社会支持对早期乳腺癌患者手术方式决策冲突的影响：自我效能和积极应对的中介作用分析-现代医学

社会支持对早期乳腺癌患者手术方式决策冲突的影响：自我效能和积极应对的中介作用分析

单位：1. 新疆医科大学护理学院, 新疆乌鲁木齐 830016;
2. 新疆医科大学附属肿瘤医院乳腺癌外科一病区, 新疆乌鲁木齐 830011;
3. 新疆乳腺甲状腺肿瘤临床医学研究中心, 新疆乌鲁木齐 830011;
4. 新疆区域人群疾病与健康照护研究中心, 新疆乌鲁木齐 830016

关键词：社会支持自我效能积极应对决策冲突乳腺癌中介作用

分类号：R737.9

出版年·卷·期（页码）：2025·53·第五期（760-766）

摘要：

目的： 调查早期乳腺癌患者手术方式决策冲突现状，分析自我效能和积极应对在社会支持与决策冲突中的中介作用。方法： 选取2023年11月至2024年6月在新疆医科大学附属肿瘤医院乳腺外科就诊的355例早期乳腺癌患者作为研究对象，采用一般资料调查表、领悟社会支持量表、一般自我效能量表、简易应对方式量表和决策冲突量表进行横断面调查，使用SPSS 26.0软件和AMOS 27.0软件进行中介效应分析。结果： 早期乳腺癌患者手术方式决策冲突得分为(42.55±16.67)分，社会支持得分为(55.37±10.00)分。决策冲突与社会支持呈负相关(r=-0.621，P<0.01)，与自我效能呈负相关(r=-0.610，P<0.01)，与积极应对呈负相关(r=-0.653，P<0.01)；社会支持可以直接影响决策冲突(β=-0.50，P<0.001)；自我效能和积极应对对社会支持与决策冲突的中介效应显著，间接效应占总效应的34.63%，其中自我效能路径占总效应14.37%，积极应对路径占总效应20.26%。结论： 早期乳腺癌患者手术方式决策冲突程度较高，社会支持可以直接影响决策冲突，也可以分别通过自我效能和积极应对间接影响决策冲突。

Objective: To investigate the current status of decision conflict in surgical method selection among patients with early-stage breast cancer and to analyze the mediating effects of self-efficacy and positive coping on the relationship between social support and decision conflict. Methods: A total of 355 early-stage breast cancer patients who visited the Breast Surgery Department of the Affiliated Tumor Hospital of Xinjiang Medical University from November 2023 to June 2024 were selected as study subjects. A cross-sectional survey was conducted utilizing the general information questionnaire, Perceived Social Support scale, General Self-efficacy Scale, Simplified Coping Style Scale, and Decision Conflict Scale. Mediation effect analysis was performed using SPSS 26.0 and AMOS 27.0 software. Results: The decision conflict score for surgical methods in early breast cancer patients was(42.55±16.67), while the social support score was(55.37±10.00). Decision conflict was negatively correlated with social support(r =-0.621, P<0.01), self-efficacy(r =-0.610, P<0.01), and positive coping(r =-0.653, P<0.01). Social support had a direct influence on decision conflict(β =-0.50, P<0.001). The mediating effects of self-efficacy and positive coping between social support and decision conflict were significant, with the indirect effect accounting for 34.63% of the total effect. The self-efficacy pathway accounted for 14.37% of the total effect, while the positive coping pathway accounted for 20.26% of the total effect. Conclusion: The level of decision-making conflict regarding surgical options is relatively high among patients with early-stage breast cancer. Social support can directly influence decision-making conflict and can also indirectly affect it through self-efficacy and positive coping.

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