School of Nursing, Fujian Medical University, Fuzhou, China.
Internal Medicine-Oncology Department, Fujian Medical University Union Hospital, Fuzhou, China.
Support Care Cancer. 2023 Oct 6;31(10):614. doi: 10.1007/s00520-023-08075-w.
Cancer patients undergoing chemotherapy are prone to suffering a higher incidence rate of depression, leading to poor quality of life. However, how cancer affects depression is unclear. This study aimed to examine whether the relationship between cognitive appraisal and depression is mediated by perceived stress and self-efficacy in cancer patients undergoing chemotherapy.
A total of 421 cancer patients undergoing chemotherapy participated in this cross-sectional survey. Cognitive appraisal of cancer, perceived stress, self-efficacy, and depression were measured with the Perceived Life Threat Scale, Perceived Stress Scale, General Self-efficacy Scale and Hospital Anxiety, and Depression Scale-Depression Scale, respectively. Path analysis was performed to analyze the mediating effects of perceived stress and self-efficacy on the relationship between cognitive appraisal of cancer and depression.
Cognitive appraisal of cancer exerted direct (b = 0.066, SE = 0.020, p < 0.001, bias-corrected 95% CI = [0.027, 0.106]) and indirect (mediated by depression and insomnia) (b = 0.136, SE = 0.015, p < 0.001, bias-corrected 95% CI = [0.107, 0.167]) effects on depression. Perceived stress and self-efficacy were significant in mediating the relationship between cognitive appraisal of cancer and depression (b = 0.101, SE = 0.014, p < 0.001, bias-corrected 95% CI = [0.074, 0.132]; b = 0.021, SE = 0.006, p < 0.001, bias-corrected 95% CI = [0.006, 0.028], respectively). Additionally, a sequential mediating effect of perceived stress via self-efficacy was found, and the mediating effect size was 0.014 (p < 0.01, bias-corrected 95% CI = [0.010,0.034]).
This study suggests that medical staff could prevent or relieve depression through improving self-efficacy or reducing perceived stress in cancer patients undergoing chemotherapy.
接受化疗的癌症患者易患抑郁症，导致生活质量下降。然而，癌症如何影响抑郁症尚不清楚。本研究旨在探讨认知评估与抑郁症之间的关系是否通过接受化疗的癌症患者的感知压力和自我效能感来介导。
共有 421 名接受化疗的癌症患者参与了这项横断面调查。使用生活威胁感知量表、感知压力量表、一般自我效能感量表和医院焦虑和抑郁量表抑郁量表分别测量癌症的认知评估、感知压力、自我效能和抑郁。进行路径分析以分析感知压力和自我效能感对癌症认知评估与抑郁之间关系的中介作用。
癌症认知评估对抑郁有直接（b=0.066，SE=0.020，p<0.001，偏倚校正 95%置信区间[0.027，0.106]）和间接（通过抑郁和失眠介导）（b=0.136，SE=0.015，p<0.001，偏倚校正 95%置信区间[0.107，0.167]）效应。感知压力和自我效能感在癌症认知评估与抑郁之间的关系中具有显著的中介作用（b=0.101，SE=0.014，p<0.001，偏倚校正 95%置信区间[0.074，0.132]；b=0.021，SE=0.006，p<0.001，偏倚校正 95%置信区间[0.006，0.028]）。此外，还发现了感知压力通过自我效能的顺序中介效应，中介效应量为 0.014（p<0.01，偏倚校正 95%置信区间[0.010，0.034]）。
本研究表明，医务人员可以通过提高接受化疗的癌症患者的自我效能感或降低感知压力来预防或缓解抑郁。
