自我效能在肺癌患者社会支持与心理痛苦间的中介效应

The mediating effect of self-efficacy on the relationship between social support and psychological distress in patients with lung cancer

目的 分析心理痛苦与自我效能和社会支持的相关性以及自我效能在肺癌患者社会支持与心理痛苦间的中介效应。方法2021年6月至2023年1月,采用方便抽样法选取北京市某三级甲等肿瘤专科医院胸外科的204例肺癌患者作为研究对象。采用一般资料调查表、心理痛苦温度计(DT)调查表、中文版癌症自我管理效能感量表(C-SUPPH)和社会支持调查量表(SSRS)进行问卷调查。采用Pearson法分析肺癌患者社会支持、自我效能和心理痛苦之间的相关性。采用AMOS 24.0构建结构方程模型,并运用Bootstrap方法进行中介效应检验。结果204例肺癌患者中,男80例,女124例;年龄(56.01±11.46)岁;DT调查表得分为(3.94±2.00)分,其中DT调查表得分≥4分者122例,占59.8%。C-SUPPH得分为(98.40±21.31)分,SSRS总分为(44.71±6.43)分。204例肺癌患者的心理痛苦与社会支持和自我效能均呈负相关(r=-0.376,P<0.01;r=-0.647,P<0.01);204例肺癌患者的社会支持与自我效能呈正相关(r=0.325,P<0.01)。自我效能在肺癌患者社会支持与心理痛苦之间的中介效应为-0.262 (95%CI:-0.412~-0.177),占总效应的44.3%。结论 肺癌患者心理痛苦检出率较高,心理痛苦与自我效能和社会支持均呈负相关。自我效能在社会支持与心理痛苦之间存在部分中介作用。

Objective Analyze the correlation between psychological distress,selfefficacy and social support,and investigate the mediating effect of self-efficacy on the relationship between social support and psychological distress in lung cancer patients.Methods From June 2021 to January 2023,204 lung cancer patients from the Department of Thoracic Surgery of A tertiary hospital in Beijing were selected using convenience sampling.Questionnaires including demographic information,Distress Thermometer(DT),Chinese version of Strategies Used by People to Promote Health(C-SUPPH),and Social Support Rating Scale(SSRS) were used for data collection.Pearson correlation analysis was conducted to explore the relationships between social support,self-efficacy,and psychological distress in lung cancer patients.Structural equation modeling was performed using AMOS 24.0,and Bootstrap method was used to test the mediating effect.Results Among the 204 lung cancer patients,there were 80 males and 124 females,with an average age of 56.01±11.46 years.The mean score on the DT was 3.94±2.00,with 122 patients(59.8%) scoring ≥4.The C-SUPPH score was 98.40±21.31,and the SSRS total score was 44.71±6.43.Psychological distress in lung cancer patients was negatively correlated with social support and self-efficacy(r=-0.376,P< 0.01;r=-0.647,P< 0.01),while social support and self-efficacy were positively correlated(r=0.325,P< 0.01).The mediating effect of self-efficacy on the relationship between social support and psychological distress in lung cancer patients was-0.262(95%CI:-0.412 to-0.177),accounting for 44.3% of the total effect.Conclusion The detection rate of psychological distress is high in lung cancer patients,and psychological distress is negatively correlated with self-efficacy and social support.Self-efficacy plays a partial mediating role between social support and psychological distress in lung cancer patients.