认知情绪调节在癌痛与生活质量之间的中介作用及其差异分析  

Mediating role of cognitive emotion regulation in the relationship between cancer pain and quality of life and its differential analysis

作　　者：胡筱玙 吕静静[3,4] 秦畅 刘晓璇 祝健彪 崔永春 HU Xiaoyu;LYU Jingjing;QIN Chang;LIU Xiaoxuan;ZHU Jianbiao;CUI Yongchun(Department of Public Health,Shandong First Medical University(Shandong Academy of Medical Sciences),Shandong Cancer Prevention and Control Research Institute(Shandong Cancer Hospital),Jinan,Shandong 250117,China;School of Public Health,Shandong First Medical University(Shandong Academy of Medical Sciences),Jinan,Shandong 250117,China;Expanded Program lmmunization Division of Shandong Provincial Center for Disease Control and Prevention,Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention,Jinan,Shandong 250014,China;School of Public Health,Shandong University Cheeloo College of Medicine,Jinan,Shandong 250012,China;School of Public Health,Shandong Second Medical University,Weifang,Shandong261053,China)

机构地区：[1]山东省肿瘤防治研究院(山东省肿瘤医院)公共卫生教研室,山东第一医科大学(山东省医学科学院),山东济南250117 [2]山东第一医科大学(山东省医学科学院)公共卫生与健康管理学院,山东济南250117 [3]山东省疾病预防控制中心山东省传染病预防控制重点实验室,山东济南250014 [4]山东大学齐鲁医学院公共卫生学院,山东济南250012 [5]山东第二医科大学公共卫生学院,山东潍坊261053

出　　处：《中华肿瘤防治杂志》2024年第24期1526-1531,共6页Chinese Journal of Cancer Prevention and Treatment

基　　金：山东省人文社科健康教育与健康促进专项(2023-JKZX-08);山东省医药卫生科技项目(202315020614)。

摘　　要：目的探讨认知情绪调节在癌痛与生活质量之间的中介作用,并比较适应性和非适应性认知情绪调节在其中的差异。方法采用方便抽样法,选取2024-01-01-2024-02-28山东省肿瘤医院收治的276例经历癌痛的癌症患者。通过问卷收集患者的一般人口学资料、疼痛、认知情绪调节以及生活质量数据。使用SPSS 27.0对数据进行描述性统计、相关分析、中介路径系数检验,并运用中介效应模型分析认知情绪调节在癌痛与生活质量之间的中介作用。结果276例患者中,男160例(57.97%),女116例(42.03%);40~60岁的患者146例(52.90%);呼吸系统肿瘤和消化系统肿瘤占比最多,分别为36.96%和38.04%。相关分析结果显示,疼痛与适应性认知情绪调节呈负相关(r=-0.276,P<0.001),而与非适应认知情绪调节间的相关性不显著(r=0.100,P=0.098)。适应性认知情绪调节与躯体功能(r=0.493,P<0.001)、角色功能(r=0.436,P<0.001)、认知功能(r=0.207,P=0.010)和社会功能(r=0.150,P=0.013)呈正相关。非适应性认知情绪调节与情绪功能(r=-0.373,P<0.001)和认知功能(r=-0.223,P<0.001)呈负相关。中介效应路径系数检验显示,疼痛负向影响适应性认知情绪调节(B=-0.129,P<0.001),适应性认知情绪调节正向影响躯体功能(B=13.084,P<0.001)和角色功能(B=10.527,P<0.001)。疼痛对非适应性认知情绪调节影响不显著(B=0.016,P=0.167),非适应性认知情绪调节负向影响情绪功能(B=-19.765,P<0.001)和认知功能(B=-11.166,P=0.001)。中介效应检验显示,适应性认知情绪调节对躯体功能和角色功能的中介效应占总效应的19.62%和17.23%。结论医护人员在治疗过程中应减少患者非认知情绪调节策略的使用并提供适应性认知情绪训练,以帮助患者更好地应对疼痛,改善生活质量。Objective To explore the mediating role of cognitive emotion regulation in the relationship between cancer pain and quality of life,with a focus on comparing the effects of adaptive and maladaptive cognitive emotion regulation.Methods A total of 276cancer patients experiencing cancer-related pain were recruited through convenience sampling from Shandong Cancer Hospital between January 1,2024,and February 28,2024.Data on demographics,pain levels,cognitive emotion regulation,and quality of life were collected via questionnaires.Descriptive statistics,correlation analyses,and mediation path coefficient tests were conducted by using SPSS 27.0.A mediation model was applied to examine the mediating effects of cognitive emotion regulation on the association between cancer pain and quality of life.Results Among 276patients,there were 160males(57.97%)and 116females(42.03%);146patients aged 40-60years old(52.90%);Respiratory system tumors and digestive system tumors account for the highest proportion,at 36.96%and 38.04%,respectively.Correlation analyses indicated a significant negative correlation between pain and adaptive cognitive emotion regulation(r=-0.276,P<0.001),while the association between pain and maladaptive cognitive emotion regulation was non-significant(r=0.100,P=0.098).Adaptive cognitive emotion regulation was positively associated with physical functioning(r=0.493,P<0.001),role functioning(r=0.436,P<0.001),cognitive functioning(r=0.207,P=0.010),and social functioning(r=0.150,P=0.013).Conversely,maladaptive cognitive emotion regulation was negatively correlated with emotional functioning(r=-0.373,P<0.001)and cognitive functioning(r=-0.223,P<0.001).Mediation path analysis demonstrated that pain negatively impacted adaptive cognitive emotion regulation(B=-0.129,P<0.001),adaptive cognitive emotion regulation positively influenced physical functioning(B=13.084,P<0.001)and role functioning(B=10.527,P<0.001).No significant effect of pain on maladaptive cognitive emotion regulation was observed(B=0.016,P=0.167).How

关 键 词：癌痛 认知情绪调节 生活质量 中介效应 疼痛管理 

分 类 号：R473.73[医药卫生—护理学]