消化系统癌症女性患者希望水平在恐惧疾病进展与生育忧虑间的中介作用

doi:10.3761/j.issn.1672-9234.2020.04.020

摘要/Abstract

摘要：

目的探讨消化系统癌症女性患者希望水平在恐惧疾病进展与生育忧虑间的作用。方法选取2017年1月—2018年1月本院收治的285例消化系统癌症女性患者作为研究对象,调查其基本情况、希望得分、恐惧疾病进展得分和生育忧虑得分,并建立结构方程模型进行路径分析。结果消化系统癌症女性患者希望得分为（32.44±4.85）分,恐惧疾病进展得分为（43.53±6.71）分,癌症后生育忧虑得分为（65.42±8.14）分;女性消化系统癌症患者恐惧疾病进展与癌症后生育忧虑呈中度正相关性（r=0.652,P<0.001）,希望与恐惧疾病进展、癌症后生育忧虑均呈中度负相关性（r=-0.535,-0.542,P<0.001）;希望在恐惧疾病进展和癌症后生育忧虑间有部分中介效应（0.143）,占总效应的24.21%。结论消化系统癌症女性患者恐惧疾病进展水平及生育忧虑感均较高,希望水平相对较低,希望水平能抑制恐惧疾病进展加重生育忧虑效果。

关键词: 女性, 消化系统肿瘤, 恐惧, 生育力, 希望

Abstract:

Objective To explore the mediating effect of hope level on fear of disease progression and reproductive anxiety of female digestive cancer patients. Methods A total of 285 female patients with the digestive cancer in our hospital from January 2017 to January 2018 were selected. All participants were investigated with the Chinese version of Herth Hope Scale,the Chinese version of the Fear of Progression Questionnaire-Short Form,the Chinese version of Reproductive Concerns After Cancer Scale. The structural equation model was used to do the route analysis. Results The hope score was（32.44±4.85）,the fear of disease progression score was（43.53±6.71）,and the reproductive anxiety score after cancer was（65.42±8.14） in female patients with digestive system cancer. Pearson’s correlation analysis showed that there was a moderately positive correlation（r=0.652,P<0.001） between the development of fear disease and post cancer reproductive concerns and a moderate negative correlation（r=-0.535,-0.542,P<0.001）between hope and the development of fear disease and post cancer fertility anxiety. Hope has the mediating effect （0.143） between fear of disease progression and post cancer fertility anxiety,accounting for 24.21% of the total effects. Conclusion Fear disease progression and reproductive concerns of female patients with digestive system cancer are higher,and the hope level is relatively low. Hope level can inhibit the progress of fear disease and aggravate the effect of reproductive concerns.

Key words: Femininity, Digestive System Neoplasms, Fear, Fertility, Hope

白霞,王进,刘源萌,杜艳华,刘丹丹. 消化系统癌症女性患者希望水平在恐惧疾病进展与生育忧虑间的中介作用[J]. 中华护理教育, 2020, 17(4): 366-370.

BAI Xia,WANG Jin,LIU Yuan-meng,DU Yan-hua,LIU Dan-dan. The mediating effect of hope level on fear of disease progression and reproductive anxiety of female digestive cancer patients[J]. Chinese Journal of Nursing Education, 2020, 17(4): 366-370.

图/表 2

参考文献 20

[1]	刘曙正, 陈琼, 全培良 , 等. 河南省2010~2013年恶性肿瘤发病与死亡分析[J]. 肿瘤预防与治疗, 2018,31(1):12-17.
[2]	张洁, 杨菁, 黄志欣 . 年轻女性癌症患者心理适应水平与癌症后生育忧虑的关系[J]. 职业与健康, 2018,34(7):950-953.
[3]	刘秀儒, 林霞 . 女性癌症患者生育忧虑研究进展[J]. 护理学杂志, 2017,32(16):100-103.
[4]	覃彦珠, 江锦芳, 刘鑫 , 等. 妇科肿瘤患者恐惧疾病进展现状调查及其影响因素分析[J]. 广西医学, 2019,41(9):1180-1183.
[5]	程春燕, 张阳, 陈欣怡 , 等. 老年癌症患者恐惧疾病进展与希望水平的相关性研究[J]. 护理学杂志, 2019,34(1):13-16.
[6]	王艳华 . 中文版Herth希望量表用于癌症病人的可行性研究[J]. 护理研究, 2010,24(1A):20-21.
[7]	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.
[8]	Gorman JR, Su HI, Pierce JP , et al. A multidimensional scale to measure the reproductive concems of young adult female cancer survivors[J]. J Cancer Surviv, 2014,8(2):218-228. doi: 10.1007/s11764-013-0333-3 pmid: 24352870
[9]	乔婷婷, 陈丹丹, 郑蔚 , 等. 癌症后生育忧虑量表的汉化及信效度研究[J]. 中华护理杂志, 2016,51(12):1509-1514.
[10]	温忠麟, 侯杰泰, 张雷 . 调节效应与中介效应的比较和应用[J]. 心理学报, 2005,37(2):268-274.
[11]	黄家莲, 应燕萍, 陆秋芳 , 等. 癌症患者疾病进展恐惧现状及其影响因素[J]. 海南医学, 2018,29(16):2266-2269.
[12]	乔婷婷, 陈丹丹, 郑蔚 , 等. 年轻女性癌症患者生育忧虑现状及其影响因素分析[J]. 现代预防医学, 2017,44(1):64-68.
[13]	Vu JV, Llarena NC, Estevez SL , et al. Oncofertility program implementation increases access to fertility preservation options and assisted reproductive procedures for breast cancer patients[J]. J Surg Oncol, 2017,115(2):116-121. doi: 10.1002/jso.24418 pmid: 27966219
[14]	Ohtani N, Iwano H, Suda K , et al. Adverse effects of maternal exposure to bisphenol F on the anxiety- and depression-like behavior of offspring[J]. The Journal Veterinary Medical Science, 2017,79(2):432-439. doi: 10.1292/jvms.16-0502 pmid: 28025458
[15]	陈凤敏, 宋祎, 徐锦江 . 希望水平在空巢老年慢性疼痛患者生活质量与社会支持之间中介效应[J]. 现代预防医学, 2017,44(14):2553-2556,2579.
[16]	于虹娥, 郑珮, 包小兰 . 癌症患者性生活状况调查分析[J]. 河北医药, 2011,33(6):926-927.
[17]	王秋曼, 赵烨, 姚丽婷 , 等. 接受放化疗年轻女性恶性肿瘤患者的生育能力保存[J]. 国际生殖健康/计划生育杂志, 2019,38(1):71-74.
[18]	韩莹, 张云山 . 女性肿瘤患者生育力的保存[J]. 实用医学杂志, 2015,31(20):3454-3456.
[19]	van Gestel-Timmermans H, van Den Bogaard J, Brouwers E , et al. Hope as a determinant of mental health recovery:a psychometric evaluation of the herth hope index-Dutch version[J]. Scand J Caring Sci, 2010,24(Suppl 1):67-74. doi: 10.1111/j.1471-6712.2009.00758.x pmid: 20210899
[20]	刘丽, 戎明梅, 马婉贞 , 等. 两种延续性护理方式对女性生殖器官恶性肿瘤患者康复效果的影响比较[J]. 实用临床医药杂志, 2018,22(8):79-81.