以质量求发展，以服务铸品牌

护理学报 ›› 2022, Vol. 29 ›› Issue (6): 60-64.doi: 10.16460/j.issn1008-9969.2022.06.060

• 调查研究 • 上一篇    下一篇

癌症患者及其配偶二元应对与心理弹性的主体-客体互倚模型研究

孙海燕, 秦阳, 徐益荣, 陈文艳   

  1. 江苏医药职业学院 护理学院,江苏 盐城 224005
  • 收稿日期:2021-11-08 出版日期:2022-03-25 发布日期:2022-04-08
  • 作者简介:孙海燕（1983-）,女,江苏盐城人,硕士,副教授。E-mail:15951551901@139.com
  • 基金资助:
    江苏省高校哲学社会科学研究项目（2021SJA1944）; 江苏省高职院校教师专业带头人高端研修项目（苏高职培函[2020]10号）

Relationship between Dyadic Coping and Psychological Resilience in Cancer Survivor Couples: An Actor-partner Interdependence Model-based Analysis

SUN Hai-yan, QIN Yang, XU Yi-rong, CHEN Wen-yan   

  1. School of Nursing, Jiangsu Vocational College of Medicine, Yancheng 224005, China
  • Received:2021-11-08 Online:2022-03-25 Published:2022-04-08

PDF (PC)

438

赞

摘要： 目的 探讨癌症患者和配偶的二元应对与心理弹性的关系,为临床干预提供理论依据。方法 采取便利抽样法,选取盐城4所三级医院的371对癌症患者及其配偶为研究对象,采用二元应对量表、心理弹性量表进对其行调查。基于主体-客体互倚模型分析癌症患者和配偶间二元应对与心理弹性的关系。结果 癌症患者二元应对总分为（62.40±14.08）分,癌症患者配偶总分为（61.83±15.10）分。癌症患者心理弹性总分为（62.36±13.11）分,癌症患者配偶总分为（60.47±12.80）分。癌症患者及其配偶的二元应对与自身及对方的心理弹性得分均呈正相关（r=0.312~0.739, 均P<0.001）。癌症患者及其配偶的二元应对都能够正向影响自身的心理弹性（β=0.616,0.700;均P<0.001）,即主体效应显著。癌症患者及其配偶的二元应对都能够正向影响对方的心理弹性（β=0.330,0.651;均P<0.001）,即客体效应显著。结论 癌症患者及其配偶的心理弹性受自身和对方支持应对行为的交互影响。医护人员应将癌症夫妻视为一个共同体,有助于制订以夫妻为中心的相互支持应对策略,从而减少应对癌症时的心理压力。

关键词: 癌症, 配偶, 二元应对, 心理弹性, 主体-客体互倚模型

Abstract: Objective To examine the relationship between dyadic coping and psychological resilience in cancer survivors and their spouses, and to provide theoretical basis for clinical intervention. Methods With convenience sampling, a total of 371 cancer survivors and their spouses were recruited from four tertiary hospitals in Yancheng City. Dyadic Coping Inventory and Connor-Davidson Resilience Scale were used to assess dyadic coping style and psychological resilience. The actor-Partner interdependence model was used to explore the association between dyadic coping and psychological resilience. Results The total score of dyadic coping of cancer patients was 62.40±14.08, and that in their spouses 61.83±15.10. The total score of psychological resilience of cancer patients and their spouses was 62.36±13.11, and 60.47±12.80 respectively. The total score of dyadic coping in cancer patients and their spouses was positively correlated with psychological resilience (r=0.312~0.739, all P<0.001). In terms of actor-effect, the score of dyadic coping in cancer patients and their spouses was positively correlated with their own psychological resilience score respectively (β=0.616, β=0.700, all P<0.001). In terms of partner-effect, the score of dyadic coping in cancer patients and their spouses was positively correlated with the counterparts' score of psychological resilience respectively (β=0.330, β=0.651, all P<0.001). Conclusion The psychological resilience of cancer survivors and their couples is affected by individual and the dyadic supportive coping. Patients and their caregivers should be viewed as a unit, and couple-centered positive coping strategies to reduce their psychological distress with cancer should be implemented.

