肺癌化疗患者呼吸困难严重程度与抑郁症状的路径:疾病进展恐惧的双重中介作用OA
Pathway of respiratory distress severity and depressive symptoms in lung cancer chemotherapy patients:The dual mediating role of disease progression fear
目的:探讨疾病进展恐惧(FoP)的生理健康与社会家庭双维度在肺癌化疗患者呼吸困难严重程度与抑郁症状间的双重中介作用.方法:选取2022年1月至2025年1月某医院收治的108例肺癌化疗患者为研究对象.使用一般资料调查表、改良医学研究委员会呼吸困难量表(mMRC)、抑郁自评量表(SDS)和恐惧疾病进展简化量表(FoP-Q-SF)进行评估,通过结构方程模型和Bootstrap法检验疾病进展恐惧双维度的中介效应.结果:mMRC量表总分31.68±7.42分,提示中重度呼吸困难;SDS量表总分56.83±11.27分,显著高于抑郁临界值(≥50分);FoP-Q-SF量表总分40.96±8.42分,生理健康维度得分(22.59±5.13)显著高于社会家庭维度(18.37±4.25).呼吸困难严重程度与抑郁症状呈显著正相关(r=0.427,P＜0.001),与疾病进展恐惧总分(r=0.582,P＜0.01)及其生理健康维度(r=0.436,P＜0.001)、社会家庭维度(r=0.294,P＜0.05)均呈显著正相关.抑郁症状与疾病进展恐惧总分(r=0.523,P＜0.001)及双维度(社会家庭维度r=0.387,P＜0.01;生理健康维度r=0.473,P＜0.001)均呈显著正相关.疾病进展恐惧在呼吸困难严重程度与抑郁症状间起双重中介作用,总间接效应占比37.15％.其中,生理健康恐惧维度的中介路径(效应值0.117,占比27.34％)显著高于社会家庭恐惧维度(效应值0.042,占比9.81％).结论:疾病进展恐惧,尤其是生理健康维度的恐惧,是肺癌化疗患者呼吸困难严重程度影响抑郁症状的重要中介路径.临床应针对性地管理患者的疾病进展恐惧,特别是生理健康相关的恐惧,以阻断呼吸困难引发抑郁的心理机制,改善患者心理健康.
Objective:To explore the dual mediating role of the physiological health and social family dimensions of fear of disease progression(FoP)between the severity of respiratory distress and depressive symptoms in lung cancer chemotherapy patients.Methods:A total of 108 lung cancer chemotherapy patients admitted to our hospital from Jan-uary 2022 to January 2025 were selected as the study subjects.The general information questionnaire,Modified Medi-cal Research Council Dyspnea Scale(mMRC),Self Rating Depression Scale(SDS),and Simplified Fear of Disease Progression Scale(FoP-Q-SF)were used for evaluation,and the mediating effect of the fear of disease progression was examined using structural equation modeling and Bootstrap method.Results:The total score of mMRC scale was 31.68±7.42 points,indicating moderate to severe respiratory distress;The total score of SDS scale was 56.83±11.27 points,significantly higher than the critical value of depression(≥50 points);The total score of FoP-Q-SF scale was 40.96±8.42 points,and the score of physiological health dimension(22.59±5.13)was significantly higher than that of social family dimension(18.37±4.25).The severity of respiratory distress was significantly positively correla-ted with depressive symptoms(r=0.427,P＜0.001),and positively correlated with the total score of disease pro-gression fear(r=0.582,P＜0.01)and its physiological health dimension(r=0.436,P＜0.001),as well as the social and family dimension(r=0.294,P＜0.05).The total score of depression symptoms and disease progression fear(r=0.523,P＜0.001)and the dual dimensions(social and family dimension r=0.387,P＜0.01);The physiological health dimension r=0.473,P＜0.001)was positively correlated.The fear of disease progression played a dual mediating role between the severity of respiratory distress and depressive symptoms,with a total indirect effect accounting for 37.15％.Among them,the proportion of mediating pathways(effect value 0.117)in the dimension of physiological health fear(27.34％)was significantly higher than that in the dimension of social family fear(effect value 0.042,accounting for 9.81％).Conclusion:Fear of disease progression,especially in the physiological health dimension,is an important mediating pathway for the severity of respiratory distress in lung cancer chemotherapy patients to affect depressive symptoms.Clinically,patients' fear of disease progression,especially those related to physical health,should be man-aged in a targeted manner to block the psychological mechanism of depression caused by breathing difficulties and improve patients' mental health.
黄娅琳;李唯媛;耿箐;李佳
郑州大学附属肿瘤医院/河南省肿瘤医院中西医结合二病区 450008郑州大学附属肿瘤医院/河南省肿瘤医院中西医结合二病区 450008郑州大学附属肿瘤医院/河南省肿瘤医院中西医结合二病区 450008郑州大学附属肿瘤医院/河南省肿瘤医院中西医结合二病区 450008
医药卫生
肺癌化疗呼吸困难严重程度抑郁症状疾病进展恐惧
Chemotherapy for lung cancerSeverity of breathing difficultiesDepressive symptomsFear of pro-gression
《中国健康心理学杂志》 2026 (9)
1307-1311,5
2025年度河南省医学科技攻关计划联合共建项目(编号:LHCJ20250203)
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