辅助内分泌治疗的乳腺癌患者用药负担对生活质量的影响：用药信念的中介作用
The influence of medication burden on the quality of life among patients with breast cancer undergoing adjuvant endocrine therapy: The mediating role of medication beliefs.
作者信息
Liang Ruiyin, Zhan Leilei, Huang Peiling, Zhu Xiaodong
机构信息
Department of Breast Surgery, The Tenth Affiliated Hospital, Southern Medical University (Dongguan People's Hospital), Dongguan, China.
Department of Gastroenterology, The Tenth Affiliated Hospital, Southern Medical University (Dongguan People's Hospital), Dongguan, China.
出版信息
Asia Pac J Oncol Nurs. 2025 Jul 9;12:100751. doi: 10.1016/j.apjon.2025.100751. eCollection 2025 Dec.
OBJECTIVE
This study aimed to investigate the mediating role of medication beliefs in the relationship between medication burden and quality of life among Chinese patients with breast cancer undergoing adjuvant endocrine therapy (AET). Additionally, we sought to identify key factors influencing quality of life and propose targeted clinical interventions.
METHODS
This cross-sectional study involved 300 patients with breast cancer receiving AET in China from March 2023 to March 2024. Participants completed a survey that included a general information questionnaire, the Functional Assessment of Cancer Therapy - Breast (FACT-B) for assessing life quality in patients with breast cancer, the Chinese Living with Medicines Questionnaire (LMQ), and the Beliefs about Medication Questionnaire (BMQ)-Specific. Multiple linear regression analysis was utilized to identify factors influencing the quality of life among these patients. Pearson correlation analysis was used to explore the relationships among quality of life, medication burden, and medication beliefs in this population. AMOS 29.0 was utilized for structural equation modeling (SEM) to assess the mediating effect of medication beliefs on the relationship between medication burden and quality of life.
RESULTS
The mean FACT-B score among participants was 83.02 ± 19.08, the LMQ score was 109.93 ± 19.67, and the BMQ-Specific score was 1.41 ± 5.73. Quality of life demonstrated a negative correlation with medication burden ( = -0.752, < 0.01) and specific concerns ( = -0.653, < 0.01) while showing a positive correlation with medication beliefs ( = 0.717, < 0.01) and specific necessity ( = 0.475, < 0.01). Structural equation modeling revealed that medication burden and medication beliefs were directly predicted by quality of life, with respective effects of -0.567, 0.254, and -0.217, respectively (all < 0.01). Moreover, the medication burden was found to indirectly affect the quality of life through specific necessity ( = -0.078, < 0.01), and it was also an indirect predictor of quality of life via the mediation of specific concerns ( = -0.152, < 0.01).
CONCLUSIONS
The quality of life in patients with breast cancer receiving AET is notably affected by medication burden and beliefs. Medication burden directly affects the quality of life and indirectly influences it through medication beliefs. Therefore, tailored interventions are crucial for patients with breast cancer undergoing AET who face high medication burden, reduced belief in medication necessity, or increased concerns about their medication.
目的
本研究旨在探讨服药信念在接受辅助内分泌治疗（AET）的中国乳腺癌患者的药物负担与生活质量之间关系中的中介作用。此外，我们试图确定影响生活质量的关键因素，并提出针对性的临床干预措施。
方法
本横断面研究纳入了2023年3月至2024年3月在中国接受AET的300例乳腺癌患者。参与者完成了一项调查，其中包括一份一般信息问卷、用于评估乳腺癌患者生活质量的癌症治疗功能评估-乳腺（FACT-B）、中国药物生活问卷（LMQ）以及特定的服药信念问卷（BMQ）。采用多元线性回归分析来确定影响这些患者生活质量的因素。使用Pearson相关分析来探讨该人群中生活质量、药物负担和服药信念之间的关系。利用AMOS 29.0进行结构方程模型（SEM）分析，以评估服药信念对药物负担与生活质量之间关系的中介作用。
结果
参与者的FACT-B平均得分为83.02±19.08，LMQ得分为109.93±19.67，BMQ特定得分1.41±5.73。生活质量与药物负担（r=-0.752，P<0.01）和特定担忧（r=-0.653，P<0.01）呈负相关，而与服药信念（r=0.717，P<0.01）和特定必要性（r=0.475，P<0.01）呈正相关。结构方程模型显示，生活质量直接预测药物负担和服药信念，其效应分别为-0.567、0.254和-0.217（均P<0.01）。此外，发现药物负担通过特定必要性间接影响生活质量（r=-0.078，P<0.01），并且它也是通过特定担忧的中介作用对生活质量的间接预测因子（r=-0.152，P<0.01）。
结论
接受AET的乳腺癌患者的生活质量受到药物负担和信念的显著影响。药物负担直接影响生活质量，并通过服药信念间接影响生活质量。因此，对于面临高药物负担、对服药必要性信念降低或对药物担忧增加的接受AET的乳腺癌患者，量身定制的干预措施至关重要。
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