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中国内地肺癌患者道德困境的危险因素。

Risk Factors of Demoralization Among Lung Cancer Patients in Mainland China.

机构信息

Nursing Department, Zhoukou Vocational and Technical College, Zhoukou, China.

College of Nursing and Health, Henan University, Henan, China.

出版信息

Am J Health Behav. 2023 Jun 30;47(3):588-594. doi: 10.5993/AJHB.47.3.16.

DOI:10.5993/AJHB.47.3.16
PMID:37596747
Abstract

Due to the severity of cancer, patients may experience feelings of helplessness and despair, resulting in demoralization among lung cancer patients. In this study, we investigated the risk factors of demoralization in middle-aged and older Chinese lung cancer patients via their relationship with patients' demographic data and disease characteristics. This study is a cross-sectional descriptive study using a structured questionnaire including assessments of demographic data and disease, the Demoralization Scale Mandarin Version (DS-MV), the Social Support Rate Scale (SSRS), the Medical Coping Modes Questionnaire (MCMQ), as well as The European Organization for Research and Treatment of Cancer (EORTC QLQ-C30). Overall, 289/300 (96.3%) patients with lung cancer completed questionnaires. The mean score of DS-MV was 49.27 (SD=15.19) (range, 21-81) and the mean score of SSRS was 33.37 (SD=5.43) (range,17-48). Multiple linear regression analysis identified high demoralization was significantly related to age (p<.001), medical payment (p=.003), times of chemotherapy (p=.026), family monthly income (p=.025), avoidance dimension (p<.001), surrender dimension (p<.001), social support (p=.001), symptom score (p<.001), overall health score (p=.009) and function score (p<.001). This study demonstrates the factors influencing demoralization among middle-aged and older lung cancer patients. Demoralization is a prevalent psychiatric problem in Chinese lung cancer patients. Therefore, we recommend strong social support to be protective against demoralization. We suggest that medical staff establish the concept of social support for patients with lung cancer, actively seek effective resources from family, friends, and other social support organizations to help patients establish a social support system that improves patient courage and confidence in their post-cancer life.

摘要

由于癌症的严重性,患者可能会感到无助和绝望,导致肺癌患者士气低落。在这项研究中,我们通过患者的人口统计学数据和疾病特征,调查了中年和老年中国肺癌患者士气低落的风险因素。这是一项使用结构问卷的横断面描述性研究,评估了人口统计学数据和疾病、中文版 demoralization 量表(DS-MV)、社会支持率量表(SSRS)、医学应对方式问卷(MCMQ)以及欧洲癌症研究与治疗组织(EORTC)生活质量核心问卷(QLQ-C30)。共有 289/300(96.3%)例肺癌患者完成了问卷。DS-MV 的平均得分为 49.27(SD=15.19)(范围 21-81),SSRS 的平均得分为 33.37(SD=5.43)(范围 17-48)。多元线性回归分析发现,高 demoralization 与年龄(p<.001)、医疗支付(p=.003)、化疗次数(p=.026)、家庭月收入(p=.025)、回避维度(p<.001)、投降维度(p<.001)、社会支持(p=.001)、症状评分(p<.001)、整体健康评分(p=.009)和功能评分(p<.001)显著相关。本研究表明了影响中年和老年肺癌患者士气低落的因素。士气低落是中国肺癌患者普遍存在的精神问题。因此,我们建议提供强有力的社会支持来预防士气低落。我们建议医务人员为肺癌患者树立社会支持的观念,积极从家庭、朋友和其他社会支持组织中寻找有效的资源,帮助患者建立社会支持系统,提高患者在癌症后的勇气和信心。

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