Department of Nursing, The Second Hospital of Hebei Medical University, Shijiazhuang,China.
Department of Nursing, The Second Hospital of Hebei Medical University, Shijiazhuang,China.
Cancer Epidemiol. 2024 Jun;90:102577. doi: 10.1016/j.canep.2024.102577. Epub 2024 May 4.
This study aims to explore the multiple mediating roles of illness acceptance and symptom severity between health locus of control and symptom distress in acute leukemia patients.
From June 2022 to March 2023, a convenience sampling method was used to recruit 208 acute leukemia patients in the inpatient center of a hospital in Hebei. The Chinese versions of Multidimensional Health Locus of Control Scale, Illness Acceptance Scale, and Anderson Symptom Assessment Scale was used in the cross-sectional study.
All participants reported the presence of symptom distress. Symptom distress was significantly correlated with chance health locus of control, illness acceptance, and symptom severity (P＜0.05). Illness acceptance alone played a mediating role in the relationship between chance health locus of control and symptom distress in acute leukemia patients (β=0.087, 95%CI 0.030-0.167). The indirect role of chance health locus of control on symptom distress through symptom severity alone was also statistically significant (β=0.131, 95%CI 0.008-0.252). Furthermore, the multiple mediating role of chance health locus of control and symptom distress through illness acceptance and symptom severity combined was verified (β=0.027, 95%CI 0.001-0.089). The alternative model is also valid, indicating bidirectional relationships between symptom severity, illness acceptance, and chance health locus of control, collectively influencing symptom distress.
There is a positive relationship between chance health locus of control and symptom distress; additionally, increasing social psychological interventions for illness acceptance and strengthening the management of core symptoms will help alleviate the impact of health chance locus of control on symptom distress in acute leukemia patients. Longitudinal studies are needed to confirm the causal relationships among the variables explored within the model.
It is recommended that healthcare professionals pay attention to the assessment of health locus of control in patients, identify patients with health chance locus of control in a timely manner, take measures to enhance their disease acceptance, and strengthen the management of core symptoms, thereby reducing their level of symptom distress.
本研究旨在探讨急性白血病患者健康控制源与症状困扰之间的多重中介作用，即疾病接受度和症状严重程度。
2022 年 6 月至 2023 年 3 月，采用便利抽样法，在河北某医院住院中心招募 208 例急性白血病患者。采用多维健康控制源量表、疾病接受度量表和安德森症状评估量表的中文版进行横断面研究。
所有参与者均报告存在症状困扰。症状困扰与机会健康控制源、疾病接受度和症状严重程度显著相关（P＜0.05）。疾病接受度单独在急性白血病患者的机会健康控制源与症状困扰之间起中介作用（β=0.087，95%CI 0.030-0.167）。机会健康控制源通过症状严重程度单独对症状困扰的间接作用也具有统计学意义（β=0.131，95%CI 0.008-0.252）。此外，还验证了机会健康控制源和症状困扰通过疾病接受度和症状严重程度的联合多重中介作用（β=0.027，95%CI 0.001-0.089）。替代模型也是有效的，表明症状严重程度、疾病接受度和机会健康控制源之间存在双向关系，共同影响症状困扰。
机会健康控制源与症状困扰呈正相关；此外，增加对疾病接受度的社会心理干预，加强对核心症状的管理，有助于减轻急性白血病患者健康机会控制源对症状困扰的影响。需要进行纵向研究来确认模型中探索变量之间的因果关系。
建议医护人员关注患者的健康控制源评估，及时发现具有健康机会控制源的患者，采取措施增强其疾病接受度，加强核心症状管理，从而降低其症状困扰程度。
