Effect of Symptom Burden on Demoralization in Chinese Lung Cancer Patients: The Mediating Roles of Family Function, Resilience, and Coping Behaviors.

IF 3.3 2区医学 Q2 ONCOLOGY

Psycho‐Oncology Pub Date : 2025-02-01 DOI:10.1002/pon.70102

Chenxing Zhang, Fangfang Wang, Zhixuan Kang, Yuting Hong, Rachel Arbing, Wei-Ti Chen, Feifei Huang

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引用次数: 0

Abstract

Objective: This study aimed to elucidate the mechanisms by which symptom burden affects demoralization in Chinese lung cancer patients, with a focus on the roles of family functionality, resilience, and coping strategies. The study also explored differences in these pathways between two distinct demoralization categories.

Methods: A cross-sectional survey was conducted among 567 lung cancer patients who completed questionnaires assessing symptom burden, family functioning, resilience, coping strategies, and demoralization. Data were analyzed using partial least squares structural equation modeling (PLS-SEM), with multigroup structural equation modeling (MG-SEM) employed to compare pathways between the psychological distress-subjective incompetence group (PDSIG) and the low demoralization-emotional disturbance group (LDEDG).

Results: PLS-SEM analysis demonstrated a good model fit. Symptom burden (β = 0.26), confrontation coping (β = 0.11), and acceptance-resignation coping (β = 0.41) had positive direct effects on demoralization, whereas resilience (β = -0.19) and family function (β = -0.27) had negative direct effects. Additionally, family function, resilience, and acceptance-resignation coping mediated the relationship between symptom burden and demoralization. MG-SEM revealed that, in the PDSIG, symptom burden (β = 0.47) and family function (β = -0.46) had similarly strong impacts on demoralization, with stronger family function associated with lower demoralization. In contrast, resilience (β = -1.02) was the most significant factor in the LDEDG.

Conclusions: These findings highlight the importance of screening for demoralization, particularly among lung cancer patients with a high symptom burden, maladaptive resignation coping, family dysfunction, and low resilience. Effective strategies should focus on symptom management, family support, resilience building, and fostering positive coping mechanisms. Tailored interventions based on demoralization subtypes are essential to improve psychological well-being in this population.

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症状负担对中国肺癌患者士气低落的影响：家庭功能、心理韧性和应对行为的中介作用

目的：本研究旨在探讨症状负担对中国肺癌患者士气低落的影响机制，重点探讨家庭功能、心理韧性和应对策略的作用。该研究还探讨了两种不同的道德败坏类别之间这些途径的差异。方法：对567例肺癌患者进行横断面调查，这些患者完成了症状负担、家庭功能、恢复力、应对策略和士气低落的问卷调查。采用偏最小二乘结构方程模型（PLS-SEM）对数据进行分析，并采用多组结构方程模型（MG-SEM）比较心理困扰-主观无能组（PDSIG）和低士气低落-情绪障碍组（LDEDG）之间的通路。结果：PLS-SEM分析显示模型拟合良好。症状负担（β = 0.26）、对抗应对（β = 0.11）和接受-放弃应对（β = 0.41）对士气消沉有正的直接影响，而恢复力（β = -0.19）和家庭功能（β = -0.27）对士气消沉有负的直接影响。此外，家庭功能、心理韧性和接受-顺从应对在症状负担与士气低落之间起中介作用。MG-SEM显示，在PDSIG中，症状负担（β = 0.47）和家庭功能（β = -0.46）对士气低落有同样强烈的影响，家庭功能越强，士气低落程度越低。相比之下，弹性（β = -1.02）是LDEDG中最显著的因素。结论：这些发现强调了士气低落筛查的重要性，特别是在高症状负担、不适应辞职应对、家庭功能障碍和低恢复力的肺癌患者中。有效的策略应侧重于症状管理、家庭支持、恢复力建设和培养积极的应对机制。基于士气低落亚型的量身定制的干预措施对于改善这一人群的心理健康至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psycho‐Oncology 医学-心理学

CiteScore

6.30

自引率

8.30%

发文量

220

审稿时长

3-8 weeks

期刊介绍： Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues. Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.