结直肠癌患者配偶亲密关系与二元应对在自我表露与复发恐惧间的作用机制初探

A preliminary study of the action mechanism of intimacy and dyadic coping in self-disclosure and fear of recurrence in spouses of patients with colorectal cancer

目的调查结直肠癌患者配偶复发恐惧的现状及其与自我表露、亲密关系以及二元应对间的关系。方法采用一般资料调查表、配偶版恐惧疾病进展简化量表(FOP-Q-SF/P)、痛苦表露指数量表(DDI)、夫妻支持应对量表(DCI)、洛克-华莱氏婚姻调适量表(MAT)对300例结直肠癌患者配偶展开调查。结果不同年龄、是否有宗教信仰、受教育程度、工作状态、病情了解度、照顾患者总时间、家庭月收入、患者医保类型的结直肠癌患者配偶FOP-Q-SF/P评分比较差异均有统计学意义(P<0.001)。结直肠癌患者配偶FOP-Q-SF/P总分及社会功能、家庭健康维度评分与DDI、DCI总分及压力沟通、积极应对、代办应对、消极应对、共同应对维度评分、MAT评分均呈负相关(P<0.01)。DDI、DCI总分及各维度评分、MAT评分两两间均呈正相关(P<0.01)。中介模型检验结果显示,二元应对在自我表露与复发恐惧间起部分中介作用,中介效应值-0.110,效应占比为33.2%。亲密关系与二元应对在自我表露与复发恐惧间起链式中介作用,中介效应值-0.048,效应占比为14.5%。结论结直肠癌患者配偶复发恐惧处于中等水平,自我表露可直接影响复发恐惧,也可通过二元应对的部分中介作用及亲密关系与二元应对的链式中介作用间接影响复发恐惧。

Objective To explore the status of fear of recurrence in spouses of patients with colorectal cancer and its relationships with self-disclosure,intimacy and dyadic coping.Methods The spouses of 300 patients with colorectal cancer were selected and assessed with general information questionnaire,Fear of Progression Questionnaire Short Form/Partner(FOP-Q-SF/P),Distress Disclosure Index(DDI),Dyadic Coping Inventory(DCI)and Locke-Wallce short marital adjustment and prediction test(MAT).Results There existed significant differences in FOP-Q-SF/P scores of spouses with different ages,religious beliefs,educational levels,vocational statuses,disease awareness,total time spent in looking after patients,monthly family incomes,patients’medical insurance types(P<0.001).The total score and all factor scores of FOP-Q-SF/P were negatively correlated with the total scores of DDI and MAT,as well as the total score and factor scores of pressure communication,positive coping,negative coping,commission coping and joint coping of DCI(P<0.01).The total scores of DDI,MAT and the total score as well as all factor scores of DCI were positively correlated with one another(P<0.01).The results of mediation model test showed that dyadic coping played a partial mediating role in the relationship between self-disclosure and fear of recurrence,and the mediating effect value was-0.110,accounting for 33.2%.Intimacy and dyadic coping played a chain mediating role between self-disclosure and fear of recurrence,and the mediating effect value was-0.048,accounting for 14.5%.Conclusion Fear of recurrence in spouses of colorectal cancer patients is at a moderate level,which can be directly affected by self-disclosure,and also can be indirectly affected by the partial mediating effect of dyadic coping as well as the chain mediating effect of intimacy and dyadic coping.