摘要
目的分析医学应对方式在疾病不确定感与PTSD间的作用路径,为乳腺癌患者心理护理提供参考依据。方法于2019年11月—2021年2月采用便利抽样法抽取广东省三所综合性三甲医院住院乳腺癌患者计313例作为研究对象,采用一般资料调查问卷、创伤后应激障碍症状清单-平民版量表(PCL-C)、疾病不确定感量表(MUIS-A)和医学应对方式量表(MCMQ)进行问卷调查,并借助SPSS 26.0、AMOS 24.0等统计工具完成数据分析、模型构建和效应检验。结果PTSD与疾病不确定感、面对、屈服、回避呈正相关(r=0.294、0.166、0.448、0.163,P<0.05);疾病不确定感与面对、回避呈负相关(r=-0.236、-0.111,P<0.05),与屈服呈正相关(r=0.318,P<0.05);面对在疾病不确定感和PTSD间起遮掩效应(c=0.249,c'=0.299,ab=-0.050,P<0.05),屈服在疾病不确定感和PTSD间起部分中介效应,中介效应占比为37.8%,而回避在两者间无中介作用。结论疾病不确定感正向影响乳腺癌患者PTSD水平,且医学应对方式在两者间起一定预测作用。建议在提供适当的信息支持以缓解患者的疾病不确定感,帮助其树立积极应对态度的同时加强应对能力,才能有效降低其PTSD水平。
Objective To analyze the functional route of medical coping modes between uncertainty in illness and PTSD,and provide reference for psychological care for breast cancer patients.Methods From November 2019 to February 2021,A total of 313 inpatients suffered from breast cancer from 3 tertiary hospitals in Guangdong province were selected as study objects by convenience sampling.The questionnaires includinggeneral information questionnaire,PTSD Checklist-Civilian Version(PCL-C),Mishel Uncertainty in Illness Scale(MUIS-A)and Medical Coping Modes Questionnaire(MCMQ)were used to carried out questionnaire survey.Statistical tools such as SPSS 26.0 and AMOS 24.0 were used to complete data analysis,model construction and effect test.Results PTSD was positively correlated with uncertainty in illness,confrontation,acceptance-resignation and avoidance(r=0.294,0.166,0.448,0.163,P<0.05).Uncertainty in illness was negatively correlated with confrontation and avoidance(r=-0.236,-0.111,P<0.05),and positively correlated with acceptance-resignation(r=0.318,P<0.05).Confrontation had a masking effect between uncertainty in illness and PTSD(c=0.249,c'=0.299,ab=-0.050,P<0.05),and acceptance-resignation had a partial mediating effect between uncertainty in illness and PTSD(37.8%),while avoidance had no mediating effect between them.Conclusions Uncertainty in illnesspositively affected the level of PTSD in breast cancer patients,and medical coping modes plays a predictive role between them to a certain degree.It is suggested that the level of PTSD can be effectively reduced by providing appropriate information support to relieve patients'uncertainty in illness and help them establish a positive coping attitude while strengthening their coping ability.
作者
卓蕙
梁文丽
吴燕楠
欧丹妮
张琳榆
ZhuoHui;Liang Wenli;Wu Yannan;Ou Danni;Zhang Linyu(Nursing school,Guangdong Pharmaceutical University,Guangzhou,Guangdong,510310,China;Stomatological hospital affiliated to Guangzhou Medical University,Guangzhou,Guangdong,510013,China)
出处
《齐齐哈尔医学院学报》
2023年第9期888-892,共5页
Journal of Qiqihar Medical University
关键词
创伤后应激障碍症状
疾病不确定感
应对方式
中介作用
遮掩效应
乳腺癌
Post-traumatic stress disorder
Uncertainty in illness
Coping modes
Mediating effect
Masking effect
Breast cancer patients
