中青年宫颈癌患者社会疏离与元认知在症状困扰和癌症复发恐惧中的链式中介作用

周娟; 陈丹; 李博雅; 张媛媛; 苏建萍

doi:10.16766/j.cnki.issn.1674-4152.003319

中青年宫颈癌患者社会疏离与元认知在症状困扰和癌症复发恐惧中的链式中介作用

doi: 10.16766/j.cnki.issn.1674-4152.003319

新疆医科大学护理学院，新疆乌鲁木齐 830054

基金项目:

新疆维吾尔自治区自然科学基金项目 2020D01C154

详细信息

通讯作者:
苏建萍，E-mail: 971940592@qq.com

中图分类号: R737.33 R395.6
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- 文章访问数: 137
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- PDF下载量: 12
- 被引次数: 0
出版历程
- 收稿日期: 2023-09-28
- 网络出版日期: 2024-03-09

The chain mediating effect of social alienation and metacognition on symptom distress and fear of cancer recurrence in young and middle-aged patients with cervical cancer

School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang 830054, China

摘要

摘要: 目的探讨中青年宫颈癌患者社会疏离与元认知在症状困扰与癌症复发恐惧间的链式中介效应，以期为临床癌症复发恐惧的管理及干预提供新视角。方法采用便利抽样法，选取2023年2—8月新疆某三级甲等肿瘤专科医院就诊的330例中青年宫颈癌患者作为研究对象，使用一般资料调查表、癌症复发恐惧量表简表(FCRI-SF)、元认知问卷(MCQ-30)、一般疏离感量表(GAS)、安德森症状评估量表(MDASI)进行调查，通过偏差校正的百分位Bootstrap法(Process插件)进行变量间的链式中介效应检验。结果中青年宫颈癌患者癌症复发恐惧得分(14.64±6.37)分，57.27%的患者存在较高水平的癌症复发恐惧(FCRI-SF≥13分)。症状困扰与癌症复发恐惧(r=0.495, P＜0.01)、社会疏离感(r=0.397, P＜0.01)、元认知(r=0.197, P＜0.01)均呈正相关关系。中青年宫颈癌患者的症状困扰、社会疏离及元认知能显著正向预测其癌症复发恐惧(β=0.107、0.430、0.156，均P＜0.001)，中介效应分析显示社会疏离与元认知在症状困扰、癌症复发恐惧之间起链式中介作用，效应量为0.009，总效应占比为4.27%。结论中青年宫颈癌患者存在较高水平的癌症复发恐惧，社会疏离感和元认知在症状困扰与癌症复发恐惧之间发挥链式中介作用。
- 宫颈癌 /
- 化疗 /
- 癌症复发恐惧 /
- 元认知 /
- 社会疏离 /
- 症状困扰
Abstract: Objective The purpose of this study is to explore the mediating effects of social distancing and metacognition between symptom distress and fear of cancer recurrence in young and middle-aged patients with cervical cancer, in order to provide a new perspective for the management and intervention of fear of cancer recurrence. Methods A total of 330 middle-aged and young cervical cancer patients from February to August 2023 in a Grade A cancer hospital in Xinjiang were selected as the study objects by convenience sampling method. The general information questionnaire, the fear of cancer recurrence inventory short form (FCRI-SF), the metacognitive questionnaire (MCQ-30), the general alienation scale (GAS), and the M.D. Anderson symptom inventory (MDASI) were used to conduct the questionnaire survey. The chain mediation effect between variables was tested by percentile Bootstrap method (Process plug-in) with deviation correction. Results The average score of fear of cancer recurrence in young and middle-aged patients with cervical cancer was (14.64±6.37) points, and 57.27% of the patients had a high level of fear of cancer recurrence (FCRI-SF≥13 points). Symptom distress was positively correlated with social alienation (r=0.397, P < 0.01), metacognition (r=0.197, P < 0.01) and fear of cancer recurrence (r=0.495, P < 0.01). Symptom distress, social alienation and metcognition of young and middle-aged patients with cervical cancer could significantly positively predict their fear of cancer recurrence (β=0.107, 0.430, 0.156, P < 0.001). Mediating effect analysis showed that social alienation and metcognition played a chain mediating role between symptom distress and fear of cancer recurrence with an effect size of 0.009. The total effect accounted for 4.27%. Conclusion There is a high level of fear of cancer recurrence in young and middle-aged patients with cervical cancer. Social alienation and metacognition play a chain mediating role between symptom distress and fear of cancer recurrence.
- Cervical cancer /
- Chemotherapy /
- Fear of cancer recurrence /
- Metacognition /
- Social alienation /
- Symptom distress

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图 1 社会疏离、元认知在症状困扰和癌症复发恐惧之间的链式中介模型

注：^aP＜0.05，^bP＜0.001。

Figure 1. The chain mediation model of social alienation and metacognition between symptom distress and fear of cancer recurrence

下载: 全尺寸图片幻灯片

表 1 中青年宫颈癌患者FCR与症状困扰、元认知、社会疏离的相关性分析(r值)

Table 1. Correlation analysis of FCRI-SF with symptom distress, metacognition and social distancing in middle-aged and young cervical cancer patients(r value)

变量	癌症复发恐惧	社会疏离	元认知	症状困扰
癌症复发恐惧	1
社会疏离	0.638^a	1
元认知	0.454^a	0.234^a	1
症状困扰	0.495^a	0.397^a	0.197^a	1
注：^aP＜0.01。

下载: 导出CSV

表 2 中青年宫颈癌患者症状困扰与癌症复发恐惧链式中介模型的回归分析

Table 2. Regression analysis of the chain mediation model between symptom distress and fear of cancer recurrence in young and middle-aged cervical cancer patients

结果变量	预测变量	整体拟合指数			回归系数显著性
结果变量	预测变量	R	R²	F值	β	t值	P值
社会疏离	症状困扰	0.397	0.158	61.485	0.186	7.841	0.001
元认知	症状困扰	0.260	0.068	11.884	0.100	2.127	0.034
	社会疏离				0.320	3.181	0.002
癌症复发恐惧	症状困扰	0.746	0.557	136.591	0.107	6.179	0.001
	社会疏离				0.430	11.520	0.001
	元认知				0.156	7.705	0.001

下载: 导出CSV

表 3 社会疏离和元认知在症状困扰和癌症复发恐惧间的链式中介效应检验

Table 3. The mediating effects of social distancing and metacognition on symptom distress and fear of cancer recurrence

路径/效应模型	效应值	Boot标准误	Boot标准CI下限	Boot标准CI上限	相对中介效应占比(%)
总效应c	0.211	0.021	0.171	0.252
直接效应c'	0.107	0.017	0.073	0.141	50.71
总中介效应	0.105	0.015	0.077	0.134	49.76
中介效应1	0.080	0.013	0.057	0.107	37.91
中介效应2	0.016	0.008	＜0.001	0.033	7.58
中介效应3	0.009	0.004	0.003	0.017	4.27
注：间接效应2中Boot标准CI下限≈0.0002≠0；中介效应1，症状困扰-社会疏离-FCR；中介效应2，症状困扰-元认知-FCR；中介效应3，症状困扰-社会疏离-元认知-FCR。

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