摘要
目的探讨肺癌患者多维疲劳水平的影响因素。方法采用便利抽样法选取2024年3—12月扬州大学附属医院、南京医科大学附属脑科医院、南京鼓楼医院集团宿迁医院收治的肺癌患者作为调查对象。采用自制一般资料调查表调查患者一般资料,多维疲劳量表(MFI-20)调查患者多维疲劳水平,压力知觉量表(PSS-10)调查患者压力知觉水平,社会支持评定量表(SSRS)调查患者社会支持水平,中文版疾病感知问卷简化版(BIPQ)调查患者疾病感知情况,自尊量表(SES)调查患者自尊水平,Cnonor-Davidson韧性量表(CD-RISC)调查患者心理弹性。肺癌患者多维疲劳水平的影响因素分析采用多元线性回归分析,采用AMOS 24.0软件构建结构方程模型。结果本研究共发放问卷500份,回收问卷489份,其中有效问卷487份,有效问卷回收率为97.4%(487/500)。487例肺癌患者MFI-20评分(61.16±6.05)分。不同年龄、病程、TNM分期及有无转移、是否合并其他慢性病患者MFI-20评分比较,差异有统计学意义(P<0.05)。肺癌患者MFI-20评分与PSS-10评分、中文版BIPQ评分呈正相关(P<0.01),与SSRS评分、SES评分、CD-RISC评分呈负相关(P<0.01)。多元线性回归分析结果显示,年龄≥60岁、TNM分期为Ⅱ~Ⅳ期、合并其他慢性病、PSS-10评分、SSRS评分、中文版BIPQ评分、SES评分、CD-RISC评分是肺癌患者多维疲劳水平的独立影响因素(P<0.05)。结构方程模型结果显示:年龄、TNM分期、合并其他慢性病、压力知觉、疾病感知对肺癌患者多维疲劳水平有直接正向效应(P<0.001),社会支持、自尊、心理弹性对肺癌患者多维疲劳水平有直接负向效应(P<0.001)。压力知觉对肺癌患者多维疲劳水平的总效应最大(β'=0.577),压力知觉可通过社会支持、自尊、心理弹性间接影响肺癌患者多维疲劳水平(β'=0.438)。结论肺癌患者多维疲劳水平较高,年龄、TNM分期、合并其他慢性病、压力知觉、疾病感知可直接正向影响肺癌患者多维疲劳水平,压力知觉还可通过社会支持、自尊、心理弹性间接影响肺癌患者多维疲劳水平。
Objective To explore the influencing factors of multidimensional fatigue level in lung cancer patients.Methods Convenience sampling method was used to select lung cancer patients admitted to Affiliated Hospital of Yangzhou University,the Affiliated Brain Hospital of Nanjing Medical University,and Nanjing Drum Tower Hospital Group Suqian Hospital from March to December 2024 as the research objects.The self-made General Data Questionnaire was used to investigate the general data of patients,the Multidimensional Fatigue Inventory(MFI-20)was used to investigate the multidimensional fatigue level of patients,the Perceived Stress Scale-10(PSS-10)was used to investigate the stress perception level of patients,the Social Support Rating Scale(SSRS)was used to investigate the social support level of patients,the Chinese version Brief Illness Perception Questionnaire(BIPQ)was used to investigate the disease perception of patients,the Self-Esteem Scale(SES)was used to investigate the self-esteem level of patients,and the Connor-Davidson Resilience Scale(CD-RISC)was used to investigate the psychological resilience of patients.Multivariate linear regression analysis was used to analyze the influencing factors of multidimensional fatigue level in lung cancer patients,and AMOS 24.0 software was used to construct a structural equation model.Results In this study,a total of 500 questionnaires were distributed and 489 questionnaires were collected,of which 487 were valid questionnaires,and the effective questionnaire recovery rate was 97.4%(487/500).The MFI-20 score of 487 patients with lung cancer was(61.16±6.05).There were statistically significant differences in MFI-20 scores among patients with different age,course of disease and TNM stage,between patients with and without metastasis and other chronic diseases(P<0.05).The MFI-20 score of lung cancer patients was positively correlated with PSS-10 score and Chinese version BIPQ score(P<0.01),and negatively correlated with SSRS score,SES score and CD-RISC score(P<0.01).Multiple linear regression analysis showed that age≥60 years old,TNM stage ofⅡ-Ⅳ,combined with other chronic diseases,PSS-10 score,SSRS score,Chinese version BIPQ score,SES score and CD-RISC score were independent influencing factors of multidimensional fatigue level in patients with lung cancer(P<0.05).The results of the structural equation model showed that age,TNM stage,combined with other chronic diseases,stress perception,and disease perception had a direct positive effect on multidimensional fatigue level in patients with lung cancer(P<0.001).Social support,self-esteem,and psychological resilience had a direct negative effect on mult-idimensional fatigue level in patients with lung cancer(P<0.001).The total effect of perceived stress on multidimensional fatigue level in lung cancer patients was the largest(β'=0.577).Perceived stress could indirectly affect multidimensional fatigue level in lung cancer patients through social support,self-esteem and psychological resilience(β'=0.438).Conclusion The level of multidimensional fatigue in patients with lung cancer is higher.Age,TNM stage,combined with other chronic diseases,stress perception,and disease perception can directly and positively affect multidimensional fatigue level in patients with lung cancer,and perceived stress can indirectly affect the multidimensional fatigue level of lung cancer patients through social support,self-esteem and psychological resilience.
作者
林建琴
孔令敏
陈勇
金凤
欧阳晓平
戈丹艳
陈方梅
LIN Jianqin;KONG Lingmin;CHEN Yong;JIN Feng;OUYANG Xiaoping;GE Danyan;CHEN Fangmei(Department of Respiratory and Critical Care Medicine,Affiliated Hospital of Yangzhou University,Yangzhou 225000,China;Department of Nursing,Affiliated Hospital of Yangzhou University,Yangzhou 225000,China;Yangzhou University,Yangzhou 225009,China;Department of Oncology,Affiliated Hospital of Yangzhou University,Yangzhou 225000,China;Department of Respiratory and Critical Care Medicine,Nanjing Drum Tower Hospital Group Suqian Hospital,Suqian 223800,China;Department of Respiratory Medicine,the Affiliated Brain Hospital of Nanjing Medical University,Nanjing 210029,China)
出处
《实用心脑肺血管病杂志》
2025年第11期23-29,共7页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
国家自然科学基金青年科学基金项目(81903850)
江苏省人兽共患病学重点实验室“护馨”基金项目(HX2423)
江苏省自然科学基金面上项目(BK20191218)
扬州市科技计划项目——社会发展(YZ2024077)。
关键词
肺癌
多维疲劳
影响因素分析
结构方程模型
Lung cancer
Multidimensional fatigue
Root cause analysis
Structural equation model