Key words: cancer, spouse, dyadic coping, psychological resilience, actor-partner interdependence model

中图分类号: 

  • R473.73
[1] Bodenmann G, Hilpert P, Nussbeck FW, et al.Effects of Stress on the Social Support Provided by Men and Women in Intimate Relationships[J]. Psychol Sci,2015,26(10):1584-1594. DOI:10.1177/0956797615594616.
[2] 于歌,崔金金.二元应对模式对慢性心力衰竭患者生活质量及其配偶间亲密关系的影响[J].护理学报,2019,26(16):63-67. DOI:10.16460/j.issn1008-9969.2019.16.063.
[3] Traa MJ, De Vries J, Bodenmann G, et al.Dyadic Coping and Relationship Functioning in Couples Coping with Cancer: A Systematic Review[J]. Br J Health Psychol,2015,20(1):85-114. DOI:10.1111/bjhp.12094.
[4] Sinclair RR, Britt TW.Building Psychological Resilience in Military Personnel: Theory and Practice[M]. Washington, DC: American Psychological Association, 2013.
[5] Lim J, Shon E, Paek M, et al.The Dyadic Effects of Coping and Resilience on Psychological Distress for Cancer Survivor Couples[J]. Support Care Cancer,2014,22(12):3209-3217. DOI:10.1007/s00520-014-2334-9.
[6] Kenny DA, Kashy DA, Cook WL.Dyadic Data Analysis[M]. New York: Guilford Publications,2020:145-148.
[7] Wang H, Yue H, Ren M, et al.Dyadic Effects of Family-functioning and Resilience on Quality of Life in Advanced Lung Cancer Patients and Caregivers: An Actor-partner Interdependence Mediation Model[J]. Eur J Oncol Nurs,2021,52:101963. DOI: 10.1016/j.ejon.2021.101963.
[8] 罗群,周利华,王维利,等.妇科癌症患者和配偶夫妻支持应对与亲密关系的关系[J].中国心理卫生杂志,2017,31(12):964-970. DOI:10.3969/j.issn.1000-6729.2017.12.006.
[9] Falconier MK, Nussbeck F, Bodenmann G.Dyadic Coping in Latino Couples:Validity of the Spanish Version of the Dyadic Coping Inventory[J]. Anxiety Stress Coping,2013,26(4):447-466. DOI: 10.1080/10615806.2012.699045.
[10] Xu F, Hilpert P, Randall AK, et al.Validation of the Dyadic Coping Inventory with Chinese Couples: Factorial Structure, Measurement Invariance, and Construct Validity[J]. Psychol Assess,2016,28(8): e127. DOI:10.1037/pas0000329.
[11] Connor KM,Davidson JR.Development of a New Resilience Scale: The Connor-davidson Resilience Scale (CD-RISC)[J]. Depress Anxiety,2003, 18(2):76-82.DOI:10.1002/da.10113.
[12] Yu X, Zhang J.Factor Analysis and Psychometric Evaluation of the Connor-davidson Resilience Scale(CD-RISC) with Chinese People[J].Soc Behav Personal,2007,35(1):19-30. DOI:10.2224/sbp.2007.35.1.19.
[13] 佟阳,金咏梅,王恬,等.心理弹性在女性乳腺癌术后上肢淋巴水肿患者正念水平与生活质量间的中介效应[J].护理学报,2019,26(10):7-10.DOI:10.16460/j.issn1008-9969.2019.10.007.
[14] Kenny DA, Ledermann T. Detecting, Measuring,Testing Dyadic Patterns in the Actor-partner Interdependence Model[J].J Fam Psychol,2010,24(3):359-366.DOI:10.1037/a0019651.
[15] 汤丹丹,温忠麟. 共同方法偏差检验:问题与建议[J]. 心理科学,2020,43(1):215-223.DOI:10.16719/j.cnki.1671-6981.20200130.
[16] Kim Y,Carver CS, Spillers RL, et al.Individual and Dyadic Relations Between Spiritual Well‐being and Quality of Life among Cancer Survivors and Their Spousal Caregivers[J]. Psycho-oncology,2011,20(7):762-770.DOI:10.1002/pon.1778.
