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中国早期肺癌术后患者症状负担、疾病认知、心理弹性、社会支持、应对方式与癌因性担忧的关系:一项横断面研究。

The links between symptom burden, illness perception, psychological resilience, social support, coping modes, and cancer-related worry in Chinese early-stage lung cancer patients after surgery: a cross-sectional study.

机构信息

Department of Health Care, Shanghai Health and Medical Center, No. 67, Dajishan, Wuxi City, Jiangsu Province, 214063, People's Republic of China.

School of Medicine, Tongji University, 1239 Siping Road, Shanghai, 200092, People's Republic of China.

出版信息

BMC Psychol. 2024 Aug 31;12(1):463. doi: 10.1186/s40359-024-01946-9.

Abstract

OBJECTIVES

This study aims to investigate the links between the clinical, demographic, and psychosocial factors and cancer-related worry in patients with early-stage lung cancer after surgery.

METHODS

The study utilized a descriptive cross-sectional design. Questionnaires, including assessments of cancer-related worry, symptom burden, illness perception, psychological resilience, coping modes, social support and participant characteristics, were distributed to 302 individuals in early-stage lung cancer patients after surgery. The data collection period spanned from January and October 2023. Analytical procedures encompassed descriptive statistics, independent Wilcoxon Rank Sum test, Kruskal-Wallis- H- test, Spearman correlation analysis, and hierarchical multiple regression.

RESULTS

After surgery, 89.07% had cancer-related worries, with a median (interquartile range, IQR) CRW score of 380.00 (130.00, 720.00). The most frequently cited concern was the cancer itself (80.46%), while sexual issues were the least worrisome (44.37%). Regression analyses controlling for demographic variables showed that higher levels of cancer-related worry (CRW) were associated with increased symptom burden, illness perceptions, and acceptance-rejection coping modes, whereas they had lower levels of psychological resilience, social support and confrontation coping modes, and were more willing to obtain information about the disease from the Internet or applications. Among these factors, the greatest explanatory power in the regression was observed for symptom burden, illness perceptions, social support, and sources of illness information (from the Internet or applications), which collectively explained 52.00% of the variance.

CONCLUSIONS

Healthcare providers should be aware that worry is a common issue for early stage lung cancer survivors with a favorable prognosis. During post-operative recovery, physicians should identify patient concerns and address unmet needs to improve patients' emotional state and quality of life through psychological support and disease education.

摘要

目的

本研究旨在探讨临床、人口统计学和心理社会因素与手术后早期肺癌患者癌症相关担忧之间的关系。

方法

本研究采用描述性横断面设计。研究共纳入 302 例手术后早期肺癌患者,采用问卷评估其癌症相关担忧、症状负担、疾病认知、心理弹性、应对方式、社会支持以及患者特征等方面。数据收集时间为 2023 年 1 月至 10 月。分析方法包括描述性统计分析、独立 Wilcoxon 秩和检验、Kruskal-Wallis H 检验、Spearman 相关分析和分层多元回归分析。

结果

手术后,89.07%的患者存在癌症相关担忧,CRW 中位数(四分位距,IQR)为 380.00(130.00,720.00)。最常见的担忧是癌症本身(80.46%),而性问题是最不令人担忧的(44.37%)。在控制人口统计学变量后进行回归分析显示,癌症相关担忧(CRW)水平越高,症状负担、疾病认知和接纳-拒绝应对方式得分越高,而心理弹性、社会支持和面对应对方式得分越低,更倾向于从互联网或应用程序获取疾病相关信息。在这些因素中,症状负担、疾病认知、社会支持和疾病信息来源(互联网或应用程序)对回归的解释力最大,共解释了 52.00%的变异。

结论

医疗保健提供者应意识到,对于预后良好的早期肺癌幸存者来说,担忧是一个常见问题。在术后康复期间,医生应识别患者的担忧并满足其未满足的需求,通过心理支持和疾病教育改善患者的情绪状态和生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c53/11365146/bd0b5d0ef4d5/40359_2024_1946_Fig1_HTML.jpg

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