希望水平在肝癌术后患者心理韧性、恐惧疾病进展中的中介效应  

Mediating effects of hope level in psychological toughness and fear of disease progression in postoperative hepatocellular carcinoma patients

作　　者：钱皓月 陈保菊[1] 王慧敏[1] 李颜含 王璐[1] QIAN Hao-yue;CHEN Bao-ju;WANG Hui-min;LI Yan-han;WANG Lu(Department of Hepatobiliary and Pancreatic Surgery/Liver Transplantation,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州大学第一附属医院肝胆胰外科/肝移植,河南郑州450000

出　　处：《海南医学》2024年第13期1958-1963,共6页Hainan Medical Journal

基　　金：2021年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20212301)。

摘　　要：目的探讨希望水平在肝癌术后患者心理韧性、恐惧疾病进展中的中介效应,为临床及时采取应对措施提供依据。方法选取2021年1月至2023年6月郑州大学第一附属医院收治的180例肝癌术后患者作为研究对象,采用问卷调查患者人口学特征、病情相关信息及希望水平、心理韧性、恐惧疾病进展情况。利用SPSS26.0软件行描述性分析、Pearson相关性分析、多元线性回归及分层回归分析,采用AMOS软件构建结构方程模型分析希望水平在肝癌术后患者心理韧性、恐惧疾病进展中的中介效应。结果172例肝癌术后患者CD-RISC评分为(59.77±6.33)分,HHI评分为(32.59±4.26)分,FoP-Q-SF评分为(34.11±5.47)分;恐惧疾病进展与心理韧性呈负相关(r=-0.687,P<0.01),与希望水平呈负相关(r=-0.744,P<0.01),希望水平与心理韧性呈正相关(r=0.737,P<0.01);心理韧性、希望水平是肝癌术后患者恐惧疾病进展的影响因素;希望水平在肝癌术后患者心理韧性与恐惧疾病进展间具有中介效应,且直接效应和中介效应分别占总效应的68.58%和31.42%。结论肝癌术后患者希望水平在心理韧性与疾病进展恐惧间发挥部分中介效应,临床工作中医护人员需注重对患者希望水平的干预,协助其提升希望水平,从而进一步强化心理韧性对疾病进展恐惧的影响作用,以促进肝癌患者身心健康发展。Objective To explore the mediating effect of hope level on psychological toughness and fear of disease progression in patients with hepatocellular carcinoma after surgery,and to provide evidence for timely clinical countermeasures.Methods A total of 180 patients with hepatocellular carcinoma after surgery in the First Affiliated Hospital of Zhengzhou University from January 2021 to June 2023 were selected as the study objects.A questionnaire was used to investigate the patients'demographic characteristics,information related to their disease condition,and their level of hope,psychological toughness,and fear of disease progression.SPSS26.0 software was used for descriptive analysis,Pearson correlation analysis,multiple linear regression,and hierarchical regression analysis.AMOS software was used to build a structural equation model to analyze the mediating effect of hope level on psychological toughness and fear of disease progression in patients with hepatocellular carcinoma after surgery.Results The CD-RISC score,HHI score,and FoP-Q-SF score of 172 patients were(59.77±6.33)points,(32.59±4.26)points,and(34.11±5.47)points.Fear of disease progression was negatively correlated with psychological toughness(r=-0.687,P<0.01)and hope level(r=-0.744,P<0.01),and hope level was positively correlated with psychological toughness(r=0.737,P<0.01).Psychological toughness and hope level were influencing factors for fear of disease progression in patients with hepatocellular carcinoma after surgery.Hope level had a mediating effect between psychological toughness and fear of disease progression in patients with hepatocellular carcinoma after surgery,and the direct effect and mediating effect accounted for 68.58%and 31.42%of the total effect,respectively.Conclusion Hope level of patients with hepatocellular carcinoma after surgery plays a partial mediating effect between toughness and fear of disease progression.In clinical work,medical staff should pay attention to the intervention of hope level of patients to help them impro

关 键 词：希望水平 恐惧疾病进展 中介效应 心理韧性 肝癌 应对措施 

分 类 号：R735.7[医药卫生—肿瘤]