Ma Yaomei, Chen Shiyue, Dong Hanyu, Guo Ruimeng, Liu Ruoyan, Xie Juan, Sun Zhuoyu
Department of Gynecological Oncology, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China.
Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
J Cancer. 2024 Apr 29;15(11):3418-3426. doi: 10.7150/jca.91260. eCollection 2024.
The patients of cervical cancer have more negative emotions and lower quality of life. The aim of this study was to explore the relationships between existential well-being (EWB), social support, resilience, negative emotions in patients with cervical cancer, and to examine whether resilience mediates the associations between EWB or social support and negative emotions. This study enrolled patients with cervical cancer who were treated at the Tianjin Medical University Cancer Institute and Hospital in China during 2012-2019. The Hospital Anxiety and Depression Scale (HADS), the Resilience Scale of 14 items (RS-14) and the McGill Quality of Life Questionnaire (MQOL) were utilized to assess patient's anxiety, depression, resilience, social support and EWB via telephone. Spearman's correlation analyses were used to assess bivariate correlations, and mediation analyses were applied to examine whether resilience mediated the relationship between social support or EWB and negative emotions. A total of 150 (92.0%) out of 163 eligible patients completed the questionnaires. EWB and social support were negatively correlated with anxiety (=-0.560 and =-0.561) and depression (=-0.508 and =-0.526), and positively correlated with resilience (=0.691 and =0.652). Resilience was negatively associated with anxiety (=-0.545) and depression (r=-0.505). Negative direct effects of social support on anxiety and EWB on anxiety and depression were statistically significant (<0.05). Resilience played a partial mediating role in the relationship between EWB and depression (=-0.085, 95%: -0.150 to -0.020), accounting for 37.12% of the total effect. It also served as a partial mediator in the association between EWB and anxiety (=-0.061, 95%: -0.107 to -0.015), explaining 34.46% of the overall effect. Additionally, resilience partially mediated the connection between social support and depression (=-0.173, 95%: -0.312 to -0.053), explicating 57.48% of the total effect. : A combination of existential, supportive and resilient interventions may help reduce psychological distress and improve quality of life among cervical cancer patients, thereby promoting both physical and psychological health.
宫颈癌患者有更多负面情绪且生活质量较低。本研究旨在探讨宫颈癌患者的生存幸福感（EWB）、社会支持、心理韧性与负面情绪之间的关系，并检验心理韧性是否在EWB或社会支持与负面情绪之间的关联中起中介作用。本研究纳入了2012年至2019年期间在中国天津医科大学肿瘤医院接受治疗的宫颈癌患者。通过电话使用医院焦虑抑郁量表（HADS）、14项心理韧性量表（RS - 14）和麦吉尔生活质量问卷（MQOL）来评估患者的焦虑、抑郁、心理韧性、社会支持和EWB。采用Spearman相关分析评估双变量相关性，并应用中介分析来检验心理韧性是否在社会支持或EWB与负面情绪之间的关系中起中介作用。163名符合条件的患者中共有150名（92.0%）完成了问卷调查。EWB和社会支持与焦虑（=-0.560和=-0.561）及抑郁（=-0.508和=-0.526）呈负相关，与心理韧性呈正相关（=0.691和=0.652）。心理韧性与焦虑（=-0.545）和抑郁（r=-0.505）呈负相关。社会支持对焦虑以及EWB对焦虑和抑郁的负向直接效应具有统计学意义（<0.05）。心理韧性在EWB与抑郁的关系中起部分中介作用（=-0.085，95%：-0.150至-0.020），占总效应的37.12%。它在EWB与焦虑的关联中也起部分中介作用（=-0.061，95%：-0.107至-0.015），解释了总体效应的34.46%。此外，心理韧性部分中介了社会支持与抑郁之间的联系（=-0.173，95%：-0.312至-0.053），解释了总效应的57.48%。结论：生存、支持和韧性干预相结合可能有助于减轻宫颈癌患者的心理困扰并改善其生活质量，从而促进身心健康。
