Qi Yue, Zhu Kangsheng, Liu Wei, Xu Xiaolei
Department of Hematology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Department of Anesthesiology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
PLoS One. 2025 Sep 8;20(9):e0331865. doi: 10.1371/journal.pone.0331865. eCollection 2025.
While perceived stress and coping strategies have been established as significant determinants of quality of life (QoL) in patients with solid malignancies, their impact on hematological malignancy population have not been fully elucidated. This study aimed to examine how perceived stress and medical coping strategies interact with sociodemographic factors to influence QoL in patients with hematologic malignancies.
The study, involving 185 hematologic cancer patients in China, was conducted between August 2024 and December 2024. Self-reported scales were used to assess QoL, perceived stress and medical coping strategies. Data analysis included univariate analyses, Pearson correlation, and multivariate regression analyses using SPSS V26.0.
178 patients completed the survey with a response rate of 96.2%. The overall QoL score was 55.99 ± 24.6 indicating a moderate-to-low level. The functional domains averaged 64.81 ± 21.83, while the symptomatic domains averaged 24.95 ± 19.38. The overall QoL was associated with age, sex, marital status, place of residence, type of insurance (p < 0.05). Stress perception (r = -0.389, -0.591), crisis perception (r = -0.489, -0.638), and yielding coping (r = -0.479, -0.547) exhibited significant negative correlations with overall QoL and functional scores, respectively (p < 0.001). Stress perception (r = 0.435), crisis perception (r = 0.535), avoidance (r = 0.280), and yielding (r = 0.472) were positively correlated with symptom scores (p < 0.001). Multiple linear regression analysis identified sex, crisis perception, and yielding as key factors affecting overall QoL (explaining 36.5% of the variance) and functional status (explaining 45.6% of the variance), while residence, crisis perception, avoidance, and yielding significantly influenced the symptomatic fields (34.2% variance) in patients with hematological malignancies (p < 0.05).
This study revealed that the QoL of patients with hematological malignancies is generally suboptimal and influenced by sex, crisis perception, and stress-coping strategies. These findings underscore the need for integrated psychosocial interventions targeting stress management and adaptive coping strategies in clinical care. This study contributes to the growing body of evidence on psychosocial determinants of QoL in oncology and can inform tailored supportive care programs for this population.
虽然感知压力和应对策略已被确认为实体恶性肿瘤患者生活质量（QoL）的重要决定因素，但其对血液系统恶性肿瘤人群的影响尚未完全阐明。本研究旨在探讨感知压力和医疗应对策略如何与社会人口学因素相互作用，以影响血液系统恶性肿瘤患者的生活质量。
该研究于2024年8月至2024年12月在中国进行，纳入了185例血液系统癌症患者。采用自我报告量表评估生活质量、感知压力和医疗应对策略。数据分析包括单因素分析、Pearson相关性分析以及使用SPSS V26.0进行的多因素回归分析。
178例患者完成了调查，应答率为96.2%。总体生活质量评分为55.99±24.6，表明处于中低水平。功能领域平均分为64.81±21.83，而症状领域平均分为24.95±19.38。总体生活质量与年龄、性别、婚姻状况、居住地点、保险类型相关（p<0.05）。压力感知（r=-0.389，-0.591）、危机感知（r=-0.489，-0.638）和屈服应对（r=-0.479，-0.547）分别与总体生活质量和功能评分呈显著负相关（p<0.001）。压力感知（r=0.435）、危机感知（r=0.535）、回避（r=0.280）和屈服（r=0.472）与症状评分呈正相关（p<0.001）。多因素线性回归分析确定性别、危机感知和屈服是影响总体生活质量（解释36.5%的方差）和功能状态（解释45.6%的方差）的关键因素，而居住地点、危机感知、回避和屈服显著影响血液系统恶性肿瘤患者的症状领域（34.2%方差）（p<0.05）。
本研究表明，血液系统恶性肿瘤患者的生活质量总体欠佳，且受性别、危机感知和压力应对策略的影响。这些发现强调了在临床护理中针对压力管理和适应性应对策略进行综合心理社会干预的必要性。本研究为肿瘤学中生活质量的心理社会决定因素的证据积累做出了贡献，并可为该人群量身定制支持性护理计划提供参考。
