宫颈癌术后患者自我表露对创伤后成长的作用路径分析

Pathway analysis of self-disclosure to posttraumatic growth in patients after cervical cancer surgery

目的调查宫颈癌术后患者自我表露对创伤后成长的作用路径,为提升患者的创伤后成长水平提供参考。方法采用横断面调查研究方法,以便利抽样法,2022年6-11月应用一般资料调查表、痛苦表露指数量表、心理韧性量表、家庭弹性评定量表中文简化版及创伤后成长量表对山东第一医科大学附属省立医院的300例宫颈癌术后患者进行调查。结果共回收有效问卷290份,有效回收率96.7%。纳入的患者年龄23~70(48.13±10.39)岁。宫颈癌术后患者的自我表露得分为(46.41±9.82)分,心理韧性得分为(67.06±14.63)分,家庭弹性得分为(108.18±11.06)分,创伤后成长得分为(58.24±17.86)分;路径分析结果显示,宫颈癌术后患者的自我表露不仅可以直接预测创伤后成长,亦可以分别通过心理韧性、家庭弹性的中介作用,以及心理韧性和家庭弹性的链式中介作用间接预测创伤后成长。其中自我表露对创伤后成长的直接效应为0.236(95%CI 0.138~0.335),家庭弹性和心理韧性在自我表露与创伤后成长间的链式中介效应为0.036(95%CI 0.018~0.060)。结论医护人员既要考虑到自我表露对宫颈癌术后患者创伤后成长的直接影响,也应注重提升宫颈癌术后患者的心理韧性与家庭弹性,从而促进其创伤后成长。

Objective To investigate the pathway of self-disclosure to posttraumatic growth in patients after cervical cancer surgery,and to provide reference for improving the level of posttraumatic growth in patients.Methods A convenient sampling method was used to investigate 300 patients with cervical cancer after surgery in Shandong Provincial Hospital Affiliated to Shandong First Medical University from June to November 2022 by using general data questionnaire,Distress Disclosure Index(DDI),Connor-Davidson Resilience Scale(CD-RISC),the Shortened Chinese Version of the Family Resilience Assessment Scale(FRAS-C)and the Posttraumatic Growth Inventory(PTGI)in a cross-section study.Results A total of 290 valid questionnaires were collected,with an effective recovery rate of 96.7%.The patients were aged 23-70(48.13±10.39)years.The scores of self-disclosure,resilience,family resilience and posttraumatic growth were(46.41±9.82),(67.06±14.63),(108.18±11.06)and(58.24±17.86)respectively.The results of pathway analysis showed that self-disclosure could not only directly predict posttraumatic growth,but also indirectly predict posttraumatic growth through the mediating role of resilience and family resilience,and the chain mediating role of resilience and family resilience,respectively.The direct effect of self-disclosure on posttraumatic growth was 0.236(95%CI 0.138-0.335),and the chain mediating effect of family resilience and resilience between self-disclosure and posttraumatic growth was 0.036(95%CI 0.018-0.060).Conclusions Medical staff should not only consider the direct influence of self-disclosure on posttraumatic growth,but also pay attention to improve the resilience and family flexibility of patients after cervical cancer surgery,so as to promote their posttraumatic growth.