Relationship between psychosocial adjustment, post-traumatic growth and self-efficacy in patients with ovarian cancer
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摘要:
目的 卵巢癌患者创伤后成长(PTG)、自我效能感、心理社会适应能力之间关系的研究较少。本研究探讨卵巢癌患者心理社会适应水平与PTG、自我效能感的关系, 以期为今后此类患者临床干预提供依据。 方法 于2022年6月-2023年11月采用方便抽样方法对河北大学附属医院收治的228例卵巢癌患者进行问卷调查, 采用Pearson相关性分析研究心理社会适应量表(PAIS-SR)评分与中文版创伤后成长评定量表(PTGI)评分和中文版癌症自我效能评估量表(C-SUPPH)评分的关系; 应用多元线性回归分析探究患者心理社会适应水平的影响因素。 结果 本研究调查表回收有效率为99.12%(226/228);确诊时间≤1个月、分期Ⅲ~Ⅳ期患者PAIS-SR评分高于确诊时间>1个月、分期Ⅰ~Ⅱ期的患者(t=3.705、2.429, P < 0.05);相关性分析显示PAIS-SR与PTGI、C-SUPPH呈负相关关系(r=-0.540、-0.557, P < 0.05), 与蒙特利尔认知评估量表(MoCA)呈正相关关系(r=0.584, P < 0.05);回归分析显示新的可能性(β=-2.010)、对生活的欣赏(β=-0.929)、情绪控制(β=-1.276)、人际关系协调(β=1.930)以及MoCA评分(β=-0.411)是卵巢癌患者心理社会适应水平的影响因素(P < 0.05)。 结论 卵巢癌患者心理社会适应水平普遍较低, 这与患者PTG、自我效能感、认知功能均有一定关系。 Abstract:Objective There are relatively few studies on the relationship among post-traumatic growth (PTG), self-efficacy and psychosocial adaptability in patients with ovarian cancer.This study explores the relationship between the psychosocial adaptation level, PTG and self-efficacy, with the aim of providing a basis for clinical intervention of such patients in the future. Methods A total of 228 patients with ovarian cancer treated in Affiliated Hospital of Hebei Medical University from June 2022 to November 2023 were investigated by questionnaire using convenient sampling method.Pearson correlation was used to analyze the relationship of self-report psychosocial adjustment to illness scale (PAIS-SR) with post-traumatic growth inventory (PTGI) score and Chinese-version strategies used by people to promote health (C-SUPPH) in ovarian cancer patients.Multiple linear regression analysis was used to explore the influencing factors of psychosocial adaptation level of patients. Results In this study, the recovery efficiency rate of questionnaires was 99.12%(226/228).The PAIS-SR scores of patients with diagnosis time ≤1 month and disease stage Ⅲ-Ⅳ were higher than those with diagnosis time >1 month and disease stage Ⅰ-Ⅱ(t=3.705 and 2.429, P < 0.05).Correlation analysis showed that PAIS-SR score was negatively correlated with PTGI and C-SUPPH (r=-0.540 and-0.557, P < 0.05), and positively correlated with Montreal cognitive assessment scale (MoCA, r=0.584, P < 0.05).Regression analysis showed that new possibilities (β=-2.010), appreciation of life (β=-0.929), emotional control (β=-1.276), interpersonal relationship (β=1.930) and MoCA score (β=-0.411) were the influencing factors of psychosocial adaptation level in ovarian cancer patients (P < 0.05). Conclusion Ovarian cancer patients generally have a low level of psychosocial adaptation level, which is related to PTG, self-efficacy and cognitive function to some extent. -
