希望和积极应对在甲状腺癌症患者宽恕与主观幸福感间的多重中介作用

谢长华; 戴玉; 周利华; 王新燕

doi:10.16766/j.cnki.issn.1674-4152.002834

希望和积极应对在甲状腺癌症患者宽恕与主观幸福感间的多重中介作用

doi: 10.16766/j.cnki.issn.1674-4152.002834

1.
安徽医科大学附属宿州医院普外三科，安徽宿州 234000
2.
安徽医科大学护理学院，安徽合肥 230032
3.
安徽医科大学附属宿州医院护理部

基金项目:

安徽省高校自然科学研究项目 KJ2017A828

宿州市科技计划自筹项目宿科技[2020]65号

详细信息

通讯作者:
周利华，E-mail：531879548@qq.com

中图分类号: R736.1 R395.6
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出版历程
- 收稿日期: 2021-07-11

Relationship between forgiveness and general well-being in patients with thyroid cancer: multiple mediating effects of hope and positive coping

1.
Third Department of General Surgery of Suzhou Hospital Affiliated to Anhui Medical University, Suzhou, Anhui 234000, China

摘要

摘要: 目的探讨甲状腺癌症患者希望、积极应对、宽恕和主观幸福感之间的关系并检验希望和积极应对在宽恕和主观幸福感间的多重中介效应，为制定提升甲状腺癌症患者主观幸福感水平的干预方案提供科学依据。方法选取2019年5月—2021年3月安徽医科大学附属宿州医院普外三科治疗的甲状腺癌症患者177例，采用Heartland宽恕量表(HFS)、总体幸福感量表(GWB)、Herth希望量表(HHI)和简易应对方式问卷(SCSS)进行调查，运用结构方程模型和Bootstrap程序进行中介效应检验。结果 (1) 甲状腺癌患者宽恕、希望、积极应对和主观幸福感的得分分别为(103.97±20.45)分、(34.76±3.78)分、(15.38±5.78)分、(57.50±10.10)分。(2)宽恕与希望、积极应对、主观幸福感呈正相关关系(r=0.229、0.513、0.480，均P＜0.01)；希望与积极应对、主观幸福感呈正相关关系(r=0.278、0.390，均P＜0.01)，积极应对与主观幸福感呈正相关关系(r=0.508，P＜0.01)。(3)多重中介检验结果显示宽恕对主观幸福感的直接效应显著；希望、积极应对在宽恕和主观幸福感之间起到并行多重中介效应(95% CI：0.132~0.409)，总效应为0.62，直接效应为0.35，总中介效应为0.27，中介效应占总效应的43.5%。结论宽恕可直接影响主观幸福感，也可通过希望和积极应对间接影响主观幸福感，本研究结果可为甲状腺癌症患者心理健康干预方案的制定提供理论依据。
- 甲状腺癌症 /
- 宽恕 /
- 主观幸福感 /
- 希望 /
- 积极应对 /
- 多重中介
Abstract: Objective To explore the relationship among hope, positive coping, forgiveness and subjective well-being of thyroid cancer patients, and to test the multiple mediating effect of hope and positive coping between forgiveness and general well-being, so as to provide scientific basis for formulating intervention programs to improve the level of general well-being of thyroid cancer patients. Methods A total of 177 patients with thyroid cancer in the Third Department of Gneral Surgery of Suzhou Hospital Affiliated to Anhui Medical University from May 2019 to March 2021 were selected. They were surveyed by simple coping style scale (SCSS), general well-being scale (GWB), Herth hope index (HHI), and Heartland forgiveness scale (HFS). The structural equation model was established, and the mediation effect test was performed by Bootstrapping method. Results (1) The scores of forgiveness, hope, positive coping and general well-being of patients with thyroid cancer were (103.97±20.45), (34.76±3.78), (15.38±5.78) and (57.50±10.10) points respectively. (2) Forgiveness was positively correlated with hope, positive coping and general well-being (r=0.229, 0.513, 0.480, all P < 0.01); hope was positively correlated with positive coping and general well-being (r=0.278, 0.390, all P < 0.01); positive coping was positively correlated with general well-being (r=0.508, P < 0.01). (3) Multiple mediation effect model analysis showed that the level of forgiveness had a significant direct effect on the general well-being of patients with thyroid cancer. Hope and positive coping style had concurrent multiple mediating effect between forgiveness and general well-being (95% CI: 0.132-0.409). The total effect was 0.62; the direct effect was 0.35, and the total mediation effect was 0.27. The mediating effect accounts for 43.5% of the total effect. Conclusion Forgiveness can directly affect the general well-being. It can also influence the general well-being through hope and positive coping style indirectly. Results of this study can provide a theoretical basis for the formulation of mental health intervention programs for patients with thyroid cancer.
- Thyroid cancer /
- Forgiveness /
- General well-being /
- Hope /
- Positive coping style /
- Multiple mediating effects
利益冲突 无

