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应对方式对乳腺癌患者疾病不确定感与沮丧情绪关系的中介作用:一项横断面中介分析。

Contribution of coping style to the association between illness uncertainty and demoralisation in patients with breast cancer: a cross-sectional mediation analysis.

机构信息

School of Nursing, Hebei Medical University, Shijiazhuang, Hebei, China.

Critical Medicine, Hospital of Qingdao University, Qingdao, Shandong, China.

出版信息

BMJ Open. 2023 Mar 16;13(3):e065796. doi: 10.1136/bmjopen-2022-065796.

Abstract

OBJECTIVE

Demoralisation is a common psychological issue in patients with cancer and aggravates depression, reduces the quality of life and even causes suicidal ideation. There is a lack of knowledge about illness uncertainty, coping style and demoralisation in patients with breast cancer. The current study explored the relationship between illness uncertainty and demoralisation among those patients, as well as the potential mediating role of coping style.

DESIGN

A cross-sectional study.

SETTING

Participants were recruited from the Breast Tumor Center in a tertiary hospital in Shijiazhuang, Hebei province.

PARTICIPANTS

A total of 211 patients with breast cancer completed the survey.

OUTCOME MEASURES

A total of 211 patients with breast cancer completed the Mishel's Uncertainty in Illness Scale, Trait Coping Style Questionnaire and the Mandarin version of Demoralization Scale (DS-MV).

RESULTS

Of the patients, 47.40% exhibited symptoms of demoralisation (DS-MV>30), and the mean of demoralisation score was (29.55±13.21). The results demonstrated that illness uncertainty and negative coping styles were positively related to demoralisation (p<0.001), while active coping styles were negatively related to demoralisation (p<0.001). Importantly, coping styles could partially mediate the relationship between illness uncertainty and demoralisation (p<0.01).

CONCLUSION

Our study illustrated that illness uncertainty was associated with demoralisation in patients with breast cancer, and coping style acted as a mediator in this relationship. The findings highlighted the critical role of reducing negative coping styles to the early prevention and efficient treatment of demoralisation among those patients.

摘要

目的

沮丧是癌症患者常见的心理问题,会加重抑郁,降低生活质量,甚至导致自杀意念。乳腺癌患者对疾病不确定性、应对方式和沮丧的了解不足。本研究探讨了乳腺癌患者疾病不确定性与沮丧之间的关系,以及应对方式的潜在中介作用。

设计

横断面研究。

地点

参与者来自河北省石家庄市一家三级医院的乳腺肿瘤中心。

参与者

共有 211 名乳腺癌患者完成了调查。

结果测量

共有 211 名乳腺癌患者完成了米舍尔疾病不确定感量表、特质应对方式问卷和中文版沮丧量表(DS-MV)。

结果

在这些患者中,有 47.40%出现沮丧症状(DS-MV>30),沮丧评分的平均值为(29.55±13.21)。结果表明,疾病不确定性和消极应对方式与沮丧呈正相关(p<0.001),而积极应对方式与沮丧呈负相关(p<0.001)。重要的是,应对方式可以部分中介疾病不确定性和沮丧之间的关系(p<0.01)。

结论

本研究表明,乳腺癌患者的疾病不确定性与沮丧有关,应对方式在这种关系中起中介作用。研究结果强调了减少消极应对方式对这些患者早期预防和有效治疗沮丧的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9cf/10030480/274212b4c1e8/bmjopen-2022-065796f01.jpg

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