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肺癌手术患者中耻辱感与生活质量之间医学应对方式的中介作用:一项横断面研究

The mediating role of medical coping modes between stigma and quality of life in patients undergoing lung cancer surgery: a cross-sectional study.

作者信息

Ma Fengyan, Zheng Wei, Wang Weining, Zhang Na, Liu Yan

机构信息

Department of Thoracic Surgery, National Clinical Research Center for Cancer/Cancer Hospital, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Department of Nursing, National Clinical Research Center for Cancer/Cancer Hospital, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Panjiayuannanli NO17. Chaoyang District, Beijing, 100021, China.

出版信息

BMC Cancer. 2024 Dec 20;24(1):1561. doi: 10.1186/s12885-024-13337-9.

Abstract

BACKGROUND

Stigma has been identified as a significant factor impacting the health of lung cancer patients. However, the relationship between stigma, medical coping modes, and quality of life (QoL) has not been thoroughly examined.

OBJECTIVE

This study aimed to explore the associations between stigma, medical coping modes, and QoL in patients undergoing lung cancer surgery.

METHODS

A total of 304 surgical patients participated in an online survey, which included sociodemographic data, the Lung Cancer Stigma Scale, the Medical Coping Modes Scale, and the Quality of Life Scale. Data analysis was performed using SPSS 24.0, and structural equation models were constructed using AMOS 24.0. The Bootstrap method was employed to test the mediating hypotheses.

RESULTS

The mean QoL score was 150.53 ± 15.54, showing significant associations with medical coping modes and stigma. Stigma was negatively correlated with QoL (r = -0.668, p < 0.01). Confrontation was positively associated with QoL (r = 0.339, p < 0.01), while resignation and avoidance were negatively correlated with QoL (r = -0.584, r = -0.500, p < 0.01). Stigma's effect on QoL was partially mediated by confrontation, resignation, and avoidance, with effect sizes of -0.051, -0.190, and - 0.098, respectively, accounting for 35.1% of the total effect.

CONCLUSION

Preoperative NSCLC patients in China experience moderate stigma, which detrimentally affects their QoL. Confrontation, resignation, and avoidance play mediating roles in this relationship. These findings offer new perspectives for developing interventions to improve QoL by addressing stigma and coping strategies.

摘要

背景

耻辱感已被确认为影响肺癌患者健康的一个重要因素。然而,耻辱感、医疗应对方式和生活质量(QoL)之间的关系尚未得到充分研究。

目的

本研究旨在探讨肺癌手术患者的耻辱感、医疗应对方式和生活质量之间的关联。

方法

共有304名手术患者参与了一项在线调查,调查内容包括社会人口统计学数据、肺癌耻辱感量表、医疗应对方式量表和生活质量量表。使用SPSS 24.0进行数据分析,并使用AMOS 24.0构建结构方程模型。采用Bootstrap方法检验中介假设。

结果

生活质量平均得分为150.53±15.54,与医疗应对方式和耻辱感显著相关。耻辱感与生活质量呈负相关(r = -0.668,p < 0.01)。面对与生活质量呈正相关(r = 0.339,p < 0.01),而听天由命和回避与生活质量呈负相关(r = -0.584,r = -0.500,p < 0.01)。耻辱感对生活质量的影响部分通过面对、听天由命和回避来介导,效应大小分别为-0.051、-0.190和-0.098,占总效应的35.1%。

结论

中国术前非小细胞肺癌患者存在中度耻辱感,这对他们的生活质量有不利影响。面对、听天由命和回避在这种关系中起中介作用。这些发现为通过解决耻辱感和应对策略来制定改善生活质量的干预措施提供了新的视角。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccb7/11660735/90188f2b6c9a/12885_2024_13337_Fig1_HTML.jpg

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