领悟社会支持在PICC置管癌症患者上臂运动自我效能与自我管理能力间的中介效应-现代医学

领悟社会支持在PICC置管癌症患者上臂运动自我效能与自我管理能力间的中介效应

单位：1. 贵州医科大学护理学院, 贵州贵阳 550025;
2. 广州市红十字会医院消化内科, 广东广州 510220

分类号：R730.9

出版年·卷·期（页码）：2024·52·第四期（587-594）

摘要：

目的：探讨社会支持在经外周置入中心静脉导管(PICC)癌症患者上臂运动自我效能与自我管理能力之间的中介效应，为采取针对性干预措施提高患者的上臂运动水平提供参考。方法：本研究为横断面调查，采用便利抽样法，选取广州市3所三甲医院2023年6—9月就诊的PICC置管癌症患者为研究对象，通过一般资料调查表、领悟社会支持量表、PICC置管癌症患者上臂运动自我效能量表、肿瘤患者PICC自我管理能力量表测量患者社会支持感、上臂运动自我效能及PICC自我管理能力水平。采用Pearson相关性分析探究三者间的相关性；采用Bootstrap中介效应检验法分析三者的中介效应关系。结果：调查共发放340份问卷，得到有效问卷330份。PICC置管癌症患者上臂运动自我效能、领悟社会支持与PICC自我管理能力三者均呈两两相关(r=0.832、0.806、0.763，均P＜0.001)，Bootstrap检验结果显示，领悟社会支持在上臂运动自我效能与PICC自我管理能力之间的中介效应值为0.407(95%CI 0.337~0.480)，占总效应的49.27%。结论:领悟社会支持在上臂运动自我效能与PICC自我管理能力之间起部分中介效应，帮助PICC置管癌症患者丰富社会支持网络，是提升其上臂运动自我效能的有效途径之一。

Objective: To explore the mediating effect of perceived social support between upper arm exercise self-efficacy and self-management ability in cancer patients with peripherally inserted central catheter(PICC), and to provide reference for targeted interventions to improve patients' upper arm exercise level. Methods: This study was a cross-sectional survey, using a convenience sampling method, and selected cancer patients with PICC who attended one of the three tertiary hospitals in Guangzhou from June to September 2023 as the study subjects, and measured the patients' social support level, upper arm exercise self-efficacy and PICC self-management level through the general information questionnaire, the perceived social support scale, the upper arm exercise self-efficacy scale for cancer patients with PICC, and the cancer patients PICC self-management competency scale. Pearson correlation analysis was used to investigate the correlation between the three scales; Bootstrap mediation effect test was used to analyse the mediation effect relationship between the three scales. Results: A total of 340 questionnaires were distributed, and 330 valid questionnaires were obtained. Upper arm exercise self-efficacy, perceived social support and PICC self-management competency of cancer patients with PICC were correlated in a two-by-two manner(r=0.832, 0.806, 0.763,all P<0.001). Bootstrap test results showed that the mediating effect value of perceived social support between upper arm exercise self-efficacy and PICC self-management competency was 0.407(95%CI 0.337-0.480), accounting for 49.27% of the total effect. Conclusion: Perceived social support plays a partial mediating effect between upper arm exercise self-efficacy and PICC self-management ability, helping PICC-intubated cancer patients to enrich their social support network is one of the effective ways to enhance their upper arm exercise self-efficacy.

