Yang Xuying, Bai Jingcui, Zhang Xiaohong
Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.
Outpatient, Second Hospital of Shanxi Medical University, Taiyuan, 030001, China.
BMC Psychiatry. 2025 Apr 2;25(1):322. doi: 10.1186/s12888-025-06635-4.
Immunotherapy has significantly improved the survival rates of lung cancer patients. However, prevalent adverse immune reactions associated with this treatment can detrimentally affect their quality of life. Coping strategies play a crucial role throughout the cancer treatment process. Consequently, this study hypothesised that coping strategies act as a mediating factor between symptom clusters and quality of life. This study intended to provide a theoretical foundation and empirical data to support the optimisation of coping strategies for lung cancer patients, thereby enhancing their overall quality of life.
This study consisted of a cross-sectional survey. Data were collected using the Memorial Symptom Assessment Scale, the Medical Coping Modes Questionnaire, the Quality of Life Questionnaire-Lung Cancer 43, and a self-designed General Information Evaluation Form. The data were fitted, and the model was refined using the maximum likelihood estimation method. Additionally, the Bootstrap method was employed to assess mediating effects.
In total, 240 participants completed the survey. During immunotherapy, lung cancer patients predominantly adopted the acceptance-resignation coping strategy, which served as a mediating factor between symptom clusters and quality of life. In contrast, the mediating effects of confrontation and avoidance coping strategies between symptom clusters and quality of life were not significant.
Both symptom clusters and the acceptance-resignation coping strategy negatively impacted quality of life, with acceptance-resignation serving as a mediating factor between symptom clusters and quality of life. Future research should focus on developing interventions for cognitive behaviour to improve coping strategies and quality of life throughout the disease trajectory.
免疫疗法显著提高了肺癌患者的生存率。然而,与这种治疗相关的普遍不良免疫反应会对他们的生活质量产生不利影响。应对策略在整个癌症治疗过程中起着至关重要的作用。因此,本研究假设应对策略是症状群与生活质量之间的中介因素。本研究旨在提供理论基础和实证数据,以支持优化肺癌患者的应对策略,从而提高他们的整体生活质量。
本研究采用横断面调查。使用 Memorial 症状评估量表、医学应对方式问卷、肺癌生活质量问卷 43 和自行设计的一般信息评估表收集数据。对数据进行拟合,并使用最大似然估计法对模型进行优化。此外,采用 Bootstrap 方法评估中介效应。
共有 240 名参与者完成了调查。在免疫治疗期间,肺癌患者主要采用接受-放弃应对策略,该策略是症状群与生活质量之间的中介因素。相比之下,对抗和回避应对策略在症状群与生活质量之间的中介效应不显著。
症状群和接受-放弃应对策略均对生活质量产生负面影响,接受-放弃应对策略是症状群与生活质量之间的中介因素。未来的研究应侧重于开发认知行为干预措施,以在疾病发展过程中改善应对策略和生活质量。