Li Ziyun, Huang Shuangni, Zhong Jiudi, Zhang June
School of Nursing, Sun Yat-Sen University, Guangzhou, China.
Department of Thoracic Oncology, Sun Yat-Sen University, Cancer Centre, Guangzhou, China.
J Cancer Surviv. 2025 Jun 25. doi: 10.1007/s11764-025-01853-x.
This cross-sectional study aimed to examine the level of psychosocial adjustment among young and middle-aged patients with lung cancer, explore the influencing factors of psychosocial adjustment, and identify the mediating role of resilience between stigma and psychosocial adjustment.
Between October 2022 and October 2023, data were collected using a self-designed demographic and disease-related questionnaire, the Psychosocial Adjustment to Illness Scale-Self-Report (PAIS-SR), Social Impact Scale (SIS), and Connor-Davidson Resilience Scale (CD-RISC). The sample comprised 245 patients with lung cancer recruited from a tertiary grade A cancer center in southern China. To analyze the data, hierarchical multiple regression analyses were used, and the mediation Model 4 of the PROCESS macro in SPSS was implemented.
Participants (42.9%) had moderate or severe psychosocial maladjustment. Financial stress, cancer stage, time since treatment completion, dyspnea, stigma, and resilience were included in the final regression model and explained 46.2% of the variance of psychosocial adjustment. The total and direct effects of stigma on psychosocial adjustment were significant, and a positive indirect effect was identified for stigma on psychosocial adjustment via resilience.
Stigma had a negative impact on psychosocial adjustment among young and middle-aged lung cancer patients, while resilience had a partial mediating effect on the relationship between stigma and psychosocial adjustment.
Targeted psychosocial interventions should be developed to alleviate stigma, enhance psychological resilience, and ultimately support patients' reintegration into society and their return to normal life.
本横断面研究旨在调查中青年肺癌患者的心理社会适应水平，探讨心理社会适应的影响因素，并确定心理韧性在耻辱感与心理社会适应之间的中介作用。
2022年10月至2023年10月期间，使用自行设计的人口统计学和疾病相关问卷、疾病心理社会适应量表-自我报告（PAIS-SR）、社会影响量表（SIS）和康纳-戴维森心理韧性量表（CD-RISC）收集数据。样本包括从中国南方一家三级甲等癌症中心招募的245例肺癌患者。采用分层多元回归分析对数据进行分析，并在SPSS中实施PROCESS宏程序的中介模型4。
参与者中有42.9%存在中度或重度心理社会适应不良。最终回归模型纳入了经济压力、癌症分期、治疗结束后的时间、呼吸困难、耻辱感和心理韧性，这些因素解释了心理社会适应差异的46.2%。耻辱感对心理社会适应的总效应和直接效应均显著，且发现耻辱感通过心理韧性对心理社会适应产生正向间接效应。
耻辱感对中青年肺癌患者的心理社会适应有负面影响，而心理韧性在耻辱感与心理社会适应的关系中起部分中介作用。
应制定有针对性的心理社会干预措施，以减轻耻辱感，增强心理韧性，最终支持患者重新融入社会并回归正常生活。
