Zhang Chen, Wang Jingjing, He Yunhui, Wang Kaili, Wang Chonghan, Zhang Luxiang, Wu Xiaofei, Liang Shuangquan, Wu Xiaoyan, Wei Yujie, Zhang Mingjie, Wang Wenjuan
School of Mental Health, Bengbu Medical University, Bengbu, 233030, Anhui, China.
Bengbu Medical University, Bengbu, 233030, Anhui, China.
Sci Rep. 2025 Jul 9;15(1):24727. doi: 10.1038/s41598-025-09908-w.
Previous studies have only established a strong association between depression and post-traumatic stress disorder in cancer patients, without clarifying the potential mechanisms underlying this relationship. This study examines the relationship between depression and PTSD(Post-Traumatic Stress Disorder) in cancer patients, focusing on the sequential mediation of hope and perceived social support. A cross-sectional study was conducted at oncology wards in an Anhui tertiary hospital between February-August 2024. The investigation employed four instruments: PTSD checklist-civilian version, self-rating depression scale, perceived social support scale, and herth hope index. Analysis included 192 cancer patients, after removing 8 invalid responses from 200 initial participants. Treating depression as the predictor variable in cancer patients revealed a robust association with PTSD symptoms. (β = 0.620, t = 10.904, p < 0 0.001, R = 0.385). A small indirect effect was observed in the association between depression and post-traumatic stress disorder in cancer patients. On one hand, perceived social support demonstrated a mediating effect between depression and PTSD (SE = 0.024, Z = 2.883, 95% CI [0.007, 0.101]). On the other hand, hope alone did not show a significant mediating effect (SE = 0.039, Z = -2.211, 95% CI [-0.148, 0.006]). However, the serial mediation model confirmed depression's impact on Post-traumatic stress disorder operated through sequential effects of hope and perceived social support (SE = 0.015, Z = 2.934, 95% CI [0.004, 0.064]).The proportion of the total effect mediated was approximately 3.13%. Depression significantly associates PTSD symptoms in cancer patients through the sequential mediation of hope and perceived social support. These findings suggest that integrated interventions targeting both hope enhancement within social contexts and social support improvement may be more effective than single-component approaches.
以往的研究仅证实了癌症患者抑郁与创伤后应激障碍之间存在密切关联,但未阐明这种关系背后的潜在机制。本研究探讨癌症患者抑郁与创伤后应激障碍(PTSD)之间的关系,重点关注希望和感知社会支持的顺序中介作用。2024年2月至8月期间,在安徽一家三级医院的肿瘤科病房进行了一项横断面研究。该调查使用了四种工具:PTSD检查表-平民版、自评抑郁量表、感知社会支持量表和赫思希望指数。分析纳入了192名癌症患者,这是在最初的200名参与者中剔除8份无效回复后得到的。将抑郁作为癌症患者的预测变量时,发现其与PTSD症状存在显著关联(β = 0.620,t = 10.904,p < 0.001,R = 0.385)。在癌症患者抑郁与创伤后应激障碍的关联中观察到一个较小的间接效应。一方面,感知社会支持在抑郁与PTSD之间起中介作用(SE = 0.024,Z = 2.883,95% CI [0.007, 0.101])。另一方面,单独的希望并未显示出显著的中介作用(SE = 0.039,Z = -2.211,95% CI [-0.148, 0.006])。然而,序列中介模型证实,抑郁对创伤后应激障碍的影响是通过希望和感知社会支持的顺序效应起作用的(SE = 0.015,Z = 2.934,95% CI [0.004, 0.064])。中介的总效应比例约为3.13%。抑郁通过希望和感知社会支持的顺序中介作用与癌症患者的PTSD症状显著相关。这些发现表明,针对社会背景下增强希望和改善社会支持的综合干预措施可能比单一成分的方法更有效。