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乳腺癌患者康复期间社会支持与自我护理能力的关系:心理弹性和抑郁的多重中介作用

Relationship between social support and self-care ability among patients with breast cancer during rehabilitation: The multiple mediating roles of resilience and depression.

作者信息

Tang Xiu-Ying, Wei Yu-Xian, Kong Ling-Na, Lu Fang

机构信息

Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

School of Nursing, Chongqing Medical University, Chongqing, China.

出版信息

J Clin Nurs. 2025 Jan;34(1):161-170. doi: 10.1111/jocn.17290. Epub 2024 May 26.

Abstract

AIMS

To identify the multiple mediating effects of resilience and depression between social support and self-care ability among patients with breast cancer during rehabilitation to provide reference for developing and implementing targeted interventions.

DESIGN

A cross-sectional study reported according to the STROBE checklist.

METHODS

A convenience sample of 320 patients with breast cancer during rehabilitation was recruited from one hospital in China. Data were collected from April to August 2022 using a self-report questionnaire, including the demographic and clinical information, Appraisal of Self-Care Agency Scale-Revised, Multidimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale-10 item, and Patient Health Questionnaire-9. The mediation analysis was conducted using the SPSS Process macro.

RESULTS

Self-care ability was positively associated with social support (β = .229) and resilience (β = .290), and negatively associated with depression (β = -.208). The relationship between social support and self-care ability was mediated by resilience and depression, respectively, and together in serial. The multiple mediating effects accounted for 34.0% of the total effect of social support on self-care ability.

CONCLUSION

Our findings identify resilience and depression as multiple mediators between social support and self-care ability and highlight the important roles of social support, resilience and depression in improving self-care ability.

RELEVANCE TO CLINICAL PRACTICE

Healthcare providers should pay great attention to the underlying mechanisms of how social support affects patients' self-care ability during breast cancer rehabilitation. Integrated intervention programmes targeted at enhancing social support, building resilience and alleviating depression might be beneficial to the improvement of self-care ability.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

REPORTING METHOD

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies was applied to report the results.

摘要

目的

识别乳腺癌患者康复期社会支持与自我护理能力之间心理韧性和抑郁的多重中介作用,为制定和实施针对性干预措施提供参考。

设计

一项按照STROBE清单报告的横断面研究。

方法

从中国一家医院招募了320例处于康复期的乳腺癌患者作为便利样本。于2022年4月至8月使用自填式问卷收集数据,包括人口统计学和临床信息、修订版自我护理能力评估量表、多维感知社会支持量表、10项Connor-Davidson心理韧性量表和患者健康问卷-9。使用SPSS Process宏进行中介分析。

结果

自我护理能力与社会支持(β = 0.229)和心理韧性(β = 0.290)呈正相关,与抑郁(β = -0.208)呈负相关。社会支持与自我护理能力之间的关系分别由心理韧性和抑郁介导,并呈串联中介。多重中介效应占社会支持对自我护理能力总效应的34.0%。

结论

我们的研究结果确定了心理韧性和抑郁是社会支持与自我护理能力之间的多重中介,并强调了社会支持、心理韧性和抑郁在提高自我护理能力方面的重要作用。

与临床实践的相关性

医疗保健提供者应高度关注社会支持在乳腺癌康复期间如何影响患者自我护理能力的潜在机制。针对增强社会支持、培养心理韧性和减轻抑郁的综合干预方案可能有助于提高自我护理能力。

患者或公众贡献

无患者或公众贡献。

报告方法

采用流行病学观察性研究强化报告(STROBE)横断面研究清单来报告结果。

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