心理韧性在肿瘤患儿父母疾病不确定感和医学应对方式间的中介效应分析

Analysis of the mediating effect of mental toughness on the uncertainty of illness and medical coping styles of parents of children with cancer

目的探讨心理韧性在肿瘤患儿父母疾病不确定感和医学应对方式间的中介效应。方法选取2020年9月至2021年8月在重庆大学附属肿瘤医院住院治疗的228例肿瘤患儿父母为研究对象;采用一般情况调查问卷、10条目心理韧性量表(CD-RISC-10)、修订版中文版父母用疾病不确定感量表(PPUS)和中文版父母用应对方式量表(CHIP)收集和评估肿瘤患儿父母一般资料、心理韧性、疾病不确定感及医学应对情况。采用Pearson相关分析肿瘤患儿父母CD-RISC-10得分与PPUS得分、CHIP得分的相关性;根据Baron和Kenny的中介及调节效应分析心理韧性在肿瘤患儿父母疾病不确定感和医学应对方式间的中介效应。结果共发放调查问卷228份,回收有效问卷218份,有效率为95.61%。家庭月收入<5000元、医疗费用自费肿瘤患儿父母的CD-RISC-10得分和CHIP得分均低于家庭月收入≥5000元、医疗费用非自费的肿瘤患儿父母,差异均有统计学意义(P<0.05);独生子女、家庭月收入<5000元、医疗费用自费肿瘤患儿父母PPUS得分高于非独生子女、家庭月收入≥5000元及医疗费用非自费的肿瘤患儿父母,差异均有统计学意义(P<0.05)。Pearson相关性分析结果显示,肿瘤患儿父母CD-RISC-10得分与PPUS得分呈负相关(r=-0.420,P<0.05),与CHIP得分呈正相关(r=0.776;P<0.05)。中介效应分析结果显示,心理韧性在肿瘤患儿父母疾病不确定感与医学应对方式间的中介效应为37.78%。结论心理韧性与肿瘤患儿父母疾病不确定感和医学应对方式均具显著相关,疾病不确定感可通过影响肿瘤患儿父母心理韧性进而影响瘤患儿父母的医学应对方式。

Objective To explore the mediating effect of mental toughness on the uncertainty of illness and medical coping styles of parents of children with cancer.Methods Parents of 228 children with cancer who were hospitalized in Chongqing University Cancer Hospital from September 2020 to August 2021 were prospectively selected as the research subjects;the general information questionnaire,10 item Conner Davidson Resilience Scale(CD-RISC-10),Parents′Perception of Uncertainty Scale(PPUS)and Chinese version of the Coping Styles for Parents Inventory(CHIP)were used to collect and assessed general information,psychological resilience,illness uncertainty and medical coping of parents of children with tumors.Pearson′s correlation was used to analyze the correlation between CD-RISC-10 score and PPUS score and CHIP score of parents of children with tumors;the mediating effect of mental toughness between disease uncertainty and medical coping of parents of children with tumors was analyzed according to the mediating and moderating effects of Baron and Kenny.Results A total of 228 questionnaires were distributed,and 218 valid questionnaires were recovered,with a validity rate of 95.61%.The CD-RISC-10 scores and CHIP scores of parents of children with tumors whose monthly family income was<5000 yuan and who paid out-of-pocket for medical expenses were lower than those of parents of children with tumors whose monthly family income was≥5000 yuan and who did not pay out-of-pocket for medical expenses(P<0.05);the PPUS scores of parents of children with tumors who had only one child,whose monthly family income was<5000 yuan and who paid out-of-pocket for medical expenses were higher than those of parents of children who had not only one child,whose monthly family income was≥5000 yuan and who did not pay out-of-pocket for medical expenses(P<0.05).The results of Pearson correlation analyses showed that the CD-RISC-10 scores of parents of children with tumors were negatively correlated with the scores of PPUS(r=-0.420,P<0.05)and positively correlated with the scores of CHIP(r=0.776,P<0.05).The results of the mediation effect analysis showed that the mediation effect of mental toughness between disease uncertainty and medical coping style of parents of children with cancer was 37.78%.Conclusion Mental toughness is significantly related to the uncertainty of illness and medical coping style of parents of children with cancer,and the uncertainty of illness can affect the psychological toughness of parents of children with cancer and then affect the medical coping style of parents of children with cancer.