脑胶质瘤患者的社会支持与合理用药自我效能在癌症相关性疲乏与口服化疗药依从性中的平行中介分析  

Parallel mediated analysis of social support and rational medication self-efficacy in cancer-related fatigue and oral chemotherapy adherence in patients with glioma

作　　者：鲍凯璇 谢玉凤 鲍凯瑜 杜鹏[3] BAO Kaixuan;XIE Yufeng;BAO Kaiyu;DU Peng(School of Nursing,Xinjiang Medical University,Xinjiang Uygur Autonomous Region,Urumqi830017,China;School of Nursing,Chengdu Medical College,Sichuan Province,Chengdu610002,China;Department of Neurosurgery,the Second Affiliated Hospital of Xinjiang Medical University,Xinjiang Uygur Autonomous Region,Urumqi830063,China)

机构地区：[1]新疆医科大学护理学院,新疆乌鲁木齐830017 [2]成都医学院护理学院,四川成都610002 [3]新疆医科大学第二附属医院神经外科,新疆乌鲁木齐830063

出　　处：《中国医药导报》2024年第30期79-84,共6页China Medical Herald

基　　金：新疆维吾尔自治区科技支疆项目(2022E02135)。

摘　　要：目的探讨社会支持与合理用药自我效能在癌症相关性疲乏与脑胶质瘤患者口服化疗药依从性之间的平行中介效应。方法采用方便抽样法收集2023年12月至2024年6月新疆医科大学第一附属人民医院、新疆医科大学第二附属医院、新疆医科大学第三附属医院及四川省肿瘤医院的脑胶质瘤患者,问卷选取一般资料调查表、简短疲乏量表(BFI)调查脑胶质瘤患者资料和疲乏程度,采用社会支持量表(SSRS)、合理用药自我效能量表(SEAMS)、Morisky服药依从性评估量表-8(MMAS-8)分别评估其社会支持度、合理用药自我效能度和服化疗药依从性。结果共发放问卷480份,剔除无效问卷,最终有效问卷464份。SSRS、SEAMS、BFI、MMAS-8得分分别为(38.3±7.29)、(27.83±6.66)、(4.57±1.48)、(4.53±1.92)分。Pearson相关性分析结果显示,口服化疗药依从性与癌症相关性疲乏呈负相关(r<0,P<0.01);与合理用药自我效能及社会支持呈正相关(r>0,P<0.01)。因果逐步分析法、Bootstrap、Mplus三种统计方法显示,社会支持和合理用药自我效能起到完全中介作用,分别占总效应的59.09%、50.84%,合理用药自我效能间接效应路径受遮掩效应影响。结论癌症相关性疲乏可直接抑制脑胶质瘤患者口服化疗药依从性,同时可以通过社会支持与合理用药效能影响癌症患者口服化疗药依从性。Objective To explore the parallel mediated analysis of social support and rational medication self-efficacy in cancer-related fatigue and oral chemotherapy adherence in patients with glioma.Methods Glioma patients from the First Affiliated People’s Hospital of Xinjiang Medical University,the Second Affiliated Hospital of Xinjiang Medical University,the Third Affiliated Hospital of Xinjiang Medical University,and Sichuan Cancer Hospital from December 2023 to June 2024 were collected by convenience sampling method.The general information questionnaire and brief fatigue inventory(BFI)were selected to investigate the general information and fatigue degrees of glioma patients.The social support rate scale(SSRS),self-efficacy for appropriate medication use scale(SEAMS),and 8-item Morisky medication adherence scale(MMAS-8)were employed to evaluate the social support degree,appropriate medication self-efficacy and medication adherence.Results A total of 480 questionnaires were distributed,elimination of invalid questionnaires,and 464 valid ques-tionnaires.The scores of SSRS,SEAMS,BFI,and MMAS-8 were(38.3±7.29),(27.83±6.66),(4.57±1.48)points,and(4.53±1.92)points,respectively.Pearson correlation analysis showed that compliance with oral chemotherapy was negatively corr-elated with cancer-related fatigue(r<0,P<0.01),it was positively correlated with rational drug use self-efficacy and social support(r>0,P<0.01).Three statistical methods,including causal stepwise analysis,Bootstrap,and Mplus were used to confirm that social support and rational medication self-efficacy exert complete mediating effects,accounting for 59.09%and 50.84%,respectively,of the total effects.The indirect effect pathway of rational medication self-efficacy is affected by the masking effect.Conclusion Cancer-related fatigue can directly inhibit the oral chemotherapy adherence of patients with glioma,at the same time,social support and rational drug use can influence the compliance of cancer patients with oral chemotherapy drugs.

关 键 词：脑胶质瘤 化疗 癌症相关性疲乏 依从性 

分 类 号：R739.4[医药卫生—肿瘤]