宫颈癌术后患者的社会支持和肿瘤复发恐惧:疾病不确定感的中介作用

Social support and fear of cancer recurrence among postoperative patients with cervical cancer:the mediation role of illness uncertainty

目的调查宫颈癌术后患者的癌症复发恐惧(FCR)、疾病不确定感、社会支持的现状,探讨疾病不确定感在宫颈癌术后患者FCR与社会支持的中介作用。方法本研究为横断面调查研究,采用便利抽样法选取2021年9月至2022年7月海安市人民医院和南通大学附属医院收治的260例宫颈癌术后患者为研究对象,采用一般资料问卷、疾病进展恐惧简化量表(FoP-Q-SF)、疾病不确定感量表(MUIS)、社会支持评定量表(SSRS)对患者进行调查。结果179例(68.85%)宫颈癌术后患者存在复发恐惧,FoP-Q-SF的总分为(37.08±6.01)分,MUIS总分为(79.86±11.21)分,SSRS总分为(40.83±10.94)分;宫颈癌术后患者的FCR、疾病不确定感与社会支持呈负相关,FCR与疾病不确定感呈正相关(P<0.01);疾病不确定感在FCR与社会支持的中介效应为-0.189,占总效应的47.97%。结论宫颈癌术后患者FCR水平较高,疾病不确定感处于中等水平,社会支持良好,宫颈癌术后患者的疾病不确定感在社会支持和FCR起中介效应。临床工作者应采取针对性的干预措施,以降低患者的疾病不确定感,促进社会支持水平的提升,进而降低FCR水平。

Objective To investigate the fear of cancer recurrence(FCR)、illness uncertainty and social support in postoperative patients with cervical cancer,and to analyze illness uncertainty in FCR and social support.Method From September 2022 to July 2022,a cross sectional survey research,a convenience sampling method was used to select 260 postoperative patients with cervical cancer in Hai′an People′s Hospital and Affiliated Hospital of Nantong University as the research objects.The general information questionnaire and the fear of progression questionnaire-short form(FoP-Q-SF),the disease uncertainty scale(MUIS),social support rating scale(SSRS)were used to investigate the patients.Result The majority of cervical cancer survivors have FCR(68.85%).The scores of FoP-Q-SF、MUIS and SSRS in postoperative patients with cervical cancer were(37.08±6.01)points,(79.86±11.21)points,(40.83±10.94)points.FCR and MUIS was significantly negatively associated with social support,FCR was significantly positively associated with uncertainty in illness(P<0.01).Moreover,uncertainty in illness was found to mediate the relationship between social support and FCR,the indirect effect-0.189 and the mediating effect accounted for 47.97%.Conclusion The FCR level of postoperative patients with cervical cancer is high and good social support can directly mitigate FCR,while illness uncertainty can play a mediation role between social support and FCR.Clinicians should conducted to explore effective interventions for social support and IU to ultimately mitigate FCR in cervical cancer survivors.