心理韧性和家庭支持在肺癌患者围手术期恐惧与焦虑症状间的中介效应

The mediating effect of psychological resilience and perceived family support on perioperative fear and anxiety symptoms of lung cancer patients

目的分析心理韧性和家庭支持在肺癌患者围手术期恐惧与焦虑症状间的中介效应。方法纳入2021年1月至2023年4月中山大学孙逸仙纪念医院收治的225例肺癌围手术期患者作为研究对象,采用一般资料调查量表、心理韧性评定量表、领悟社会支持量表、外科手术恐惧问卷、状态-特质焦虑量表进行问卷调查,采用Pearson相关性分析心理韧性、家庭支持及手术恐惧与焦虑症状的相关性,采用Process的Model 6分析心理韧性及家庭支持在肺癌患者围手术期恐惧与焦虑症状的中介效应。结果研究纳入220例肺癌患者,焦虑症状得分为(49.22±10.17)分。不同年龄、受教育年限、肿瘤分期、心理韧性及家庭支持得分的患者的焦虑症状得分差异有统计学意义(P<0.05)。焦虑症状得分与恐惧得分呈正相关(r=0.85,P<0.05),与心理韧性(r=-0.90,P<0.05)及家庭支持得分(r=-0.81,P<0.05)呈负相关。链式中介效应分析显示,围手术期恐惧→心理韧性→焦虑症状的效应值为0.36,占总效应的63.54%,占总间接效应的75.30%,间接效应1成立(P=0.0214);围手术期恐惧→家庭支持→焦虑症状的效应值为0.06,占总效应的11.21%,占总间接效应的13.29%,间接效应2成立(P=0.0013);围手术期恐惧→心理韧性→家庭支持→焦虑症状的效应值为0.05,占总效应的9.63%,占总间接效应的11.41%,间接效应3成立(P=0.0025)。结论肺癌患者围手术期表现出较为显著的焦虑症状,心理韧性和家庭支持在肺癌患者围手术期恐惧与焦虑症状间存在链式中介效应,临床医护人员可以根据围手术期恐惧影响焦虑症状的路径,促进患者的心理韧性和家庭支持,改善肺癌患者焦虑症状。

Objective To analyze the mediating effect of psychological resilience and family support on perioperative fear and anxiety disorders of lung cancer patients.Methods 225 perioperative lung cancer patients admitted to Sun Yat-sen Memorial Hospital from January 2021 to April 2023 were included as the study subjects.The general information questionnaire,Connor Davidson Resilience Scale(CD-RISC),Perceived Social Support Scale(PSSS),Surgical Fear Questionnaire(SFQ),State-Trait Anxiety Inventory(STAI)were used to conduct a questionnaire survey.Pearson correlation analysis was used to analyze the correlation between psychological resilience,family support,fear of surgery and anxiety symptoms.Model 6 of Process was used to analyze the mediating effect of psychological resilience and family support on perioperative fear and anxiety disorders of lung cancer patients.Results 220 patients with lung cancer were included in the study,and the score of anxiety symptoms was(49.22±10.17).There were statistically significant differences in anxiety symptoms scores among patients with different ages,educational levels,tumor stages,psychological resilience and family support scores(P<0.05).The scores of anxiety symptoms were positively correlated with the scores of fear(r=0.85,P<0.05),and negatively correlated with the scores of psychological resilience(r=-0.90,P<0.05)and family support(r=-0.81,P<0.05).The chain-mediated effect analysis showed that the effect value of perioperative fear→psychological resilience→anxiety symptoms was 0.36,accounting for 63.54%of the total effect and 75.30%of the total indirect effect,indirect effect 1 was established(P=0.0214);the effect value of perioperative fear→family support→anxiety symptoms was 0.06,accounting for 11.21%of the total effect and 13.29%of the total indirect effect,and indirect effect 2 was established(P=0.0013);the effect value of perioperative fear→psychological resilience→family support→anxiety disorders was 0.05,accounting for 9.63%of the total effect and 11.41%of the total indirect effect,indirect effect 3 was established(P=0.0025).Conclusion Patients with lung cancer showed significant anxiety symptoms during perioperative period.The chain mediation effect of psychological resilience and family support between perioperative fear and anxiety disorders of lung cancer patients is established.Clinical medical staff should take intervention measures based on the path of adjusting the influence of perioperative fear on anxiety disorders,so as to improve the anxiety disorders symptom of lung cancer patients and promote their early recovery.