摘要
目的 分析肺癌术后康复期患者疼痛恐惧对早期活动水平的影响及家庭功能和自我效能在两者间的链式中介作用.方法 采用便利抽样法,选取2020年4月1日至2023年3月31日南京医科大学附属泰州人民医院呼吸与危重症科收治的术后康复期肺癌患者256例,采用一般资料调查表、约翰霍普金斯最高活动水平评分量表、疼痛恐惧问卷、家庭功能量表和一般自我效能感量表进行测评;采用SPSS 25.0统计学软件中Pearson分析相关关系;采用Amos软件构建结构方程模型(SEM),并采用Bootstrap法进行链式中介作用检验.结果 (1)256例肺癌康复期患者早期活动水平评分(4.27±0.69)分、疼痛恐惧评分(93.62±11.46)分、家庭功能评分(162.34±17.64)分、自我效能评分(18.11±2.42)分;(2)肺癌康复期患者早期活动水平与疼痛恐惧之间呈负相关性(r=-0.854,P＜0.05),与家庭功能、自我效能均呈正相关性(r=0.813、0.724,P均＜0.05);疼痛恐惧与家庭功能、自我效能均呈负相关性(r=-0.854、-0.712,P均＜0.05);家庭功能与自我效能之间呈正相关性(r=0.822,P＜0.05);(3)家庭功能和自我效能在疼痛恐惧与早期活动水平之间的链式中介作用成立,总间接效应值为0.495,占总效应48.29％,其中家庭功能的特定中介作用效应值为0.224,占总效应21.85％,自我效能的特定中介作用效应值为0.187,占总效应18.24％,家庭功能-自我效能的链式中介作用效应值为0.084,占总效应8.20％.结论 疼痛恐惧显著负向肺癌术后康复期患者早期活动水平,且家庭功能和自我效能在疼痛恐惧与早期活动水平之间起链式中介作用.
Abstract
Objective To analyze the effects of pain fear on early activity level in convalescent patients after lung cancer surgery,and the chain mediating effect of family function and self-efficacy.Methods A convenience sampling method was used,and 256 convalescent patients with lung cancer were selected from the Department of Respiratory and Critical Care of Taizhou People's Hospital affiliated to Nanjing Medical University from April 1,2020 to March 31,2023.General information questionnaire,Johns Hopkins highest activity level rating scale,fear of pain questionnaire,family functioning scale,and general self-efficacy scale were used for the study.The correlations were analyzed by Pearson in SPSS 25.0 statistical software,and the structural equation model(SEM)was constructed by Amos software and chain mediation test was carried out by Bootstrap method.Results(1)The scores of early activity,pain fear,family function and self-efficacy were 4.27±0.69,93.62±11.46,162.34±17.64 and 18.11±2.42 respectively in 256 convalescent patients with lung cancer.(2)Early activity level was significantly and negatively correlated with pain fear(r=-0.854,P＜0.05),but was significantly and positively correlated with family function and self-efficacy(r=0.813,0.724,all P＜0.05).Pain fear was significantly and negatively correlated with family function and self-efficacy in all patients(r=-0.854,-0.712,all P＜0.05).But there was a significant and positive correlation between family function and self-efficacy(r=0.822,P＜0.05).(3)The chain mediating effect of family function and self-efficacy was established between pain fear and early activity,and the total indirect effect was 0.495,accounting for 48.29％of the total effect,in which the mediating effect of family function was 0.224,accounting for 21.85％,the mediating effect of self-efficacy was 0.187,accounting for 18.24％,the mediating effect of family function and self-efficacy was 0.084,accounting for 8.20％.Conclusion Pain fear can negatively predict the early activity level,and family function and self-efficacy play a chain mediating role in the pain fear and early activity level in convalescent patients after lung cancer surgery.
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