年轻未婚女性乳腺癌根治术后患者应对方式对社会支持和自我形象的中介作用

目的: 探讨年轻未婚女性乳腺癌根治术后患者自我形象与应对方式和社会支持的相关关系,以及应对方式在社会支持和自我形象之间的中介作用。方法: 采用横断面调查方法,便利选取天津市某3所三级甲等医院155例年轻未婚女性乳腺癌根治术后患者为研究对象,采用应对方式问卷(SCSQ)、社会支持评定量表(SSRS)、乳腺癌自我形象量表(BIBCQ)和自行设计的一般资料调查表进行问卷调查。结果: 155例年轻未婚女性乳腺癌根治术后患者自我形象得分为（150.58±25.22）分;自我形象与积极应对方式和社会支持呈正相关（P<0.05）,与消极应对方式呈负相关（P<0.05）;结构方程模型分析表明,社会支持正向预测自我形象（β=-0.28,P<0.001）和积极应对方式（β=0.40,P<0.001）,积极应对方式正向预测自我形象（β=-0.14,P=0.019）,积极应对在社会支持与自我形象之间具有部分中介作用。结论: 年轻未婚女性乳腺癌根治术后患者自我形象水平较低,临床工作中应鼓励患者多采取积极应对方式,并为患者提供最大程度的全方位的社会支持,以期提高年轻未婚女性乳腺癌根治术后患者自我形象水平,提高其生活质量。

The mediating effect of coping styles between social support and self-image among unmarried young women after radical mastectomy

Objective: To explore the relationship among self-image, coping style and social support of unmarried young women after radical mastectomy. Methods: A cross-sectional survey was conducted to select 155 young unmarried women after radical mastectomy from three grade-A hospitals in Tianjin. The simplified coping style questionnaire(SCSQ), social support rating scale(SSRS), body image after breast cancer questionnaire (BIBCQ) and self-designed general information questionnaire were used. Results: The self-image score of 155 unmarried young women after radical mastectomy was 150.58±25.22. Self-image was positively correlated with positive coping and social support(P<0.05), and negatively correlated with negative coping（P<0.05）. Structural equation model analysis showed that social support significantly positively predicted self-image（β=-0.28, P<0.001）; social support and positive coping（β=0.40,P<0.001）; positive coping significantly positively predicted self-image(β=-0.14, P=0.019); active coping is a partial mediator between social support and self-image. Conclusion: The self-image level of unmarried young women after radical mastectomy was lower. In order to improve the self-image level and living quality of the patients, we should encourage them to take more positive coping strategies and provide full range of social support in clinical work.