肺癌患者病耻感在D型人格和生活质量中的中介作用分析

Mediating role of stigma in type D personality and quality of life in lung cancer patients

目的探讨D型人格对肺癌患者生活质量的影响及病耻感在D型人格和生活质量间的中介作用。方法采用便利抽样法,于2021年2月—2022年8月选取浙江省台州市的3家三级甲等医院的334例肺癌患者为研究对象。采用一般资料调查表、D型人格量表、癌症治疗功能评价量表(FACT-G)、Cataldo肺癌患者病耻感量表对患者进行调查。采用Pearson相关分析法分析D型人格、生活质量和病耻感之间的相关性。使用SPSS 24.1宏程序PROCESS中的Model 4进行中介效应分析。本研究共发放问卷334份,回收有效问卷332份,问卷有效回收率为99.40%(332/334)。结果332例肺癌患者FACT-G总分为(75.81±7.27)分。D型人格阳性率为19.28%(64/332)。D型人格肺癌患者的生活质量总分、社会/家庭状况、功能状况、情感状况和生理状况维度得分均低于非D型人格患者,差异有统计学意义(P<0.05)。肺癌患者D型人格和病耻感与生活质量呈负相关(P<0.01),D型人格与病耻感呈正相关(P<0.01)。中介效应分析结果显示,D型人格直接负向预测生活质量,病耻感在D型人格和生活质量之间发挥部分中介效应,中介效应值为0.189,占总效应的23.05%。结论肺癌患者的D型人格直接影响其生活质量,病耻感在D型人格和生活质量之间发挥部分中介作用,进而间接作用于生活质量。对D型人格阳性的患者除了提供个性化的心理支持外,还应关注其病耻感,以降低其对生活质量造成的潜在负面效应。

Objective To explore the impact of type D personality on quality of life in lung cancer patients and the mediating role of stigma between type D personality and quality of life.Methods From February 2021 to August 2022,convenience sampling was used to select 334 lung cancer patients from three ClassⅢGrade A hospitals in Taizhou City,Zhejiang Province as participants.The patients were surveyed using the General Information Questionnaire,Type D Personality Scale-14,Functional Assessment of Cancer Therapy Scale General(FACT-G),and Cataldo Lung Cancer Stigma Scale.Pearson correlation was used to analyze the correlation between type D personality,quality of life,and stigma.Model 4 in the SPSS 24.1 macro program PROCESS was used for mediating effect analysis.A total of 334 questionnaires were distributed,and 332 valid questionnaires were collected,with a valid response rate of 99.40%(332/334).Results The FACT-G total score of 332 lung cancer patients was(75.84±7.27).The positive rate of type D personality was 19.28%(64/332).The total score of quality of life,social/family status,functional status,emotional status,and physiological status dimension scores in patients with type D personality lung cancer were lower than those in non-type D personality patients,and the difference was statistically significant(P<0.05).There were negative correlations between type D personality and quality of life,and between stigma and quality of life in lung cancer patients(P<0.01),and a positive correlation between type D personality and stigma(P<0.01).Mediating effect analysis showed that type D personality directly negatively predicted quality of life,and stigma played a partial mediating effect between type D personality and quality of life,with a mediating effect value of 0.189,accounting for 23.05%of the total effect.Conclusions The type D personality of lung cancer patients directly affects their quality of life,and the stigma plays a partial mediating role between type D personality and quality of life,thereby indirectly affecting quality of life.In addition to providing personalized psychological support,patients with type D personality should also pay attention to their stigma to reduce potential negative effects on their quality of life.