Wang Fang, Nie Anliu, Liao Shaona, Zhang Zhisheng, Su Xiangfen
The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China.
Patient Prefer Adherence. 2024 Dec 13;18:2559-2568. doi: 10.2147/PPA.S480306. eCollection 2024.
To investigate the current status of the sense of coherence in lung cancer patients undergoing chemotherapy and explore the mediating role of social support and hope in the relationship between therapy-related symptoms and sense of coherence.
We conducted a cross-sectional study to investigate lung cancer chemotherapy patients aged 18 years or older who completed at least two cycles of chemotherapy. Patients were recruited from the First Affiliated Hospital of Guangzhou Medical University's chemotherapy day ward from May to December 2023. Patients were required to complete a questionnaire that included the Sense of Coherence Scale, the Perceived Social Support Scale, the Herth Hope Index, and the Therapy-related Symptoms Checklist. The structural equation model was used to test the mediating role of social support and hope between therapy-related symptoms and the sense of coherence.
A total of 241 patients were included. The scores of the sense of coherence, hope level, therapy-related symptoms, and social support were 68.79 ± 11.24, 38.94 ± 4.25, 11.53 ± 8.15, and 69.49 ± 8.15, respectively. Sense of coherence, social support, hope, and therapy-related symptoms were significantly related (P<0.01). Therapy-related symptoms had a direct negative influence on the sense of coherence [B=-0.144, 95% CI (-0.209, -0.070)]. Meanwhile, therapy-related symptoms influenced the sense of coherence via three pathways: independent mediation of social support [B=-0.021, 95% CI (-0.065, -0.002)], independent mediation of hope [B=-0.022, 95% CI (-0.057, -0.000)], and chain mediation of social support and hope [B=-0.012, 95% CI (-0.035, -0.002)].
Lung cancer patients undergoing chemotherapy experience a medium sense of coherence. This study's findings indicate that the relationship between therapy-related symptoms and sense of coherence is affected by the independent mediating effect of social support and hope and the chain mediating effect of social support and hope. Therefore, reducing the burden of their therapy-related symptoms, providing them with social support, and fostering their hope can enhance patients' sense of coherence and improve their quality of life.
调查接受化疗的肺癌患者的心理一致感现状，并探讨社会支持和希望在治疗相关症状与心理一致感关系中的中介作用。
我们开展了一项横断面研究，调查年龄在18岁及以上且完成至少两个周期化疗的肺癌化疗患者。患者于2023年5月至12月从广州医科大学附属第一医院化疗日间病房招募。患者需完成一份问卷，其中包括心理一致感量表、领悟社会支持量表、赫氏希望指数和治疗相关症状清单。采用结构方程模型检验社会支持和希望在治疗相关症状与心理一致感之间的中介作用。
共纳入241例患者。心理一致感、希望水平、治疗相关症状和社会支持的得分分别为68.79±11.24、38.94±4.25、11.53±8.15和69.49±8.15。心理一致感、社会支持、希望和治疗相关症状显著相关（P<0.01）。治疗相关症状对心理一致感有直接负面影响[B=-0.144，95%CI（-0.209，-0.070）]。同时，治疗相关症状通过三条途径影响心理一致感：社会支持的独立中介作用[B=-0.021，95%CI（-0.065，-0.002）]、希望的独立中介作用[B=-0.022，95%CI（-0.057，-0.000）]以及社会支持和希望的链式中介作用[B=-0.012，95%CI（-0.035，-0.002）]。
接受化疗的肺癌患者心理一致感处于中等水平。本研究结果表明，治疗相关症状与心理一致感之间的关系受社会支持和希望的独立中介作用以及社会支持和希望的链式中介作用影响。因此，减轻其治疗相关症状负担、为其提供社会支持并培养其希望可增强患者心理一致感并改善其生活质量。