参考文献：

[1] MIELKE D,WITTIG A,TEICHGRÄBER U.Peripherally inserted central venous catheter(PICC) in outpatient and inpatient oncological treatment[J].Support Care Cancer,2020,28(10):4753-4760.
[2] PARK J Y,KIM H L.A comprehensive review of clinical nurse specialist-led peripherally inserted central catheter placement in Korea[J].J Infus Nurs,2015,38(2):122-128.
[3] 张华甫.留置PICC导管肿瘤患者生活质量与自我管理能力水平的相关性研究[J].护士进修杂志,2021,36(21):1983-1986,1996.
[4] LIU Q,JIN Y,WANG Y,et al.Association between self-efficacy and self-management behaviours among individuals at high risk for stroke:social support acting as a mediator[J].J Clin Nurs,2023,32(1-2):71-82.
[5] SENNESETH M,DYREGROV A,MATTHIESEN S B,et al.Improving social network support for partners facing spousal cancer while caring for minors:Four-month outcomes of a single-centre randomised controlled trial[J].Eur J Cancer Care(Engl),2019,28(1):e12907.
[6] SAWMA T,CHOUEIRI P.The influence of family functioning on the severity of fear of cancer recurrence:a cross-sectional study in a sample of breast cancer survivors of Lebanese women[J].Eur J Oncol Nurs,2022,60:102169.
[7] SHIN Y H,HUR H K,PENDER N J,et al.Exercise self-efficacy,exercise benefits and barriers,and commitment to a plan for exercise among Korean women with osteoporosis and osteoarthritis[J].Int J Nurs Stud,2006,43(1):3-10.
[8] 朱金凤,狄恒丹,季翠玲,等.中青年脑卒中患者运动自我效能及锻炼计划与运动依从性的相关性研究[J].护理学杂志,2022,37(23):36-39.
[9] 张婷,张燕燕,谢兴,等.力量训练联合关节活动度训练对PICC置管病人肢体功能的影响[J].护理研究,2019,33(21):3727-3731.
[10] 丁月华,许俊芳,殷荣华.规律握球运动对肿瘤患者PICC置管腋静脉血液流速及并发症的影响[J].护理学杂志,2020,35(6):15-17.
[11] HARKNESS K,BUCK H G,ARTHUR H,et al.Caregiver contribution to heart failure self-care(CACHS)[J].Nurs Open,2016,3(1):51-60.
[12] KROLL T,KEHN M,HO P S,et al.The SCI exercise self-efficacy scale(ESES):development and psychometric properties[J].Int J Behav Nutr Phys Act,2007,4:34.
[13] 李月仪.妊娠期糖尿病患者自我管理行为量表的研制与应用[D].广州:暨南大学,2019.
[14] ZIMET G D.Psychometric characteristics of the multidimensional scale of perceived social support[J].J Pers Assess,1988,52(1):30-41.
[15] 黄丽,姜乾金,任蔚红.应对方式、社会支持与癌症病人心身症状的相关性研究[J].中国心理卫生杂志,1996(4):160-161.
[16] 刘春丽,颜美琼,陆箴琦.肿瘤患者PICC自我管理能力量表的构建及测评[J].护理学杂志,2012,27(23):1-4.
[17] WANG Z,MCLOONE P,MORRISON D S.Diet,exercise,obesity,smoking and alcohol consumption in cancer survivors and the general population:a comparative study of 16 282 individuals[J].Br J Cancer,2015,112(3):572-575.
[18] WILLIAMS S L,FRENCH D P.What are the most effective intervention techniques for changing physical activity self-efficacy and physical activity behaviour--and are they the same?[J].Health Educ Res,2011,26(2):308-322.
[19] TABATA H,OTSUKA H,SHI H,et al.Effects of exercise habits in adolescence and older age on sarcopenia risk in older adults:the Bunkyo Health Study[J].J Cachexia Sarcopenia Muscle,2023,14(3):1299-1311.
[20] LUNDT A,JENTSCHKE E.Long-term changes of symptoms of anxiety,depression,and fatigue in cancer patients 6 months after the end of yoga therapy[J].Integr Cancer Ther,2019,18:1475494241.
[21] 吕扬,刘欣哲,朱清淼,等.社会支持与自我效能在食管癌术后患者经济毒性与生活质量间的链式中介效应[J].中国护理管理,2023,23(9):1421-1426.
[22] 董奥,冉明,张智月,等.癌症化疗患者经济毒性、社会支持、生活质量现状及其相关性[J].现代临床医学,2022,48(6):404-407.
[23] MCDONOUGH M H,BESELT L J,DAUN J T,et al.The role of social support in physical activity for cancer survivors:A systematic review[J].Psychooncology,2019,28(10):1945-1958.
[24] LEE M K,PARK S Y,CHOI G S.Association of support from family and friends with self-leadership for making long-term lifestyle changes in patients with colorectal cancer[J].Eur J Cancer Care(Engl),2018,27(3):e12846.
[25] 贾宏,范爱飞,丁小容,等.门诊肿瘤患者PICC置管的自我管理行为及其影响因素调查分析[J].中华现代护理杂志,2010,16(15):1742-1746.
[26] 潘桂华,唐娟妮,李晓玲,等.照护者参与模式提高老年肿瘤患者PICC置管居家期问握拳运动依从性的效果[J].护士进修杂志,2021,36(20):1914-1916.
[27] LAMBRINOU E,HANSEN T B,BEULENS J W.Lifestyle factors,self-management and patient empowerment in diabetes care[J].Eur J Prev Cardiol,2019,26(2_suppl):55-63.
[28] HAMILTON J B,WORTHY V C,MOORE A D,et al.Messages of hope:helping family members to overcome fears and fatalistic attitudes toward cancer[J].J Cancer Educ,2017,32(1):190-197.
[29] 袁夏霖,乔积民,周小平,等.领悟社会支持在肺动脉高压患者主观幸福感与心理弹性间的中介作用分析[J].现代医学,2023,51(4):494-500.

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