| 毕小兰,刘贵梅,张 鑫.老年非小细胞肺癌患者术后知觉压力、生活质量与癌症复发恐惧的相关性分析[J].,2025,(18):2956-2964 |
| 老年非小细胞肺癌患者术后知觉压力、生活质量与癌症复发恐惧的相关性分析 |
| Correlation Analysis of Postoperative Perceived Stress, Quality of Life and Fear of Cancer Recurrence in Elderly Non-Small Cell Lung Cancer Patients |
| 投稿时间：2025-04-25 |
| DOI：10.13241/j.cnki.pmb.2025.18.011 |
| 中文关键词: 老年 非小细胞肺癌 知觉压力 生活质量 癌症复发恐惧 |
| 英文关键词: Elderly Non-small-cell lung cancer Perceived stress Quality of life Fear of cancer recurrence |
| 基金项目:山西省国际科技合作项目（201803D42105） |
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| 中文摘要: |
| 摘要 目的：研究老年非小细胞肺癌（non-small-cell lung cancer, NSCLC）患者术后知觉压力、生活质量与癌症复发恐惧（fear of cancer recurrence, FCR）的相关性。方法：本研究为前瞻性研究设计，选取从2023年1月到2024年6月在山西省中西医结合医院就诊的147例老年NSCLC患者进行研究。患者均接受行胸腔镜肺叶切除术治疗。利用恐惧疾病进展简化量表（fear of disease progression simplified scale, FoP-Q-SF）评估患者FCR，根据FoP-Q-SF评分分为心理失调组和无心理失调组。采用肺癌患者生活质量测定量表（functional assessment of cancer therapy-lung cancer, FACT-L）评估生活质量。采用中文版知觉压力量表（Chinese version of the perceived stress scale, CPSS）评分评估知觉压力。分析老年NSCLC患者术后知觉压力、生活质量与FCR得分情况，人口学特征及临床特征对老年NSCLC患者术后FCR的影响。比较不同FCR老年NSCLC患者术后知觉压力、生活质量评分，分析老年NSCLC患者术后FCR与知觉压力、生活质量的相关性，以及老年NSCLC患者术后知觉压力、生活质量对FCR影响的模型拟合指数。结果：老年NSCLC患者术后CPSS评分为（52.17±4.02）分，FACT-L评分为（80.39±4.56）分，FoP-Q-SF总分为（31.16±8.69）分。家庭关系、疾病经济负担、化疗和临床分期与老年NSCLC患者术后FCR之间具有紧密关联（P＜0.05）。心理失调组的CPSS评分较无心理失调组更高，FACT-L评分较无心理失调组更低（P＜0.05）。根据Pearson相关性分析发现，老年NSCLC患者术后FCR与知觉压力呈正相关，而与生活质量呈负相关（P＜0.05）。将老年NSCLC患者术后生活质量记作自变量，术后知觉压力记作中介变量，而将术后FCR记作因变量，常规构建出中介效应的结构模型。结果表明模型拟合较好。生活质量对老年NSCLC患者术后FCR存在直接负向预测作用（P＜0.05），并能够经由术后知觉压力影响FCR（P＜0.05），中介效应占总效应的34.15%。通过Bootstrap法为数据予以重复取样后实施中介效应，其中各模型路径的95%CI均未包含0，表明中介效应的差异有统计学意义（P＜0.05）。结论：老年NSCLC患者术后FCR与知觉压力呈正相关，而与生活质量呈负相关，临床上可考虑对此类指标进行监测，从而更好地评估老年NSCLC患者术后FCR情况。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the correlation between postoperative perceived stress, quality of life and fear of cancer recurrence (FCR) in elderly non-small-cell lung cancer (NSCLC) patients. Methods: This study was a prospective research design, a total of 147 elderly NSCLC patients who visited Shanxi Integrated Traditional Chinese and Western Medicine Hospital from January 2023 to June 2024 were prospectively selected for the study. All patients underwent thoracoscopic lobectomy. FCR in patients was evaluated by fear of disease progression simplified scale (FoP-Q-SF), and they were divided into dysregulation group and non dysregulation group according to the FoP-Q-SF score. Quality of life was evaluated by functional assessment of cancer therapy-lung cancer (FACT-L). Perceived stress was evaluated by Chinese version of the perceived stress scale (CPSS) score. The scores of postoperative perceived stress, quality of life and postoperative FCR in elderly NSCLC patients were analyzed, and the influence of demographic and clinical characteristics on the postoperative FCR in elderly NSCLC patients. The postoperative perceived stress and quality of life scores of elderly NSCLC patients with different FCR were compared, the correlation between postoperative FCR and perceived stress and quality of life in elderly NSCLC patients were analyzed, as well as the model fitting index of the influence of postoperative perceived stress and quality of life on FCR in elderly NSCLC patients. Results: The postoperative CPSS score in elderly NSCLC patients was (52.17±4.02) points, the FACT-L score was (80.39±4.56) points, and the total score of FoP-Q-SF was (31.16±8.69) points. Family relationship, economic burden of disease, chemotherapy and clinical stage were closely associated with the postoperative FCR in elderly NSCLC patients (P<0.05). The CPSS score in dysregulation group was higher than that in nondysregulation group, and the FACT-L score was lower than that in nondysregulation group (P<0.05). Pearson correlation analysis, postoperative FCR in elderly NSCLC patients was positively correlated with perceived stress, but negatively correlated with quality of life (P<0.05). The postoperative quality of life in elderly NSCLC patients was recorded as the independent variable, the postoperative perceived stress was recorded as the mediating variable, and the postoperative FCR was recorded as the dependent variable, a structural model of the mediating effect was routinely constructed. The results showed that the model fits well. Quality of life had a direct negative predictive effect on postoperative FCR in elderly NSCLC patients (P<0.05), and could affect FCR through postoperative perceived pressure (P<0.05), with the mediating effect accounting for 34.15% of the total effect. After repeatedly sampling the data using the Bootstrap method and implementing the mediating effect, the 95%CI of each model path did not include 0, indicating that the difference in the mediating effect was statistically significant (P<0.05). Conclusion: Postoperative FCR in elderly NSCLC patients is positively correlated with perceived stress, but negatively correlated with quality of life, clinically, monitoring such indicators can be considered to better evaluate the postoperative FCR in elderly NSCLC patients. |
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