肺癌化疗患者癌因性疲乏对生活质量的影响:心理弹性和领悟社会支持的链式中介作用  

Impact of cancer-related fatigue on quality of life in lung cancer patients with chemotherapy:the chain mediating role of psychological resilience and perceived social support

作　　者：巴佳代子 贺会杰 王佳琪 杨淑君[1] 高明[1] Ba Jiadaizi;He Huijie;Wang Jiaqi;Yang Shujun;Gao Ming(Department of Oncology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院肿瘤内科,郑州450000

出　　处：《中华现代护理杂志》2025年第10期1338-1345,共8页Chinese Journal of Modern Nursing

摘　　要：目的探讨心理弹性和领悟社会支持在肺癌化疗患者癌因性疲乏和生活质量间的链式中介作用,为提高肺癌化疗患者生活质量提供依据。方法采用便利抽样法,选取2022年6月—2023年11月河南省3所三级甲等医院收治的275例肺癌化疗患者为研究对象。采用一般资料调查问卷、癌症疲乏量表、肺癌患者生活质量测定量表(QLICP-LU)、心理弹性量表和领悟社会支持量表对患者进行问卷调查。采用Spearman相关分析对肺癌化疗患者癌因性疲乏、心理弹性、领悟社会支持和生活质量的相关性进行分析,采用SPSS PROCESS程序中的Model 6检验链式中介效应。本研究共发放问卷275份,回收问卷268份,剔除规律作答问卷,有效问卷为252份,问卷有效回收率为91.64%(252/275)。结果单因素分析结果显示,不同年龄、文化程度、婚姻状况、家庭人均月收入、肿瘤分期的肺癌化疗患者QLICP-LU评分比较差异有统计学意义(P<0.01)。Spearman相关分析显示,肺癌化疗患者癌因性疲乏与心理弹性、领悟社会支持和生活质量均呈负相关(P<0.01);生活质量与心理弹性、领悟社会支持均呈正相关(P<0.01);心理弹性与领悟社会支持呈正相关(P<0.01)。中介效应分析显示,癌因性疲乏对生活质量的直接效应值为-0.302,占总效应的77.44%。心理弹性和领悟社会支持通过3条中介路径实现对癌因性疲乏与生活质量间的中介效应,总间接效应值为-0.088,占总效应的22.56%。结论癌因性疲乏不仅可以直接影响肺癌化疗患者的生活质量,还可以通过心理弹性和领悟社会支持的中介作用对其产生间接影响。临床医护人员在关注患者癌因性疲乏的同时,应注重评估患者的心理状态,提供心理支持,并增加社会支持力度,从而提高患者的生活质量。Objective To explore the chain mediating role of psychological resilience and perceived social support between cancer-related fatigue and quality of life in patients undergoing chemotherapy for lung cancer,and to inform interventions to improve quality of life in patients undergoing chemotherapy for lung cancer.Methods Convenience sampling was used to select 275 lung cancer patients with chemotherapy admitted to three ClassⅢGrade A hospitals in Henan Province from June 2022 to November 2023 for the study.General Information Questionnaire,Cancer Fatigue Scale,Quality of Life Instruments for Cancer Patients-Lung(QLICP-LU),Connor-Davidson Resilience Scale,and Perceived Social Support Scale were used to survey the patients.Correlations between cancer-related fatigue,psychological resilience,perceived social support,and quality of life in lung cancer patients with chemotherapy were analyzed using Spearman correlation.Model 6 in the SPSS PROCESS program was used to test for chain mediating effects.A total of 275 questionnaires were distributed,268 questionnaires were recovered,excluding the regular answer questionnaires,the valid questionnaires were 252,the effective recovery rate of questionnaires was 91.64%(252/275).Results Univariate analysis showed statistically significant differences in QLICP-LU scores among lung cancer patients with chemotherapy of different ages,educational levels,marital status,per capita monthly household income,and tumor stages(P<0.01).Spearman correlation analysis showed that cancer-related fatigue was negatively correlated with psychological resilience,perceived social support and quality of life in patients undergoing chemotherapy for lung cancer(P<0.01),and quality of life was positively correlated with psychological resilience and perceived social support(P<0.01),and psychological resilience was positively correlated with perceived social support(P<0.01).Mediating effect analysis showed that the direct effect of cancer-related fatigue on quality of life was-0.302,which accounted for 7

关 键 词：肺肿瘤 化疗 癌因性疲乏 心理弹性 领悟社会支持 生活质量 中介作用 

分 类 号：R73[医药卫生—肿瘤]