Liu Fang, Shan Hui, Bing Weiwei, Sun Li, Wei Lili
The Affiliated Hospital of Qingdao University, Qingdao, China.
Support Care Cancer. 2025 Aug 27;33(9):816. doi: 10.1007/s00520-025-09854-3.
Patients with gastrointestinal (GI) cancer undergoing chemotherapy frequently exhibit heterogeneous symptom burden, while psychological adaptation may exert differential impacts on benefit finding.
To explore the relationship between symptom burden and benefit finding in GI cancer patients, and to determine whether comprehensive needs and communication pattern play a mediating role in this relationship.
This was a cross-sectional study. The study employed a convenience sampling method to recruit 221 eligible GI cancer patients from the digestive oncology ward of a Tertiary Grade-A Hospital in Qingdao, China between September 2024 and January 2025. Assessments were conducted using the M.D. Anderson Symptom Inventory (MDASI), Comprehensive Needs Assessment Tool in cancer for patient (CNAT), Patient Communication Pattern Scale (PCPS), and the Benefit Finding Scale (BFS). The Cronbach's α coefficients of all scales are all above 0.8, and they are applicable to the Chinese population. The study variables are all continuous variables; data analysis was conducted using descriptive statistics, Pearson correlation, linear regression, and the PROCESS macro.
Pearson correlation analysis showed that in GI cancer patient, there was a significant positive correlation between symptom burden and comprehensive needs (r = 0.512, p < 0.001), a significant negative correlation with communication patterns (r = - 0.473, p < 0.001) and benefit finding (r = - 0.520, p < 0.001). Furthermore, the mediation analysis revealed that the total effect of symptom burden on benefit finding was - 0.351. The comprehensive needs and communication pattern served as partial mediators in the influence of symptom burden on the disease benefit. The mediating effects are 33.05% and 15.38%, respectively. The chained mediation effect was - 0.034, representing 9.69% of the total effect.
The comprehensive needs and communication pattern play a chain-mediating role in the relationship between symptom burden and benefit finding. Timely identification of patients' comprehensive needs and optimization of communication pattern undergoing chemotherapy may serve as important targets for psycho-social interventions. These findings suggest that implementing dynamic assessments to monitor evolving patient needs can facilitate the development of precision communication interventions, to mitigate the negative impact of symptom burden on benefit finding.
接受化疗的胃肠道（GI）癌症患者经常表现出异质性的症状负担，而心理适应可能对益处发现产生不同的影响。
探讨GI癌症患者症状负担与益处发现之间的关系，并确定综合需求和沟通模式在这种关系中是否起中介作用。
这是一项横断面研究。该研究采用便利抽样方法，于2024年9月至2025年1月期间，从中国青岛一家三级甲等医院的消化肿瘤病房招募了221名符合条件的GI癌症患者。使用MD安德森症状量表（MDASI）、癌症患者综合需求评估工具（CNAT）、患者沟通模式量表（PCPS）和益处发现量表（BFS）进行评估。所有量表的克朗巴哈α系数均高于0.8，且适用于中国人群。研究变量均为连续变量；数据分析采用描述性统计、Pearson相关性分析、线性回归分析和PROCESS宏程序。
Pearson相关性分析表明，在GI癌症患者中，症状负担与综合需求之间存在显著正相关（r = 0.512，p < 0.001），与沟通模式（r = -0.473，p < 0.001）和益处发现（r = -0.520，p < 0.001）之间存在显著负相关。此外，中介分析显示，症状负担对益处发现的总效应为 -0.351。综合需求和沟通模式在症状负担对疾病益处的影响中起部分中介作用。中介效应分别为33.05%和15.38%。链式中介效应为 -0.034，占总效应的9.69%。
综合需求和沟通模式在症状负担与益处发现之间的关系中起链式中介作用。及时识别患者的综合需求并优化化疗期间的沟通模式可能是心理社会干预的重要目标。这些发现表明，实施动态评估以监测患者不断变化的需求，可以促进精准沟通干预措施的制定，以减轻症状负担对益处发现的负面影响。
