目的 探讨恶性血液肿瘤患者焦虑情绪与生命质量之间的关系,以及心理弹性和自我效能感在其中的作用.方法 2017年2-6月,采用焦虑自评量表(self-rating anxiety scale,SAS)、心理弹性量表(Connor-Davidson resilience scale,CD-RISC)、一般自我效能感量表(general self-efficacy scale,GSES)以及癌症患者生命质量量表(cancer quality of life questionnaires-core 30,EORTC QLQ-C30)对284名恶性血液肿瘤患者进行问卷调查,运用SPSS 25.0软件对数据进行共同方法偏差检验、独立样本t检验和Pearson相关分析,采用PROCESS v3.4宏程序进行中介效应和调节效应检验.结果 (1)恶性血液肿瘤患者的生命质量得分[(72.52±19.18)分]显著低于常模(78.97分)(t=-5.669,P＜0.01).(2)焦虑[(43.71±11.22)分]与心理弹性[(69.96±15.32)分]、自我效能感[(22.93±6.04)分]、生命质量[(72.52±19.18)分]呈显著负相关(r=-0.232,-0.119,-0.236,均 P＜0.05),心理弹性、自我效能感和生命质量两两之间均呈显著正相关(r=0.113,0.210,0.652,均P＜0.05).(3)恶性血液肿瘤患者焦虑情绪对生命质量有显著负向预测作用(β=-0.233,t=-4.032,P＜0.01),心理弹性在焦虑情绪与生命质量间起部分中介作用,直接效应和中介效应分别占总效应的82.40％(-0.192/-0.233)、17.60％(-0.041/-0.233);自我效能感在心理弹性和生命质量之间起调节作用,对于低自我效能感组而言,心理弹性对生命质量没有预测作用(βsimple=0.059,t=0.650,P＞0.05,95％CI=-0.119～0.236);对于高自我效能感组而言,心理弹性对生命质量存在显著正向预测作用(βsimple=0.313,t=3.390,P＜0.01,95％CI=0.131～0.494).结论 恶性血液肿瘤患者的焦虑情绪不仅直接影响其生命质量,还会通过心理弹性间接影响其生命质量;自我效能感能够调节心理弹性在焦虑情绪与生命质量间的中介作用.
Anxiety and quality of life in patients with hematologic malignancy:the mediating role of resilience and the moderating role of self-efficacy
Objective To explore the correlation between anxiety and quality of life in patients with hematologic malignancy,and the role of resilience and self-efficacy in it.Methods From February to June 2017,a total of 284 patients with hematologic malignancy were surveyed by general information question-naire,self-rating anxiety scale(SAS),Connor-Davidson resilience scale(CD-RISC),general self-efficacy scale(GSES),and cancer quality of life questionnaires-core 30(EORTC QLQ-C30).SPSS 25.0 software was used to conduct common method bias testing,independent sample t-test and Pearson correlation analysis,and PROCESS 3.4 macro program was used to test the mediating and moderating effects.Results(1)The quality of life score among hematologic malignancy patients(72.52±19.18)was significantly lower than the norm(78.97)(t=-5.669,P＜0.01).(2)Anxiety(43.71±11.22)was significantly negatively corre-lated with resilience(69.96±15.32),self-efficacy(22.93±6.04),and quality of life(72.52±19.18)(r=-0.232,-0.119,-0.236,all P＜0.05).There were significant positive correlations between resilience,self-efficacy and quality of life(r=0.113,0.210,0.652,all P＜0.05).(3)Anxiety played a significant nega-tively predictive effect on quality of life in patients with hematologic malignancy(β=-0.233,t=-4.032,P＜0.01).Resilience partially mediated the relationship between anxiety and quality of life.The direct effect and the mediating effect accounted for 82.40％(-0.192/-0.233)and 17.60％(-0.041/-0.233)of the total effects respectively.Self-efficacy played a moderating role between resilience and quality of life.For the low self-efficacy group,resilience could not predict quality of life(βsimple=0.059,t=0.650,P＞0.05,95％CI=-0.119-0.236).For the high self-efficacy group,resilience had a significant positively predictive effect on quality of life(βsimple=0.313,t=3.390,P＜0.01,95％CI=0.131-0.494).Conclusion Anxiety in patients with hematologic malignancy can directly or indirectly affect quality of life through resilience,and this mediating model is moderated by self-efficacy.
Haematological malignanciesAnxietyResilienceSelf-efficacyQuality of life
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