社会支持和污名在正念与中国肺癌患者心理困扰关系中的链式中介作用。
The chain mediating role of social support and stigma in the relationship between mindfulness and psychological distress among Chinese lung cancer patients.
机构信息
Department of Nursing, Wuchuan People's Hospital, Wuchuan, Guangdong, 524500, People's Republic of China.
Nursing Faculty, Universitat Rovira I Virgili, 43002, Tarragona, Spain.
出版信息
Support Care Cancer. 2021 Nov;29(11):6761-6770. doi: 10.1007/s00520-021-06278-7. Epub 2021 May 14.
PURPOSE
Psychological distress greatly impaired the psychological and physical well-being of lung cancer patients. Identification of protective and risk factors is a prerequisite of developing effective psychological treatment protocol. The study aims to determine the relationship of mindfulness and psychological distress and further clarify the mechanism of mindfulness against psychological distress through perceived stigma and social support among Chinese lung cancer patients.
METHOD
A cross-sectional survey study involving 441 valid Chinese lung cancer patients was conducted from September 2018 to August 2019. After all validated questionnaires that measured psychological distress, level of mindfulness, social support, and perceived stigma were returned by patients, we firstly performed correlation analysis to assess the associations between mindfulness, social support, perceived stigma, and psychological distress. Then structural equation modelling analysis was conducted to further clarify the mediating effects of perceived stigma and social support on the relationship between mindfulness and psychological distress.
RESULTS
According to our hypothesis and further modification, our revised model adequately fits to data. Mindfulness (β = - 0.107, p = 0.008) and social support (β = - 0.513, p < 0.001) had a direct effect on psychological distress. Meanwhile, mindfulness had a direct effect on perceived stigma (β = - 0.185, p < 0.001), and perceived stigma had a direct effect on social support (β = - 0.373, p < 0.001). Furthermore, mindfulness had also the indirect effect on psychological distress through the chain mediating role of stigma and social support among lung cancer patients.
CONCLUSIONS
Mindfulness has direct negative effect on psychological distress and has also indirectly negative psychological distress through impacting social support and perceived stigma.
目的
心理困扰极大地损害了肺癌患者的身心健康。识别保护和风险因素是制定有效心理治疗方案的前提。本研究旨在确定正念与心理困扰的关系,并通过中国肺癌患者的感知污名和社会支持进一步阐明正念对心理困扰的作用机制。
方法
本研究采用横断面调查,于 2018 年 9 月至 2019 年 8 月共纳入 441 例有效中国肺癌患者。患者完成所有有效问卷,包括心理困扰、正念水平、社会支持和感知污名量表的测量后,我们首先进行相关性分析,以评估正念、社会支持、感知污名与心理困扰之间的关系。然后进行结构方程模型分析,进一步阐明感知污名和社会支持在正念与心理困扰之间关系中的中介作用。
结果
根据我们的假设和进一步的修正,我们的修正模型能够很好地拟合数据。正念(β= -0.107,p=0.008)和社会支持(β= -0.513,p<0.001)对心理困扰有直接影响。同时,正念对感知污名有直接影响(β= -0.185,p<0.001),感知污名对社会支持有直接影响(β= -0.373,p<0.001)。此外,正念通过肺癌患者中污名和社会支持的链式中介作用对心理困扰也具有间接影响。
结论
正念对心理困扰有直接的负向影响,通过影响社会支持和感知污名,也间接地对心理困扰产生负向影响。