疾病不确定感在甲状腺癌术后患者癌因性疲乏与生命质量间的中介效应  

The mediating effect of disease uncertainty on cancer-related fatigue and quality of life in postoperative thyroid cancer patients

作　　者：姜洋 马鑫 褚晴 赵炜婷 姜尧尧 Jiang Yang;Ma Xin;Chu Qing;Zhao Weiting;Jiang Yaoyao(Department of Nursing,Xiang′an Hospital of Xiamen University,Xiamen 361101,China;Department of General Surgery,Xiang′an Hospital of Xiamen University,Xiamen 361101,China;Department of Breast and Thyroid Surgery,Xiang′an Hospital of Xiamen University,Xiamen 361101,China;Department of Nursing,The Sixth Affiliated Hospital of Harbin Medical University,Harbin 150000,China)

机构地区：[1]厦门大学附属翔安医院护理部,厦门361101 [2]厦门大学附属翔安医院普外科,厦门361101 [3]厦门大学附属翔安医院乳腺甲状腺外科,厦门361101 [4]哈尔滨医科大学附属第六医院护理部,哈尔滨150000

出　　处：《中国实用护理杂志》2025年第7期530-537,共8页Chinese Journal of Practical Nursing

基　　金：厦门市护理学会护理科研课题(XMSHLXH2321)。

摘　　要：目的探讨疾病不确定感在甲状腺癌术后患者癌因性疲乏与生命质量间的中介效应,为甲状腺癌术后患者健康管理提供帮助。方法2023年1月至2024年6月,采用便利抽样法选取厦门大学附属翔安医院接受手术治疗的甲状腺癌患者为研究对象。应用一般资料调查表、甲状腺癌生命质量量表、癌症疲乏量表及Mishel疾病不确定感量表进行横断面调查。采用SPSS 22.0软件分析生命质量、癌因性疲乏、疾病不确定感三者之间的关系,采用AMOS24.0软件建立结构方程模型分析疾病不确定感在甲状腺癌术后患者癌因性疲乏与生命质量间的中介效应。结果回收有效问卷495份。495例甲状腺癌术后患者中,男135例,女360例,年龄(39.58±12.97)岁。甲状腺癌术后患者疾病不确定感得分为(60.98±11.61)分,癌因性疲乏得分为(42.85±7.35)分,生命质量得分为(57.51±9.81)分。Pearson相关性分析显示,癌因性疲乏得分与疾病不确定感得分呈正相关(r=0.392,P<0.01),与生命质量得分呈负相关(r=-0.465,P<0.01),疾病不确定感得分与生命质量得分呈负相关(r=-0.378,P<0.01)。疾病不确定感在甲状腺癌术后患者癌因性疲乏与生命质量间起部分中介作用,中介效应值为-0.14,占总效应的32.56%。结论甲状腺癌术后患者疾病不确定感和生命质量得分处于中等水平,癌因性疲乏得分处于中等偏上水平,疾病不确定感是甲状腺癌术后患者癌因性疲乏与生命质量的重要中介变量,改善甲状腺癌术后患者疾病不确定感,可以降低癌因性疲乏,提高患者生命质量。Objective To explore the mediating effect of disease uncertainty on cancer-related fatigue and quality of life in postoperative thyroid cancer patients,and to provide assistance for health management of thyroid cancer patients.MethodsFrom January 2023 to June 2024,thyroid cancer patients who underwent surgical treatment in Xiang′an Hospital of Xiamen University were selected by convenience sampling method.Conduct a survey using The general information questionnaire,Cancer Quality of Life for Thyroid Cancer 34,Cancer Fatigue Scale,and Mishel Uncertainty in Illness Scale were used to conduct cross-sectional investigation.SPSS 22.0 was used to statistically analyze the relationship between the three factors,and AMOS 24.0 software was used to establish a structural equation model to analyze the mediating effect of disease uncertainty on cancer-related fatigue and quality of life in postoperative thyroid cancer patients.ResultsFinally,495 valid questionnaires were ultimately collected.Among 495 postoperative patients with thyroid cancer,there were 135 males and 360 females,with an age of(39.58±12.97)years old.The uncertainty score of postoperative thyroid cancer patients was(60.98±11.61)points,cancer-related fatigue score was(42.85±7.35)points,and quality of life score was(57.51±9.81)points.Pearson correlation analysis showed that cancer-related fatigue was positively correlated with disease uncertainty(r=0.392,P<0.01)and negatively correlated with quality of life(r=-0.465,P<0.01).Disease uncertainty was negatively correlated with quality of life(r=-0.378,P<0.01).Disease uncertainty partially mediated the relationship between cancer-related fatigue and quality of life in postoperative thyroid cancer patients,with a mediation effect value of-0.14,accounting for 32.56%of the total effect.ConclusionsThe disease uncertainty score and the quality of life score of postoperative thyroid cancer patients were at a moderate level,the cancer-related fatigue score was at an upper moderate level.Disease uncertainty is an imp

关 键 词：甲状腺肿瘤 生活质量 癌因性疲乏 疾病不确定感 中介效应 

分 类 号：R473.73[医药卫生—护理学]