心理灵活性在术后乳腺癌幸存者疾病感知和癌症复发恐惧间的中介作用  

The mediating role of psychological flexibility between illness perception and fear of recurrence in postoperative breast cancer patients

作　　者：杨月波 张玉芳[1] 李娜[1] 禚玥 孟雯琪 张俊福 Yang Yuebo;Zhang Yufang;Li Na;Zhuo Yue;Meng Wenqi;Zhang Junfu(School of Nursing,Shandong University of Traditional Chinese Medicine,Jinan,250355,China;Ward II,Department of Gastroenterology,Central Hospital Affiliated to Shondong First Medical Unirersity,Jinan,250013,China)

机构地区：[1]山东中医药大学护理学院,山东济南250355 [2]山东大学第一医科大学附属中心医院消化二科,山东济南250013

出　　处：《现代临床护理》2022年第8期1-8,共8页Modern Clinical Nursing

基　　金：山东省医药卫生科技发展计划项目,项目编号为202014051149。

摘　　要：目的了解疾病感知和心理灵活性对术后乳腺癌幸存者癌症复发恐惧的影响,探讨心理灵活性在疾病感知和癌症复发恐惧间的中介作用。方法以240例术后乳腺癌幸存者为研究对象,采用疾病感知问卷简化版、承诺行动问卷以及癌症复发恐惧量表进行横断面研究。运用Pearson相关性分析法分析术后乳腺癌幸存者疾病感知、心理灵活性与癌症复发恐惧间的相关性,采用AMOS21.0软件建立心理灵活性在疾病感知与癌症复发恐惧间的中介效应模型,并用Bootstrap置信区间评估法验证其中介效应。结果共有221例术后乳腺癌幸存者完成研究。术后乳腺癌幸存者的复发恐惧得分为(93.10±17.54)分,与疾病感知呈正相关(r=0.614,P<0.01),与心理灵活性呈负相关(r=-0.562,P<0.01);疾病感知直接预测癌症复发恐惧的标准化效应值为0.358,以乳腺癌术后幸存者心理灵活性为中介变量间接预测癌症复发恐惧的标准化效应值为0.337,疾病感知对癌症复发恐惧的总效应值为0.695,中介效应占总效应的48.49%。结论疾病感知可直接影响癌症复发恐惧,也可通过心理灵活性间接影响癌症复发恐惧。护理人员可通过减少术后乳腺癌幸存者的消极性疾病感知,提高心理灵活性,以减轻其癌症复发恐惧心理。Objective To understand the impacts of illness perception and psychological flexibility on fear of cancer recurrence in postoperative breast cancer patients and to explore the mediating role of psychological flexibility between the illness perception and the fear of cancer recurrence. Methods A total of 240 postoperative breast cancer patients were investigated by brief illness perception questionnaire,commitment action questionnaire and fear of cancer recurrence inventory. The correlations between the illness perception,the psychological flexibility and the fear of cancer recurrence among the patients were analysed using the pearson correlation method. The mediating effect of psychological flexibility between the illness perception and the fear of cancer recurrence was modelled by AMOS 21.0software and evaluated by Bootstrap confidence interval. Results A total of 221 patients completed the study. The fear of recurrence score of the patients was(93.10±17.54), which was positively correlated with the illness perception(r=0.614,P<0.01) and negatively correlated with the psychological flexibility(r=-0.562,P<0.01). The standardised effect value for the illness perception that directly predicted the fear of cancer recurrence was 0.358. The standardised effect value that indirectly predicted the fear of cancer recurrence,with the psychological flexibility of the cancer patients as a mediating variable was 0.337. The value of total effect for the illness perception on the fear of cancer recurrence was 0.695,with the mediating effect accounting for 48.49% of the total effect. Conclusions Illness perception can directly and indirectly affect the fear of cancer recurrence through psychological flexibility. Nursing staff should help the postoperative breast cancer patients to reduce the negative illness perception and improve the psychological flexibility,hence to minimise the fear of cancer recurrence in the patients.

关 键 词：乳腺癌 疾病感知 心理灵活性 癌症复发恐惧 横断面研究 

分 类 号：R473.73[医药卫生—护理学]