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恶性肿瘤患者知情程度与治疗依从性的关系:心理状态和家庭社会支持的中介作用分析
作者:崔艳丽  范丽娟  张玲玲 
单位:新疆维吾尔自治区人民医院 肿瘤科, 新疆 乌鲁木齐 830000
关键词:恶性肿瘤 知情程度 治疗依从性 心理状态 家庭支持 中介效应 
分类号:R473.73
出版年·卷·期(页码):2023·51·第三期(328-333)
摘要:

目的:探讨恶性肿瘤患者知情程度与治疗依从性的关系,分析患者的心理状态、家庭韧性及社会支持在知情程度和治疗依从性之间的中介效应。方法:以2019年6月至2021年8月在我院肿瘤科住院的350例患者为研究对象,采用一般资料调查、服药依从性量表(MMAS)、焦虑抑郁量表(HADS)、家庭坚韧力量表(FHI)、MOS社会支持量表(MOS-SSS)及医院自制的知情程度量表对患者进行问卷调查。采用Pearson相关模型分析患者治疗依从性与心理状态和家庭社会支持度之间的关系,采用结构方程模型分析患者的心理状态与家庭韧性及社会支持在知情程度和依从性间的中介效应。结果:350份问卷中剔除30份无效问卷,最终320份问卷纳入本研究。患者知情度评估显示,150例患者知情,100例患者部分知情,70例患者不知情,据此分组后对比临床资料显示,3组患者MMAS评分、HADS评分、FHI评分及MOS-SSS评分比较差异有统计学意义(P<0.001);Pearson相关性分析显示,恶性肿瘤患者治疗依从性MMAS评分与HADS评分呈负相关,与FHI评分、MOS-SSS评分呈正相关(P<0.05);HADS评分与FIH、MOS-SSS评分呈负相关(P<0.05);结构方程模型显示,心理状态和家庭及社会支持对依从性有直接正向效应(β值分别为0.44、1.08,均P<0.05);知情程度对依从性有直接负向效应(β=-0.17,P<0.05)。结论:患者的治疗依从性与其知情程度呈现高度相关性;家庭韧性和社会支持度与患者心理状态也存在中介效应,社会支持度高的患者其心理状态、治疗依从性也较好。

Objective: To explore the relationship between the degree of awareness and treatment compliance in patients with malignant tumors, and to analyze the mediating effects of the patients' psychological state, family resilience and social support on the degree of awareness and treatment compliance. Methods: From June 2019 to August 2021, 350 patients who were hospitalized in the oncology department of our hospital were selected as the research objects. Morisky Medication Adherence Scale (MMAS), Hospital Anxiety and Depression Scale (HADS), Family Hardiness Index (FHI), MOS Social Support Scale (MOS-SSS) and the hospital-made informedness scale were used to conduct a questionnaire survey on the patients. Pearson correlation model was used to analyze the relationship between patients' awareness and treatment compliance, psychological state and family social support, and structural equation model was used to analyze the mediating effect of patients' psychological state, family resilience and social support between patients' awareness and treatment compliance. Results: There were 350 questionnaires distributed, 30 invalid questionnaires excluded, and 320 valid questionnaires were finally recovered. The survey of the degree of knowledge scale showed that 150 patients were informed, 100 patients were partially informed, and 70 patients were not aware. There were statistically significant differences in MMAS score, HADS score, FHI score and MOS-SSS score between the three groups(P<0.001). Pearson correlation analysis showed that patients' MMAS score was negatively correlated with HADS score, there was a positive correlation between MMAS score and FHI score, MOS-SSS score (P<0.001); HADS score was negatively correlated with FIH and MOS-SSS scores (P<0.001). Structural equation model showed that psychological status and family and social support had a directly positive effect on compliance(β=0.44, 1.08, all P<0.05); the degree of awareness had a directly negative effect on compliance (β=-0.17, P<0.05). Conclusion: There is a significant correlation between cancer patients' awareness of their own diseases and patients' treatment compliance. Family resilience and social support also have mediating effects on patients' psychological status. Giving patients higher social and family support is essential for improving patients' psychological status and psychological status, and also can improve their treatment compliance.

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