恶性血液肿瘤患者焦虑情绪与生命质量:心理弹性的中介作用和自我效能感的调节作用  

Anxiety and quality of life in patients with hematologic malignancy:the mediating role of resilience and the moderating role of self-efficacy

作　　者：张丽敏 张秀贞 刘传新[1] Zhang Limin;Zhang Xiuzhen;Liu Chuanxin(School of Mental Health,Jining Medical University,Jining 272067,China;Shandong Daizhuang Hospital,Jining 272051,China)

机构地区：[1]济宁医学院精神卫生学院,济宁272067 [2]山东省戴庄医院,济宁272051

出　　处：《中华行为医学与脑科学杂志》2024年第12期1099-1105,共7页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：山东省研究生教育教学改革项目(SDYJG19212);济宁医学院贺林院士新医学临床转化工作站科研基金(JYHL2021ZD02)。

摘　　要：目的探讨恶性血液肿瘤患者焦虑情绪与生命质量之间的关系,以及心理弹性和自我效能感在其中的作用。方法2017年2—6月,采用焦虑自评量表(self-rating anxiety scale,SAS)、心理弹性量表(Connor-Davidson resilience scale,CD-RISC)、一般自我效能感量表(general self-efficacy scale,GSES)以及癌症患者生命质量量表(cancer quality of life questionnaires-core 30,EORTC QLQ-C30)对284名恶性血液肿瘤患者进行问卷调查,运用SPSS 25.0软件对数据进行共同方法偏差检验、独立样本t检验和Pearson相关分析,采用PROCESS v3.4宏程序进行中介效应和调节效应检验。结果(1)恶性血液肿瘤患者的生命质量得分[(72.52±19.18)分]显著低于常模(78.97分)(t=-5.669,P<0.01)。(2)焦虑[(43.71±11.22)分]与心理弹性[(69.96±15.32)分]、自我效能感[(22.93±6.04)分]、生命质量[(72.52±19.18)分]呈显著负相关(r=-0.232,-0.119,-0.236,均P<0.05),心理弹性、自我效能感和生命质量两两之间均呈显著正相关(r=0.113,0.210,0.652,均P<0.05)。(3)恶性血液肿瘤患者焦虑情绪对生命质量有显著负向预测作用(β=-0.233,t=-4.032,P<0.01),心理弹性在焦虑情绪与生命质量间起部分中介作用,直接效应和中介效应分别占总效应的82.40%(-0.192/-0.233)、17.60%(-0.041/-0.233);自我效能感在心理弹性和生命质量之间起调节作用,对于低自我效能感组而言,心理弹性对生命质量没有预测作用(β_(simple)=0.059,t=0.650,P>0.05,95%CI=-0.119~0.236);对于高自我效能感组而言,心理弹性对生命质量存在显著正向预测作用(β_(simple)=0.313,t=3.390,P<0.01,95%CI=0.131~0.494)。结论恶性血液肿瘤患者的焦虑情绪不仅直接影响其生命质量,还会通过心理弹性间接影响其生命质量;自我效能感能够调节心理弹性在焦虑情绪与生命质量间的中介作用。Objective To explore the correlation between anxiety and quality of life in patients with hematologic malignancy,and the role of resilience and self-efficacy in it.Methods From February to June 2017,a total of 284 patients with hematologic malignancy were surveyed by general information questionnaire,self-rating anxiety scale(SAS),Connor-Davidson resilience scale(CD-RISC),general self-efficacy scale(GSES),and cancer quality of life questionnaires-core 30(EORTC QLQ-C30).SPSS 25.0 software was used to conduct common method bias testing,independent sample t-test and Pearson correlation analysis,and PROCESS 3.4 macro program was used to test the mediating and moderating effects.Results(1)The quality of life score among hematologic malignancy patients(72.52±19.18)was significantly lower than the norm(78.97)(t=-5.669,P<0.01).(2)Anxiety(43.71±11.22)was significantly negatively correlated with resilience(69.96±15.32),self-efficacy(22.93±6.04),and quality of life(72.52±19.18)(r=-0.232,-0.119,-0.236,all P<0.05).There were significant positive correlations between resilience,self-efficacy and quality of life(r=0.113,0.210,0.652,all P<0.05).(3)Anxiety played a significant negatively predictive effect on quality of life in patients with hematologic malignancy(β=-0.233,t=-4.032,P<0.01).Resilience partially mediated the relationship between anxiety and quality of life.The direct effect and the mediating effect accounted for 82.40%(-0.192/-0.233)and 17.60%(-0.041/-0.233)of the total effects respectively.Self-efficacy played a moderating role between resilience and quality of life.For the low self-efficacy group,resilience could not predict quality of life(β_(simple)=0.059,t=0.650,P>0.05,95%CI=-0.119-0.236).For the high self-efficacy group,resilience had a significant positively predictive effect on quality of life(β_(simple)=0.313,t=3.390,P<0.01,95%CI=0.131-0.494).Conclusion Anxiety in patients with hematologic malignancy can directly or indirectly affect quality of life through resilience,and this mediating model is mod

关 键 词：恶性血液肿瘤 焦虑 心理弹性 自我效能感 生命质量 

分 类 号：R73[医药卫生—肿瘤]