Huang Jingui, Shi Yumei, Chen Yuemei, Tang Ling, Zhang Zhaoli
Department of Medical Oncology, Chongqing University Cancer Hospital, Chongqing, China.
Department of Nursing, Chongqing University Cancer Hospital, Chongqing, China.
Front Psychol. 2024 Sep 5;15:1436495. doi: 10.3389/fpsyg.2024.1436495. eCollection 2024.
Social support, which is a crucial external resource for cancer patients, was demonstrated to be a positive predictor of learned helplessness (LH). But it is far from clear whether and how social support decreases the LH in cancer patients. The purpose of present study is to detect the association between social support and LH and the role of individual resilience and self-efficacy in mediating this relationship.
The convenience sampling method was utilized. From August 2022 to February 2024, a total of 537 lung cancer patients ( = 60.25 years, SD = 9.85 years) from five tertiary hospitals in one municipalities (Chongqing), and two provinces (Sichuan and Yunnan) were recruited, among which 389 were males and 148 were females. LH, social support, individual resilience, and self-efficacy were assessed by using standard scales. A structural equation model was constructed employing AMOS 23.0 to examine the interrelationships among social support, individual resilience, self-efficacy, and LH of lung cancer patients.
A total of 537 lung cancer patients were finally included. Social support, individual resilience, and self-efficacy were positively related to LH ( = -0.299 to -0.451, < 0.01). The mediation model revealed that the direct effect of social support on LH was significant ( = -0.407, < 0.001). Besides, social support could also affect LH through three pathways: (1) the mediating effect of individual resilience ( = -0.075, < 0.001); (2) the mediating effect of self-efficacy ( = -0.060, < 0.05); (3) the chain mediating effect of individual resilience and self-efficacy ( = -0.011, < 0.05).
The results indicate that social support alleviates lung cancer patients' LH, and that individual resilience and self-efficacy mediate the correlation between social support and LH. Besides providing adequate social support, intervention strategies built on individual resilience and self-efficacy should be applied to reduce LH in lung cancer patients.
社会支持是癌症患者重要的外部资源，被证明是习得性无助（LH）的积极预测因素。但社会支持是否以及如何降低癌症患者的习得性无助尚不清楚。本研究的目的是检测社会支持与习得性无助之间的关联，以及个体心理韧性和自我效能感在介导这种关系中的作用。
采用便利抽样法。2022年8月至2024年2月，从一个直辖市（重庆）以及两个省份（四川和云南）的五家三级医院招募了537例肺癌患者（年龄=60.25岁，标准差=9.85岁），其中男性389例，女性148例。使用标准量表评估习得性无助、社会支持、个体心理韧性和自我效能感。采用AMOS 23.0构建结构方程模型，以检验肺癌患者社会支持、个体心理韧性、自我效能感和习得性无助之间的相互关系。
最终纳入537例肺癌患者。社会支持、个体心理韧性和自我效能感与习得性无助呈正相关（= -0.299至-0.451，<0.01）。中介模型显示，社会支持对习得性无助的直接效应显著（= -0.407，<0.001）。此外，社会支持还可通过三条途径影响习得性无助：（1）个体心理韧性的中介效应（= -0.075，<0.001）；（2）自我效能感的中介效应（= -0.060，<0.05）；（3）个体心理韧性和自我效能感的链式中介效应（= -0.011，<0.05）。
结果表明，社会支持可减轻肺癌患者的习得性无助，个体心理韧性和自我效能感介导了社会支持与习得性无助之间的相关性。除提供充分的社会支持外，应应用基于个体心理韧性和自我效能感的干预策略来降低肺癌患者的习得性无助。
