肺癌患者及其配偶适应性元认知、家庭回避癌症沟通对心理困扰的交互影响  

Interaction Effect of Adaptive Metacognition and Family Avoidance of Communication About Cancer on Psychological Distress in Lung Cancer Patients and Spouses

作　　者：冯然 史玉佳 林子涵 刘军晓 FENG Ran;SHI Yujia;LIN Zihan;LIU Junxiao(The Affiliated Cancer Hospital of Zhengzhou University(Henan Cancer Hospital),Zhengzhou 450008,China)

机构地区：[1]郑州大学附属肿瘤医院(河南省肿瘤医院),河南郑州450008

出　　处：《河南医学研究》2025年第8期1398-1403,共6页Henan Medical Research

基　　金：河南省医学科技攻关计划项目(LHGJ20200203)。

摘　　要：目的 基于主客体互倚模型探讨肺癌患者及其配偶的适应性元认知、家庭回避癌症沟通对双方心理困扰的影响。方法 采用便利抽样法,于2023年1—12月运用一般资料调查表、积极元认知元情绪问卷(PMCEQ)、家庭回避癌症沟通量表(FACCS)及凯斯勒心理困扰量表(K10)对河南省肿瘤医院450例肺癌患者及其配偶进行调查。采用主客体互倚模型处理数据。结果 肺癌患者及配偶的PMCEQ得分分别为(53.12±8.70)分及(52.42±9.14)分;FACCS得分分别为(45.72±15.96)分及(42.99±12.98)分;K10得分分别为(25.78±4.46)分及(25.38±3.79)分。主客体互倚模型结果显示,主体中介效应肺癌患者及其配偶家庭回避癌症沟通在适应性元认知对其自身心理困扰的关系中起部分中介作用(β=-0.008,β=-0.024);客体中介效应肺癌患者及其配偶的家庭回避癌症沟通在配偶适应性元认知对患者心理困扰的关系中起部分中介作用(β=-0.009,β=-0.017)。结论 肺癌患者及其配偶心理健康状况较差。夫妻双方的适应性元认知和家庭回避癌症沟通均对自身的心理困扰产生影响。此外,双方的适应性元认知也可通过家庭回避癌症沟通的中介作用对心理困扰产生主体和客体效应。Objective To explore the impact of adaptive metacognition and family avoidance of cancer communication on the psychological distress of lung cancer patients and their spouses based on the actor-partner interdependence model(APIM).Methods A convenient sampling method was used to investigate 450 couples of patients with lung cancer in Henan Cancer Hospital from January to December 2023 by using the general information questionnaire,positive metacognitions and positive meta-emotions questionnaire(PMCEQ),family avoidance of communication about cancer(FACCS)and 10-item Kessler psychological distress scale(K10).Paired data were processed with APIM.Results The PMCEQ scores of lung cancer patients and their spouses were(53.12±8.70)and(52.42±9.14)points,respectively.The FACCS scores were(45.72±15.96)and(42.99±12.98)points,respectively.The K10 scores were(25.78±4.46)and(25.38±3.79)points,respectively.The results of APIM showed that family avoidance of communication about cancer played a partial mediating role in the relationship between the adaptive metacognitions and psychological distress in lung cancer patients and spouses(β=-0.008,β=-0.024).Lung cancer patients and their spouses’family avoidance of communication about cancer played a partial mediating role in the relationship between spouse adaptive metacognitions and spouse psychological distress(β=-0.009,β=-0.017).Conclusion Lung cancer patients and spouses have poor mental health.The couples’adaptive metacognitions and family avoidance of communication about cancer have an impact on their own psychological distress.In addition,the couples’adaptive metacognitions also have subjective and object effects on psychological distress through the mediating role of family avoidance of communication about cancer.

关 键 词：肺癌 配偶 心理困扰 主客体互倚模型 适应性元认知 家庭回避癌症沟通 

分 类 号：R734.2[医药卫生—肿瘤]