Lv Xiao-Qing, Wang Bing-Qing, Tong Huan-Huan, Liu Shan-Shan, Tang Hsin-Yi Jean, Hong Jing-Fang
Author Affiliations: The First Affiliated Hospital of Anhui Medical University (Ms Lv and Dr Hong) and School of Nursing, Anhui Medical University (Ms Lv, Dr Hong, and Mss Wang, Tong, and Liu), Anhui, China; and School of Nursing, University of Washington, Seattle (Dr Tang).
Cancer Nurs. 2022;45(1):E59-E67. doi: 10.1097/NCC.0000000000000837.
Patients with lung cancer suffer from significant psychological distress. The underlying theoretical model that may explain what predicts or mediates the degree of psychological distress has not been elucidated.
To describe the incidence of psychological distress in patients with lung cancer and to test a predictive theoretical model of psychological distress based on symptom burden, type D personality, social support, and intrusive thoughts.
Three hundred eighty-nine patients with stages I to IV lung cancer were recruited. Participants completed a battery of scales, including measures of psychological distress, symptom burden, type D personality, perceived social support, intrusive thoughts, and demographic and clinical characteristics. The predictive theoretical model was tested using structural equation modeling.
Experiencing clinically significant psychological distress was reported by 63.75% of participants. Consistent with the social cognitive processing model, symptom burden, type D personality, social support, and intrusive thoughts all significantly and directly predicted the level of psychological distress in patients with lung cancer. Moreover, intrusive thoughts mediated the effects of type D personality and symptom burden on psychological distress; social support and symptom burden mediated the effects of type D personality on psychological distress.
The majority of the participants experienced psychological distress at a clinically significant level. Intrusive thoughts and social support mediated the effects of type D personality and symptom burden on psychological distress.
Patients with type D personality and symptom burden should be identified. Interventions for targeting social support and intrusive thoughts might ultimately reduce their psychological distress.
肺癌患者存在显著的心理困扰。尚未阐明可能解释心理困扰程度的预测因素或中介因素的潜在理论模型。
描述肺癌患者心理困扰的发生率，并基于症状负担、D型人格、社会支持和侵入性思维测试心理困扰的预测理论模型。
招募了389例I至IV期肺癌患者。参与者完成了一系列量表，包括心理困扰、症状负担、D型人格、感知社会支持、侵入性思维以及人口统计学和临床特征的测量。使用结构方程模型对预测理论模型进行了测试。
63.75%的参与者报告有临床上显著的心理困扰。与社会认知加工模型一致，症状负担、D型人格、社会支持和侵入性思维均显著且直接预测了肺癌患者的心理困扰水平。此外，侵入性思维介导了D型人格和症状负担对心理困扰的影响；社会支持和症状负担介导了D型人格对心理困扰的影响。
大多数参与者经历了临床上显著水平的心理困扰。侵入性思维和社会支持介导了D型人格和症状负担对心理困扰的影响。
应识别出具有D型人格和症状负担的患者。针对社会支持和侵入性思维的干预措施可能最终减轻他们的心理困扰。
