晚期肺癌病人心理生态的组态效应机制研究及其对死亡教育的启示OA

Objective:To explore the multiple influencing pathways of death anxiety and death attitude in patients with advanced lung cancer,so as to provide a reference for formulating precise death education strategies.Methods:A cross-sectional survey design was adopted.A total of 164 patients with advanced lung cancer from a tertiary grade A cancer specialty hospital in Yunnan province were selected as the research subjects.General information questionnaires,the Chinese version of the Death Anxiety Scale(CT-DAS),and the Chinese version of the Death Attitude Profile-Revised(DAP-R)were used for the investigation.Data analysis was conducted using the fuzzy-set qualitative comparative analysis(fsQCA)method to identify the antecedent condition configurations leading to high levels of death anxiety,negative and positive death attitudes.Results:There were 6 configuration paths of death anxiety in patients with advanced lung cancer,presenting 5 different patterns,namely long-term isolation-communication deficiency type,high load-silence type,prognosis fear type,traumatic notification type,and spiritual struggle-silence negative type.Negative death attitudes had 8 configuration paths,presenting 5 different patterns,namely exhaustion silence type,early shock type,sudden high malignancy type,high malignancy load type,long-term aphasia type.Positive death attitudes had 6 configuration paths,presenting 4 different patterns,namely open communication type,long-term adaptation type,positive planning type,and focused on the present type.Conclusion:The death anxiety and death attitudes of patients with advanced lung cancer are the result of multiple factors coupling.The multiple causal paths discovered in this study could provide a basis for formulating precise death education strategies based on the combination of patients'individual characteristics,and are of great significance for promoting the development of clinical death education.