【作者】 李兰；

【导师】 孙丽娟； 金丽花；

【作者基本信息】 延边大学 ， 护理（专业学位）， 2024， 硕士

【摘要】 目的:通过了解癌症化疗患者生命意义感、人文关怀体验、应对方式的现状,分析人文关怀体验、应对方式和生命意义感之间的相关性,明确生命意义感的影响因素,探讨应对方式在人文关怀体验和生命意义感之间的中介作用,以开发临床护理干预,提升癌症患者生命质量提供依据。方法:本研究采用便利抽样法,选取2023年2月～10月吉林省一所三级甲等综合医院肿瘤内科进行住院治疗的癌症化疗患者217例为研究对象,使用一般资料调查表、中文版慢性病患者人文关怀体验量表、简易应对方式问卷、中文版生命意义感量表等研究工具进行调查。使用SPSS 28.0对收集到的有效数据进行描述性分析独立样本t检验、单因素方差分析、Pearson相关分析、多元线性回归分析。运用AMOS 28.0构建结构方程模型并进行中介效应分析。结果:(1)癌症化疗患者生命意义感得分为43.35±10.85分,人文关怀体验得分为83.33±16.57分,应对方式得分为51.68±12.58分。(2)癌症化疗患者生命意义感在不同年龄、性别、文化程度、婚姻状况、职业状态、居住地、家庭人均月收入、医疗付费方式存在统计学差异(P<0.05)。(3)生命意义感与人文关怀体验呈正相关(r=0.431,P<0.05)、生命意义感与应对方式呈正相关(r=0.189,P<0.05),人文关怀体验与应对方式呈正相关(r=0.224,P<0.05)。(4)多元线性回归分析显示,年龄、性别、文化程度、职业状态、居住地、医疗付费方式、人文关怀体验、应对方式8个变量进入生命意义感的回归方程。可共同解释生命意义感的42.0%的变异量(F=14.478,P<0.01)。(5)结构方程模型结果显示,癌症化疗患者应对方式在人文关怀体验与生命意义感中起部分中介作用。人文关怀体验对生命意义感的总效应为0.534,直接效应为0.327,间接效应通过应对方式作为中介路径为0.207,中介效应占总效应的比例约为38.8%。结论:(1)癌症化疗患者生命意义感处于中等水平;人文关怀体验水平较低;应对方式主要以积极应对为主。(2)癌症化疗患者人文关怀体验水平越高,生命意义感越强;应对方式越积极,生命意义感越强;人文关怀体验水平越高,应对方式越好。(3)癌症化疗患者生命意义感的影响因素为:年龄、性别、文化程度、职业状态、居住地、医疗付费方式、人文关怀体验、应对方式。(4)癌症化疗患者人文关怀体验不仅可以直接影响生命意义感,也可以通过应对方式间接影响生命意义感。更多还原

【Abstract】 Objective:To understand the correlation between humanistic care experience,coping style and meaning in life,analyze the influencing factors of meaning in life,and explore the mediating effect of coping style between humanistic care experience and meaning in life through the investigation of the status quo of meaning in life of cancer patients undergoing chemotherapy,so as to provide a basis for developing clinical nursing intervention and improving the quality of life of cancer patients.Methods:From February 2023 to October 2023,convenience sampling was used to select217 cancer patients with chemotherapy who were hospitalized in the Department of Oncology of a tertiary care hospital in Jilin Province as the research object.The general information Questionnaire,Chinese Version of Humanistic Care Experience Scale for Cancer Patients,Simple Coping Style Questionnaire,Chinese version of Meaning in Life Scale and other research tools were used in the investigation.SPSS 28.0 was used for descriptive analysis of the collected effective data,independent sample t test,one-way analysis of variance,Pearson correlation analysis,and multiple linear regression analysis.AMOS 28.0was used to construct the structural equation model and analyze the mediating effect.P<0.05was considered statistically significant.Results:(1)The scores of meaning in life,humanistic care experience and coping style of cancer chemotherapy patients were 43.35±10.85,83.33±16.57 and 51.68±12.58 respectively.(2)There were statistical differences in the meaning in life of cancer chemotherapy patients with different ages,genders,education levels,marital status,occupational status,residence,family per capita monthly income,and medical payment methods(P<0.05).(3)The sense of meaning in life was positively correlated with humanistic care experience(r=0.431,P<0.05),the sense of meaning in life was positively correlated with coping style(r=0.189,P<0.05),and the humanistic care experience was positively correlated with coping style(r=0.224,P<0.05).(4)Multiple linear regression analysis showed that age,gender,education level,marital status,occupational status,residence,family per capita monthly income,medical payment party,humanistic care experience and coping style entered the regression equation of the sense of meaning in life.They could explain 42.0%of the variance of meaning in life(F=14.478,P<0.01).(5)The results of structural equation model showed that the coping style of cancer patients with chemotherapy played a partial mediating role in the humanistic care experience and the sense of meaning in life.The total effect of humanistic care experience on the sense of meaning in life was 0.534,the direct effect was 0.327,and the indirect effect through coping style as the mediating path was 0.207.The mediating effect accounted for about 38.8%of the total effect.Conclusion:(1)The meaning of life of cancer patients with chemotherapy is at a medium level.The level of humanistic care experience was low;The main coping style was positive coping.(2)The higher the level of humanistic care experience of cancer patients with chemotherapy,the stronger the sense of meaning in life;The better the coping style,the more positive the coping style,the stronger the sense of meaning in life.The higher the level of humanistic care experience,the better the coping style.(3)The influencing factors of meaning in life of cancer patients with chemotherapy were age,gender,education level,marital status,occupational status,residence,family monthly income per capita,medical payment method,humanistic care experience,and coping style.(4)The humanistic care experience of cancer chemotherapy patients can not only directly affect the sense of life meaning,but also indirectly affect the sense of life meaning through coping style.更多还原