衰弱和抑郁在肺癌化疗患者恐惧疾病进展与生活质量间的链式中介作用

doi:10.16460/j.issn1008-9969.2023.18.065

摘要/Abstract

摘要： 目的探讨衰弱和抑郁在肺癌化疗患者恐惧疾病进展和生活质量间的链式中介作用。方法便利抽样法调查安徽省某三级甲等医院呼吸与危重症医学科住院的309例肺癌化疗患者,使用恐惧疾病进展简化量表、中文版衰弱量表、患者健康问卷抑郁量表和简明健康测量量表对研究对象的恐惧疾病进展、衰弱、抑郁和生活质量进行调查,构建并检验链式中介模型。结果肺癌化疗患者恐惧疾病进展总分为27.00（20.00,32.00）分、衰弱发生率为37.5%、抑郁患病率为46.7%、生活质量总分为59.41（42.53,75.48）分。中介效应分析显示恐惧疾病进展对生活质量的间接效应显著,总间接效应为-0.319,衰弱的特定中介效应占总间接效应的9.7%;抑郁的特定中介效应占总间接效应的72.7%;衰弱和抑郁在肺癌化疗患者恐惧疾病进展和生活质量间的链式中介效应占总间接效应的17.6%。结论衰弱和抑郁在肺癌化疗患者恐惧疾病进展和生活质量间的多重中介效应成立。临床工作人员应加大对肺癌化疗患者恐惧疾病进展的关注度,采取干预措施防止过度恐惧,从而减少衰弱、抑郁等不良身心应对结局,提高个体的生活质量。

关键词: 肺癌, 恐惧疾病进展, 生活质量, 衰弱, 抑郁

中图分类号:

R473.73

崔静萍, 蒋燕, 赵姗姗. 衰弱和抑郁在肺癌化疗患者恐惧疾病进展与生活质量间的链式中介作用[J]. 护理学报, 2023, 30(18): 65-70.

CUI Jing-ping, JIANG Yan, ZHAO Shan-shan. Chain mediating effect of weakness and depression between fear of progression and quality of life[J]. Journal of Nursing, 2023, 30(18): 65-70.

