心理一致感在直肠癌保肛术后患者疾病不确定感与心理痛苦间的中介效应分析  

The mediating role of sense of coherence between uncertainty in illness and psychological distress in patients undergoing sphincter-preserving surgery for rectal cancer

作　　者：姚薇 孙娜[1] 刘帅 Yao Wei;Sun Na;Liu Shuai(First Operating Room,the 2nd Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第二医院第一手术室,哈尔滨150001

出　　处：《中华现代护理杂志》2024年第34期4640-4645,共6页Chinese Journal of Modern Nursing

摘　　要：目的探讨心理一致感在直肠癌保肛术后患者疾病不确定感与心理痛苦间的中介效应,为制订改善直肠癌保肛术后患者心理痛苦的干预方案提供理论依据。方法采用便利抽样法,选取2023年1—12月在哈尔滨医科大学附属第二医院门诊复查的220例直肠癌保肛术后患者为研究对象。采用一般资料调查问卷、心理一致感量表、疾病不确定感量表、心理痛苦温度计对患者进行调查。采用AMOS 26.0软件构建结构方程模型,采用Bootstrap法检验心理一致感在直肠癌保肛术后患者疾病不确定感与心理痛苦间的中介效应。结果本研究共发放220份问卷,回收有效问卷208份,问卷有效回收率为94.55%。208例直肠癌保肛术后患者疾病不确定感量表总分为(75.40±21.38)分、心理一致感量表总分为(50.24±14.92)分、心理痛苦温度计总分为(4.70±2.50)分。中介效应分析结果显示,心理一致感在直肠癌保肛术后患者疾病不确定感与心理痛苦间的中介效应值为0.217(P<0.01),中介效应占总效应的37.41%(0.217/0.580),起部分中介效应。结论直肠癌保肛术后患者疾病不确定感对心理痛苦有直接影响,心理一致感在疾病不确定感与心理痛苦间起部分中介效应。提示医护人员应全面评估患者的疾病不确定感,给予患者信息支持,提供个性化的指导;并且采用一定的心理疗法提高患者的心理一致感,从而降低直肠癌保肛术后患者的心理痛苦水平。ObjectiveTo explore the mediating effect of sense of coherence(SOC)in the relationship between uncertainty in illness and psychological distress in patients undergoing sphincter-preserving surgery for rectal cancer and provide a theoretical basis for developing interventions to alleviate psychological distress in these patients.MethodsTotally 220 patients who underwent sphincter-preserving surgery for rectal cancer and attended follow-up at the 2nd Affiliated Hospital of Harbin Medical University from January to December 2023 were selected by convenience sampling.Data were collected using a general information questionnaire,Sense of Coherence Scale(SOC-13),Mishel Uncertainty in Illness Scale(MUIS),and Distress Thermometer(DT).Structural equation modeling was performed using AMOS 26.0 software,and the mediating effect of SOC between uncertainty in illness and psychological distress was tested using the Bootstrap method.ResultsA total of 220 questionnaires were distributed,and 208 valid questionnaires were returned,with a response rate of 94.55%.The total score for MUIS was(75.40±21.38),the total score for SOC was(50.24±14.92),and the total score for DI was(4.70±2.50).The mediating effect analysis showed that SOC had a mediating effect value of 0.217(P<0.01)between uncertainty in illness and psychological distress,accounting for 37.41%(0.217/0.580)of the total effect,indicating a partial mediation.ConclusionsUncertainty in illness has a direct impact on psychological distress in patients undergoing sphincter-preserving surgery for rectal cancer.SOC partially mediates the relationship between uncertainty in illness and psychological distress.These findings suggest that healthcare providers should comprehensively assess patients'uncertainty in illness and provide personalized information and guidance.In addition,psychological interventions aimed at enhancing patients'SOC may help reduce their psychological distress.

关 键 词：直肠癌 保肛术 心理一致感 疾病不确定感 心理痛苦 

分 类 号：R473.73[医药卫生—护理学]