[17] Aydogan D, Kara E, Kalkan E.Understanding Relational Resilience of Married Adults in Quarantine Days[J]. Curr Psychol,2021,3:1-11. DOI: 10.1007/s12144-021-02224-2.
[18] 王孟成. 潜变量建模与Mplus应用(基础篇)[M].重庆:重庆大学出版社,2014:98-104.
[19] 刘畅,伍新春.主客体互倚性的成对模式及其检验[J].心理发展与教育,2017, 33(1):105-112. DOI:10.16187/j.cnki.issn1001-4918.2017.01.12.
[20] Ernst J, Hinz A, Niederwieser D, et al.Dyadic Coping of Patients with Hematologic Malignancies and Their Partners and Its Relation to Quality of Life: A Longitudinal Study[J]. Leuk Lymphoma, 2017,58(3):655-665.DOI:10.1080/10428194.2016.1194983.
[21] Rottmann N, Hansen DG, Larsen PV, et al.Dyadic Coping within Couples Dealing with Breast Cancer: A Longitudinal, Population-based Study[J]. Health Psychol, 2015,34(5):486-495. DOI: 10.1037/hea0000218.
[22] Conner KM, Davidson JR. Conner-davidson Resilience Scale Manual. User Guide [EB/OL]. (2009-04-02)[2021-08-20]. http://www.cd-risc.com/user-guide.
[23] 王慧. 晚期肺癌患者及其照顾者心理弹性、社会支持对生活质量影响的机制研究[D].济南:山东大学,2021. DOI:10.27272/d.cnki.gshdu.2021.001253.
[24] Seiler A, Jenewein J.Resilience in Cancer Patients[J]. Front Psychiatry,2019,10:208.DOI:10.3389/fpsyt.2019.00208.
[25] Aydogan D, Ozbay Y.Mediation Role of Dyadic Coping on Parenting Stress and Relational Resilience in Couples[J]. Marriage Fam Rev,2018,54(2):128-147.DOI:10.1080/01494929.2017.1302900.
[26] 王晓旭,张清. 家庭弹性对血液透析患者及其照顾者创伤后成长的交互影响[J]. 解放军护理杂志,2021,38(5):45-47. DOI:10.3969/j.issn.1008-9993.2021.05.012.
[27] Meyers E, Lin A, Lester E, et al.Baseline Resilience and Depression Symptoms Predict Trajectory of Depression in Dyads of Patients and Their Informal Caregivers Following Discharge from the Neuro-ICU[J]. Gen Hosp Psychiatry,2020,62:87-92. DOI: 10.1016/j.genhosppsych.2019.12.003.
[28] Cook KS, Cheshire C, Rice ER, et al.Social Exchange Theory: Handbook of Social Psychology (2nd Ed)[M]. New York: Springer,2013: 61-88.
[1] 吴晓云, 毕清泉, 周桂琴, 潘海峰. 心理弹性在角膜移植患者情绪创造力与创伤后成长中的中介作用[J]. 护理学报, 2022, 29(6): 11-14.
[2] 张营, 孟英涛, 尚美美, 杨德艳, 朱玉方, 王倩. 癌症相关认知功能障碍评估和管理的证据总结[J]. 护理学报, 2022, 29(3): 52-56.
[3] 张会敏, 孙晓晨, 马红梅. 年轻癌症患者生育忧虑心理体验质性研究的Meta整合[J]. 护理学报, 2022, 29(2): 51-56.
[4] 杨月波, 张玉芳, 李娜, 禚玥, 孟雯琪, 张俊福. 负性信息注意偏向在癌症幸存者中应用研究进展[J]. 护理学报, 2022, 29(1): 25-29.
[5] 黄薇, 梁清桃, 曾培容, 林小玲, 辛明珠, 张利峰. 470例癌症复发后患者心理痛苦现状及影响因素分析[J]. 护理学报, 2021, 28(9): 58-61.
[6] 田丽, 李梦媛, 肖抒情, 阎玲. 晚期癌症患者预期性悲伤的现状及影响因素分析[J]. 护理学报, 2021, 28(7): 11-14.
[7] 信博, 赵秋利, 王楠楠, 马得欣, 邢慧, 吴燕妮, 于洋. 消化系统癌症高危人群预防主动行为测评量表的编制与信效度评价[J]. 护理学报, 2021, 28(5): 6-11.
[8] 亢东琴, 陆宇晗, 马晓晓, 王云. 国内外癌症患者家属居丧干预研究进展[J]. 护理学报, 2021, 28(5): 12-15.
[9] 孙丽娜, 丁淑贞, 袁理, 张政, 徐一元. 癌症幸存者复发恐惧干预研究进展[J]. 护理学报, 2021, 28(5): 16-20.
[10] 林佳楠, 张赫, 于秀丽, 徐兆宁, 朴丽. 正念减压疗法对体外受精—胚胎移植失败患者心理弹性及正念注意觉知的影响[J]. 护理学报, 2021, 28(3): 69-73.
[11] 宋静雨, 舒瑶雅, 王蒙蒙, 徐天梦, 岳鹏. 终末期病人配偶照护者需求的Meta整合[J]. 护理学报, 2021, 28(20): 30-38.
[12] 周梦珂, 李惠萍, 张珊珊, 王全兰, 陈娟娟, 王艺璇. 癌症患者癌因性疲乏真实体验质性研究的Meta整合[J]. 护理学报, 2021, 28(12): 27-32.
[13] 刘丽萍, 周春兰, 吴艳妮, 从维莲, 胡明钰, 李晓霞. 情绪抑制量表的汉化及信效度检验[J]. 护理学报, 2020, 27(8): 6-10.
[14] 刘丽萍, 吴艳妮, 从维莲, 胡明钰, 李晓霞, 周春兰. 癌症患者化疗期自我护理体验质性研究的系统评价[J]. 护理学报, 2020, 27(7): 1-6.
[15] 马新莉, 胡志琴. 182例晚期癌症患者主要照顾者预感性悲伤现状及影响因素分析[J]. 护理学报, 2020, 27(5): 42-46.
Viewed
Full text