参考文献

[1] Kuang X, Long F, Chen H, et al.Correlation research between fear of disease progression and quality of life in patients with lung cancer[J]. Ann Palliat Med, 2022, 11(1):35-44. DOI:10.21037/apm-21-2821.
[2] Gilmore N, Mohile S, Lei L, et al.The longitudinal relationship between immune cell profiles and frailty in patients with breast cancer receiving chemotherapy[J]. Breast Cancer Res,2021,23(1):19.DOI:10.1186/s13058-021-01388-w.
[3] Dinkel A, Herschbach P.Fear of progression in cancer patients and survivors[J]. Recent Results Cancer Res, 2018, 210:13-33. DOI:10.1007/978-3-319-64310-6_2.
[4] Giesler JM,Weis J.Patient competence in the context of cancer: its dimensions and their relationships with coping, coping self-efficacy,fear of progression,and depression[J]. Support Care Cancer, 2021, 29(4):2133-2143. DOI:10.1007/s00520-020-05699-0.
[5] Choi S, Ryu E.Effects of symptom clusters and depression on the quality of life in patients with advanced lung cancer[J]. Eur J Cancer Care (Engl), 2018, 27(1):10. DOI:10.1111/ecc.12508.
[6] Alwhaibi M, AlRuthia Y, Sales I. The impact of depression and anxiety on adult cancer patients' health-related quality of life[J]. J Clin Med,2023,12(6):2196.DOI:10.3390/jcm12062196.
[7] Ma L, Sun F, Tang Z.Social frailty is associated with physical functioning, cognition, and depression, and predicts mortality[J]. J Nutr Health Aging, 2018, 22(8):989-995. DOI:10.1007/s12603-018-1054-0.
[8] 倪平,陈京立,刘娜.护理研究中量性研究的样本量估计[J].中华护理杂志,2010,45(4):378-380. DOI:10.3761/j.issn.0254-1769.2010.04.037.
[9] Mehnert A, Herschbach P, Berg P, et al.Fear of progression in breast cancer patients--validation of the short form of the Fear of Progression Questionnaire (FoP-Q-SF)[J]. Z Psychosom Med Psychother, 2006,52(3):274-288.DOI:10.13109/zptm.2006.52.3.274.
[10] 吴奇云,叶志霞,李丽,等.癌症患者恐惧疾病进展简化量表的汉化及信效度分析[J].中华护理杂志, 2015, 50(12):1515-1519. DOI:10.3761/j.issn.0254-1769.2015.12.021.
[11] 曹艳,木巴拉克·依克拉木,高颖.恐惧疾病进展在肺癌患者希望水平与生活质量间的中介效应[J].现代临床护理,2022,21(4):18-24. DOI:10.3969/j.issn.1671-8283.2022.04.003.
[12] Hagell P, Westergren A, Årestedt K.Beware of the origin of numbers: standard scoring of the SF-12 and SF-36 summary measures distorts measurement and score interpretations[J]. Res Nurs Health, 2017, 40(4):378-386.DOI:10.1002/nur.21806.
[13] Fong DY, Lam CL, Mak KK, et al.The Short Form-12 Health Survey was a valid instrument in Chinese adolescents[J]. J Clin Epidemiol, 2010, 63(9):1020-1029. DOI:10.1016/j.jclinepi.2009.11.011.
[14] 臧瑜,于虹,李妍,等.肺癌患者症状群的调查研究[J].中华护理杂志,2016, 51(3):316-320.DOI:10.3761/j.issn.0254-1769.2016.03.01.
[15] Dent E, Lien C, Lim WS, et al.The Asia-Pacific clinical practice guidelines for the management of frailty[J]. J Am Med Dir Assoc, 2017, 18(7):564-575. DOI:10.1016/j.jamda.2017.04.018.
[16] Dong L, Qiao X, Tian X, et al.Cross-cultural adaptation and validation of the FRAIL Scale in Chinese community-dwelling older adults[J]. J Am Med Dir Assoc, 2018, 19(1):12-17.DOI:10.1016/j.jamda.2017.06.011.
[17] 景冬梅,沈冲,莫永珍,等.中文版衰弱量表在老年衰弱评价中的信效度研究[J].护士进修杂志,2021,36(9):784-788.DOI:10.16821/j.cnki.hsjx.2021.09.004.
[18] Morley JE, Malmstrom TK, Miller DK.A simple frailty questionnaire(FRAIL) predicts outcomes in middle aged African Americans[J]. J Nutr Health Aging, 2012,16(7):601-608. DOI:10.1007/s12603-012-0084-2.
[19] Kroenke K, Spitzer RL, Williams JB.The PHQ-9: validity of a brief depression severity measure[J].J Gen Intern Med, 2001, 16(9):606-613.DOI:10.1046/j.1525-1497.2001.016009606.x.
[20] 徐勇,吴海苏,徐一峰.病人健康问卷抑郁量表(PHQ-9)在社区老年人群中的应用——信度与效度分析[J].上海精神医学, 2007, 19(5):257-259. DOI:10.3969/j.issn.1002-0829.2007.05.001.
[21] Hayes A.Introduction to mediation, moderation, and conditional process analysis[J]. J Educ Meas, 2013, 51(3):335-337.DOI:10.1111/jedm.12050.
[22] Podsakoff PM, MacKenzie SB, Podsakoff NP. Sources of method bias in social science research and recommendations on how to control it[J]. Annu Rev Psychol, 2012, 63:539-569. DOI:10.1146/annurev-psych-120710-100452.
[23] 陈菲菲,庞永慧,茅乃权,等.老年肺癌患者衰弱现状及影响因素分析[J].护理学报,2020,27(15):7-11.DOI:10.16460/j.issn1008-9969.2020.15.007.
[24] Farrugia M, Erickson K, Wendel E, et al.Change in physical performance correlates with decline in quality of life and frailty status in head and neck cancer patients undergoing radiation with and without chemotherapy[J]. Cancers (Basel), 2021, 13(7):1638. DOI:10.3390/cancers13071638.
[25] 罗晶晶,洪乔军,周道平,等.肺癌患者生活质量调查及化疗期间发生抑郁的影响因素分析[J]. 现代生物医学进展,2020, 20(13):2512-2515. DOI:10.13241/j.cnki.pmb.2020.13.023.
[26] 顾芬,侯黎莉,李玉梅,等.非小细胞肺癌化疗患者抑郁状况及其影响因素[J].中国慢性病预防与控制, 2016,24(5):359-362. DOI:10.16386/j.cjpccd.issn.1004-6194.2016.05.012.
[27] 何燕,赵龙超,刘丹萍,等.SF-36和SF-12在人群生命质量调查中的性能比较研究[J].现代预防医学, 2017,44(5):852-862.
[28] Prapa P, Papathanasiou IV, Bakalis V, et al.Quality of life and psychological distress of lung cancer patients undergoing chemotherapy[J]. World J Oncol, 2021, 12(2-3):61-66. DOI:10.14740/wjon1371.
[29] Daroszewski C, Stasiewicz M, Jaźwińska-Tarnawska E, et al.Quality of life in patients with advanced non-small-cell lung cancer receiving palliative chemotherapy[J]. Adv Exp Med Biol,2019,1160:11-18. DOI:10.1007/5584_2019_346.
[30] Lee JY, Jang Y, Hyung W.Mediating effect of illness perception on psychological distress in patients with newly diagnosed gastric cancer: based on the common-sense model of self-regulation[J]. Cancer Nurs, 2023, 46(3):E138-E145. DOI:10.1097/NCC.0000000000001103.
[31] 杨玉颖,莫福琴,黄晓琳,等.青年鼻咽癌患者疾病进展恐惧现状及其与放疗后症状困扰的相关性研究[J].中国护理管理,2023,23(1):126-130. DOI:10.3969/j.issn.1672-1756.2023.01.025.
[32] 王丹丹,郑蔚,闫婷婷,等.胃癌患者复发恐惧及其与抑郁的相关性研究[J].现代预防医学,2018,45(20):3824-3827.
[33] Soysal P, Veronese N, Thompson T, et al.Relationship between depression and frailty in older adults: a systematic review and Meta-analysis[J]. Ageing Res Rev, 2017, 36(1):78-87. DOI:10.1016/j.arr.2017.03.005.

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