社会生态系统视角下癌症应对缺陷行为现状及影响因素通径分析  

Path analysis of coping-deficient behaviors in cancer response from a socio-ecological system perspective

作　　者：任晓晴 方硕文 张新洲 肖剑 储著源 卢曼曼[1] REN Xiaoqing;FANG Shuowen;ZHANG Xinzhou;XIAO Jian;CHU Zhuyuan;LU Manman(School of Health Management,Anhui Medical University,Hefei,Anhui 230032,China;不详)

机构地区：[1]安徽医科大学卫生管理学院,安徽合肥230032 [2]浙江中医药大学附属杭州市西溪医院 [3]安徽省肿瘤医院 [4]安徽医科大学马克思主义学院

出　　处：《中国预防医学杂志》2025年第3期282-288,共7页Chinese Preventive Medicine

基　　金：国家自然科学基金资助项目(71804002);安徽省哲学社会科学规划项目(AHSKZ2020D21)。

摘　　要：目的了解癌症患者预防与控制应对缺陷行为、发现与诊断应对缺陷行为、治疗与管理应对缺陷行为现状以及影响路径,为改善癌症患者的应对缺陷行为提供建议。方法2020年11月—2021年10月采用自行设计问卷对安徽省癌症患者进行便利抽样调查。不同癌种得分差异采用Kruskal-Wallis H检验,通过多重线性回归分析影响癌症应对缺陷行为的因素,利用通径分析探讨影响路径。结果共调查565例癌症患者,通径分析表明,预防与控制应对缺陷行为、发现与诊断应对缺陷行为、文化程度、赞同“多与医生、家人交流有利于恢复身体健康”、生病后家庭成员提供生活照料、生病后与朋友亲近以及病友的病情变化会影响自己情绪,均直接影响治疗与管理的应对缺陷行为,直接效应分别为0.224、0.111、-0.093、-0.120、-0.229、-0.073和0.136。预防与控制应对缺陷行为、性别、文化程度、生病前受朋友或同事影响抽烟或饮酒、所在乡镇在慢性病/肿瘤预防上提供适量运动方面的宣传或教育服务、不舒服时及时告知家人以及签约家庭医生等因素则间接影响治疗与管理应对缺陷行为,间接效应分别为0.015、-0.039、-0.046、0.037、-0.030、-0.019和-0.015。预防与控制应对缺陷行为的影响最大,标准化总效应为0.239。结论结合社会生态系统理论,从个体、人际、社区和政策四大层面提供系统干预方案,以促进癌症的预防、发现、诊断、治疗和管理,改善患者生活质量。Objective To understand the current situation of preventing and controlling coping-deficient behaviors in cancer prevention and control,detection and diagnosis,and treatment and management,as well as the influencing factors and pathways,to provide suggestions for improving the coping-deficient behaviors among cancer patients.Methods From November 2020 to October 2021,a convenience sample survey was conducted among cancer patients in Anhui Province using a self-designed questionnaire.The Kruskal-Wallis H test was used to identify factors influencing.Cancer coping deficiency behaviors,with path analysis to explore the influencing pathways.Results A total of 565 cancer patients were surveyed.Path analysis showed that coping deficits in prevention and control,detection and diagnosis,educational level,the agreement that“communicating more with doctors and family is beneficial for recovery health”,family support for daily care,closeness to friends during illness,and awareness of fellow patients'conditions all directly impacted coping deficient behaviors in treatment and management,with direct effects of 0.224,0.111,-0.093,-0.120,-0.229,-0.073,and 0.136,respectively.Additionally,prevention and control of coping deficient behaviors,gender,educational level,being influenced by friends or colleagues regarding smoking or drinking before getting sick,availability of promotional or educational services for chronic disease/cancer prevention in local communities,timely communication of dis‐comfort to family members,and signing up for a family doctor indirectly affected treatment and management cop‐ing with defective behaviors,with indirect effects of 0.015,-0.039,-0.046,0.037,-0.030,-0.019,and-0.015,respectively.Among these,the impact of prevention and control of coping deficient behaviors had the largest effect,with a standardized total effect of 0.239.Conclusions Based on the social-ecological system theory,a systematic intervention program is provided at four major levels:individual,interpersonal,community,and policy

关 键 词：社会生态系统理论 癌症患者 应对缺陷行为 通径分析 

分 类 号：R197[医药卫生—卫生事业管理]