Abstract

Cited
  Shared   
[1] 孙彩云, 林征, 周美景, 顾子君, 王咪, 顾珺怡, 朱展慧. 炎症性肠病患者疾病获益感现状及影响因素分析[J]. 护理学报, 2022, 29(6): 1 -6 .
[2] 任鹏娜, 胡小懿, 汤爱玲, 张月, 许方蕾. 基于循证构建老年尿失禁患者出院准备护理方案[J]. 护理学报, 2022, 29(6): 7 -10 .
[3] 吴晓云, 毕清泉, 周桂琴, 潘海峰. 心理弹性在角膜移植患者情绪创造力与创伤后成长中的中介作用[J]. 护理学报, 2022, 29(6): 11 -14 .
[4] 米元元, 黄海燕, 陈卉, 陈汉珍, 明耀辉, 聂涛. 重症患者非计划重返ICU安全管理方案的建立及效果评价[J]. 护理学报, 2022, 29(6): 15 -19 .
[5] 刘纬华, 张红梅, 白文辉, 卢颖, 苗晓慧. 研究型医院护理学科建设评估指标体系的构建[J]. 护理学报, 2022, 29(6): 20 -25 .
[6] 阮安然, 胡浩冉, 任亚豪, 杨雪婷, 程康耀, 滕文哲. 2010-2020年炎症性肠病心理领域研究热点的可视化分析[J]. 护理学报, 2022, 29(6): 26 -31 .
[7] 阚吟诗, 刘林, 李翔宁, 刘洪园, 毕雅昕, 张露, 张瑜. 糖尿病患者体力活动波动性的研究进展[J]. 护理学报, 2022, 29(6): 32 -36 .
[8] 张慧超, 王楠楠, 张玉玺. 安宁疗护护士情感劳动经历质性研究的Meta整合[J]. 护理学报, 2022, 29(6): 37 -43 .
[9] 曹咪, 张军, 岳少婷. 早产儿出院后神经发育支持性照护的最佳证据总结[J]. 护理学报, 2022, 29(6): 44 -49 .
[10] 蔡莹莹, 张俊峰, 蔡艾芳, 曾雅燕, 李玲, 黄琼珊, 刘兴玲. 以培养护士核心能力为导向的循证护理查房模式探索[J]. 护理学报, 2022, 29(6): 50 -54 .