care burden,and quality of life among spouses of lung cancer patients,and analyze the pathway mechanisms among the three.Methods:Using the convenience sampling method,331 spouses of lung cancer patients from 5 tertiary hospitals in Hebei Province from September 2022 to April 2023 were selected as the research subjects.A survey was conducted using a general information questionnaire,caregiver burden scale(ZBI),family caregiver quality of life scale(FAMQOL),and binary coping scale(DCI)to analyze the mediating role of binary coping in the care burden and quality of life of spouses of lung cancer patients.Results:The total score of spouse care burden for 331 lung cancer patients was(24.58±13.42),the total score of quality of life was(50.41±8.08),and the total score of binary coping was(127.20±18.16).The burden of care was negatively correlated with binary coping and quality of life(r values were-0.488 and-0.265,respectively,P<0.01),while binary coping was positively correlated with quality of life(r=0.419,P<0.01).The structural equation model results show that the care burden of spouses of lung cancer patients can negatively predict their quality of life,with an effect value of-0.183.Binary coping plays a partial mediating effect on care burden and quality of life,accounting for 40.72%of the total effect.Conclusion:Dual coping is a mediating variable between the burden of care and quality of life for spouses of lung cancer patients.Medical staff should implement intervention strategies based on the influence of binary coping pathways,attempting to construct a disease management intervention plan centered on spouses,in order to reduce the care burden on patients spouses and improve their quality of life.