关键词: 黑色素瘤, 习得性无助, 社会支持, 疾病感知, 决策自我效能, 影响因素分析, 路径分析

Abstract:

Objective To investigate the current status of learned helplessness among patients with melanoma，analyze its influencing factors，and explore the influencing mechanisms among these factors，so as to provide evidence for developing targeted intervention strategies. Methods A total of 216 patients with melanoma admitted to a tertiary Grade A hospital in Henan Province were selected by convenience sampling from November 2024 to October 2025. The General Information Questionnaire，Learned Helplessness Scale，Chinese version of Decision Self-Efficacy Scale，Perceived Social Support Scale，and the short-form Chinese Brief Illness Perception Questionnaire were adopted for the investigation. Results The total score of learned helplessness among the 216 melanoma patients was（68.62±11.44）. Monthly per capita household income（3 000-5 000 yuan or >5 000 yuan，with <3 000 yuan as reference），unknown primary tumor site（with limbs as reference），first episode or recurrence，as well as scores of decision self-efficacy，perceived social support，and illness perception were significant influencing factors of learned helplessness（all P<0.05），which collectively explained 60.7% of the total variance. Path analysis demonstrated that decision self-efficacy played a partial mediating role between illness perception and learned helplessness，and between perceived social support and learned helplessness. The proportions of mediating effect to the total effect were 16.7% and 27.4%，respectively. Conclusion The level of learned helplessness in melanoma patients is relatively high. Medical staff should pay close attention to patients with low monthly per capita household income，unknown primary tumor site，non-first onset，low decision self-efficacy，insufficient perceived social support and negative illness perceptions，and implement targeted interventions for these groups，with a key focus on improving their decision self-efficacy to alleviate their learned helplessness.

Key words: Melanoma, Learned Helplessness, Social Support, Illness Perception, Decision-Making Self-Efficacy, Root Cause Analysis, Pathways Analysis