领悟社会支持和心理弹性在肺癌化疗患者病耻感与孤独感之间的链式中介效应-现代医学

领悟社会支持和心理弹性在肺癌化疗患者病耻感与孤独感之间的链式中介效应

单位：1. 安徽医科大学护理学院, 安徽合肥 230032;
2. 安徽医科大学第一附属医院重症医学科, 安徽合肥 230022

分类号：R473.73

出版年·卷·期（页码）：2025·53·第四期（570-578）

摘要：

目的： 调查肺癌化疗患者的孤独感现状，探究病耻感对肺癌化疗患者孤独感的影响以及领悟社会支持和心理弹性的中介作用。方法： 2023年11月至2024年6月，采用便利抽样法选取安徽医科大学第一附属医院就诊的273例肺癌化疗患者作为研究对象，采用一般资料调查表、中文版癌症患者孤独感量表、中文版肺癌患者病耻感评估量表、心理弹性量表、领悟社会支持量表进行调查，运用AMOS 26.0软件构建结构方程模型并进行路径分析及中介效应检验。结果： 肺癌化疗患者孤独感平均得分为(15.38±6.32)分；病耻感对孤独感的总间接效应为0.431，其中领悟社会支持和心理弹性的中介效应分别占40.65%和20.98%，两者的链式中介效应占8.62%。结论： 肺癌化疗患者孤独感处于中等水平，病耻感可以直接影响孤独感，也可通过心理弹性、领悟社会支持的中介作用及二者的链式中介3种路径间接影响孤独感。

Objective: To investigate the current status of loneliness in patients with lung cancer chemotherapy, explore the impact of stigma on their loneliness, and examine the mediating effects of perceived social support and psychological resilience. Methods: From November 2023 to June 2024, a convenience sampling method was used to recruit 273 in patients with lung cancer chemotherapy, who attended the First Affiliated Hospital of Anhui Medical University as the research subjects. Data were collected using the general information questionnaire, the Chinese version of the Cancer Patient Loneliness Scale, the Chinese version of the Lung Cancer Patient Stigma Assessment Scale, the Psychological Resilience Scale, and the Perceived Social Support Scale. A structural equation model was constructed using AMOS 26.0 software, followed by path analysis and mediation effect testing.Results: The average score of loneliness in patients with lung cancer chemotherapy was 15.38±6.32. The total indirect effect of stigma on loneliness was 0.431, of which the mediating effects of perceived social support and psychological resilience accounted for 40.65% and 20.98%, respectively, and the chain mediating effect of the two accounts for 8.62%. Conclusion: Patients receiving chemotherapy for lung cancer experience a moderate degree of loneliness. Stigma can directly affect loneliness, as well as indirectly affect loneliness through three pathways: psychological resilience, perceived social support as a mediating effect, and chain mediation between the two.

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