垂体神经内分泌肿瘤术后患者积极应对方式在疾病感知与恐惧疾病进展的中介效应

Mediating effect of positive coping style on disease perception and fear of disease progression in patients after the surgery of pituitary neuroendocrine tumour

目的 调查垂体神经内分泌肿瘤术后患者恐惧疾病进展现状,探讨积极应对方式、疾病感知与在恐惧疾病进展的中介效应。方法 采用便利抽样法,选取2022年1月至2023年1月在山西省某三级甲等综合医院神经外科行手术治疗后的垂体神经内分泌肿瘤患者345例作为研究对象,采用一般资料调查表、疾病感知问卷、医学应对方式问卷和恐惧疾病进展简化量表进行调查,采用Pearson相关分析患者疾病感知、积极应对方式及恐惧疾病进展之间的相关性,采用结构方程模型分析积极应对方式在疾病感知与恐惧疾病进展间的中介效应。结果 共337例患者完成研究。垂体神经内分泌肿瘤术后患者恐惧疾病进展得分为(35.02±4.92)分;恐惧疾病进展与疾病感知呈正相关(r=0.672,P<0.01),与积极应对方式呈负相关(r=-0.679,P<0.01),积极应对方式与疾病感知呈负相关(r=-0.610,P<0.01);疾病感知不仅对恐惧疾病进展存在直接影响,还可通过积极应对方式对恐惧疾病进展产生间接影响(中介效应值为0.202,P<0.001)占总效应的25.50%。结论 垂体神经内分泌肿瘤术后患者的积极应对方式是疾病感知与恐惧疾病进展的中介变量。医护人员应动态评估、早期识别患者的应对方式,采取个性化的指导方案,引导患者积极应对,从而降低其负性疾病感知对恐惧疾病进展的影响。

Objective To investigate the status quo of fear of disease progression(FoP)in patients after pituitary neuroendocrine tumour surgery and analyse the medication effects of positive coping style on disease perception and FoP.Methods Convenient sampling method was used to select 345 patients with pituitary neuroendocrine tumours who underwent surgical operations in the neurosurgery department of a Grade IIIA hospital in Shanxi Province from January 2022 to January 2023 as the research objects.A general data questionnaire,disease perception questionnaire,medical coping style questionnaire and fear of progression questionnaire-short form(FoP-Q-SF)were used in the investigation.Pearson correlation was employed to analyse the correlations of the disease perception,active coping style and FoP among the patients.Structural equation models were used to analyse the mediating effects of positive coping styles on disease perception and FoP.Results The FoP score of patients after pituitary neuroendocrine tumour surgery was found at(35.02±4.92).FoP was positively correlated with the disease perception(r=0.672,P<0.01),and negatively with the active coping style(r=-0.679,P<0.01).Positive coping styles were positively correlated with disease perception(r=-0.610,P<0.01).Disease perception not only had a direct effect on FoP,but also had an indirect effect on FoP via active coping style,with an intermediate effect value of 0.202(P<0.001),accounting for 25.5%of total effect.Conclusion Postoperative positive coping style in patients with pituitary neuroendocrine tumour is a mediating variable between the disease perception and FoP.Medical staff should dynamically assess and early identify coping styles of patients and adopt personalised guidance programs,therefore to guide the patients to actively cope with the disease,so as to reduce the negative disease perception and alleviate the fear of disease progression of the patients.