Key words:
- Ovarian cancer /
- Psychosocial adjustment level /
- Post-traumatic growth /
- Self-efficacy
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表 1 226例卵巢癌患者一般资料情况
Table 1. General information of 226 patients with ovarian cancer
项目 例数 占比(%) 年龄 ≤40岁 59 26.11 >40岁 167 73.89 学历 高中及以下 132 58.41 大专及以上 94 41.59 家庭收入 < 5 000元/月 102 45.13 ≥5 000元/月 124 54.87 婚姻状况 有配偶 168 74.34 无配偶 58 25.66 工作状况 在职 131 57.96 非在职 95 42.04 支付方式 医保支付 148 65.49 自费支付 78 34.51 确诊时间 ≤1个月 119 52.65 >1个月 107 47.35 疾病分期 Ⅰ~Ⅱ期 127 56.19 Ⅲ~Ⅳ期 99 43.81 治疗方式 手术治疗 97 42.92 手术+辅助治疗 72 31.86 手术+辅助+靶向治疗 57 25.22 
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表 2 不同一般资料卵巢癌患者心理社会适应水平比较(x ±s)
Table 2. Comparison of psychosocial adaptation levels in ovarian cancer patients with different general data(x ±s)
项目 例数 PAIS-SR评分(分) 统计量 P值 年龄 1.911a 0.057 ≤40岁 59 68.67±20.92 >40岁 167 63.22±18.04 文化水平 1.388a 0.167 高中及以下 132 67.48±17.65 大专及以上 94 64.02±19.57 家庭经济状况 1.786a 0.075 < 5 000元 102 68.32±20.09 ≥5 000元 124 64.01±16.18 婚姻状况 1.856a 0.065 有配偶 168 70.15±20.38 无配偶 58 64.72±15.27 工作情况 1.833a 0.068 在职 131 69.07±21.41 非在职 95 63.94±19.86 医疗费用支付方式 0.809a 0.420 医保 148 64.26±18.17 自费 78 66.36±19.28 疾病确诊时间 3.705a < 0.001 ≤1个月 119 72.31±15.92 >1个月 107 63.66±19.15 疾病分期 2.429a 0.016 Ⅰ~Ⅱ期 127 62.38±18.71 Ⅲ~Ⅳ期 99 68.94±21.85 疾病治疗方式 2.100b 0.125 手术 97 62.74±17.52 手术+辅助治疗 72 64.37±20.04 手术+辅助+靶向治疗 57 69.11±19.25 注：a为t值，b为F值。
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表 3 卵巢癌患者心理社会适应水平与PTG和自我效能感的关系
Table 3. Relationship between the psychosocial adaptation level of patients with ovarian cancer and PTG and self-efficacy
项目 得分(x±s，分) 相关性 r值 P值 与他人关系 18.45±5.21 -0.503 < 0.001 新的可能性 7.81±1.96 -0.534 < 0.001 个人力量 12.64±3.28 -0.486 < 0.001 精神变化 7.93±2.11 -0.517 < 0.001 对生活的欣赏 11.98±3.07 -0.521 < 0.001 PTGI总分 58.29±15.15 -0.540 < 0.001 采取行动应对疾病 86.43±22.09 -0.563 < 0.001 情绪控制 61.42±17.19 -0.571 < 0.001 人际关系协调 32.84±9.36 -0.565 < 0.001 配合治疗 67.25±20.71 -0.403 < 0.001 癌症自我效能评估量表总分 248.18±57.26 -0.557 < 0.001 MoCA评分 25.14±3.81 0.584 < 0.001
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表 4 影响卵巢癌患者心理社会适应水平的多因素分析
Table 4. Multivariate analysis of the psychosocial adaptation level of patients with ovarian cancer
变量 β SE Β’ t值 P值 新的可能性 -2.010 0.454 -1.364 -4.427 < 0.001 对生活的欣赏 -0.929 0.419 -0.781 -2.216 0.028 情绪控制 -1.276 0.591 -1.703 -2.157 0.032 人际关系协调 1.930 0.466 1.104 4.144 < 0.001 MoCA评分 -0.411 0.037 -0.320 -11.148 < 0.001 注：R2=0.741，调整R2=0.545；F=135.620，P＜0.001。本表仅列出差异有统计学意义的变量。
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