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图 1 希望和积极应对的中介路径分析图

注：图中数据为标准化路径系数，e1~e14为残差。

Figure 1. Analysis of intermediary paths for hope and positive response

下载: 全尺寸图片幻灯片

表 1 一般人口学和疾病特征对甲状腺癌患者各变量得分影响的单因素分析(x±s，分)

Table 1. Univariate analysis of the influence of general data and disease characteristics on the scores of various variables in patients with thyroid cancer(x±s, scores)

项目	类别	人数(%)	宽恕	积极应对	希望	主观幸福感
性别	男性	120(67.80)	105.40±19.79	15.79±6.03	35.21±3.48	59.23±9.73
	女性	57(32.20)	100.92±21.62	14.52±5.13	33.80±4.20	53.86±9.96
t值			1.365	1.364	2.348	3.407
P值			0.174	0.174	0.020	0.001
年龄(岁)	21~45	12(6.78)	99.16±24.66	14.08±6.58	34.00±2.48	54.91±6.66
	46~70	134(75.71)	103.02±19.98	15.08±5.78	34.66±3.99	56.58±10.51
	≥71	31(17.51)	109.90±20.22	17.19±5.23	35.48±3.12	62.45±7.72
F值			1.796	2.030	0.853	4.872
P值			0.167	0.134	0.428	0.009
受教育程度	小学及以下	87(49.15)	100.17±20.14	15.32±5.76	34.45±4.03	55.48±10.30
	初中	51(28.81)	104.09±20.61	14.49±5.85	34.98±4.11	57.86±10.15
	高中/专科	33(18.64)	111.06±19.30	16.09±5.14	35.36±2.51	62.09±8.49
	本科及以上	6(3.40)	118.83±15.98	20.00±7.40	34.00±2.89	58.50±7.66
F值			3.526	1.878	0.598	2.708
P值			0.016	0.135	0.617	0.032
家庭人均月收入(元)	＜2 000	108(61.02)	99.98±19.69	14.31±5.73	34.61±4.16	55.42±10.10
	2 000~5 000	39(22.03)	105.38±21.97	16.84±5.46	34.84±3.31	60.51±10.64
	＞5 000	30(16.95)	116.46±15.79	17.33±5.57	35.20±2.82	61.10±7.21
F值			8.403	5.023	0.295	3.163
P值			＜0.001	0.008	0.745	0.015
婚姻情况	已婚	155(87.57)	103.94±20.51	15.52±5.86	34.57±3.72	57.61±10.26
	丧偶	17(9.60)	104.94±21.21	15.47±5.28	36.35±4.30	58.17±8.79
	未婚和离异	5(2.83)	101.20±19.58	10.80±2.48	35.20±2.77	51.80±8.75
F值			0.064	1.631	1.746	0.843
P值			0.938	0.199	0.178	0.432
主要照顾者	配偶	84(47.46)	106.38±21.00	16.17±6.13	34.79±3.42	58.46±9.62
	子女	70(39.55)	102.85±20.04	15.25±5.69	34.97±4.27	56.18±10.79
	其他	23(12.99)	98.52±19.05	12.86±3.81	34.00±3.43	58.00±9.54
F值			1.513	3.058	0.576	1.005
P值			0.223	0.050	0.563	0.368
家庭所在地	城市	36(20.34)	108.22±18.99	16.13±6.09	34.75±3.34	57.33±10.64
	城镇	39(22.03)	104.69±19.46	15.71±5.13	35.17±3.50	57.43±8.15
	农村	102(57.63)	102.18±21.23	14.99±5.91	34.60±4.03	57.58±10.64
F值			1.194	0.606	0.320	0.009
P值			0.306	0.546	0.726	0.991
病程(年)	＜1	128(72.32)	103.48±19.56	15.53±5.85	35.21±3.70	58.80±10.22
	1~3	36(20.33)	106.50±22.31	15.08±5.93	33.66±3.79	56.83±9.87
	＞3	13(7.35)	101.69±24.52	14.69±4.83	33.30±3.79	56.38±9.98
F值			0.390	0.186	3.506	0.214
P值			0.678	0.830	0.032	0.807

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表 2 各量表相关性分析结果(r值)

Table 2. Descriptive analysis results and correlation matrix of each variable (r value)

项目	宽恕	希望	积极应对
宽恕	1
希望	0.229	1
积极应对	0.513	0.278	1
主观幸福感	0.480	0.390	0.508
注：均P＜0.01。

下载: 导出CSV

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