自我表露在乳腺癌幸存者病耻感和孤独感间的中介效应

目的：基于社会渗透理论探讨乳腺癌幸存者自我表露在病耻感和孤独感之间的中介作用，为开展干预计划提供理论支持。方法：采用便利抽样法，选取2021年10月至2022年4月在蚌埠医学院第一附属医院完成基本治疗进入随访阶段的220例乳腺癌幸存者为研究对象。采用一般资料调查表、社会影响量表(SIS)、痛苦表露指数(DDI)量表、孤独感量表(UCLA-8)进行问卷调查，分析各变量间的相关性，检验自我表露的中介效应。结果：乳腺癌幸存者平均得分SIS(63.24±7.28)分、DDI(38.28±8.76)分、UCLA-8(18.59±4.37)分。病耻感与孤独感呈正相关关系(r=0.595,P<0.01),自我表露与病耻感和孤独感呈负相关关系(r=-0.405、-0.487,P<0.01);自我表露在病耻感和孤独感间存在部分中介作用，中介效应量为21%。结论：孤独感在乳腺癌幸存者中普遍存在，自我表露和病耻感与其息息相关，医护人员应联合家庭、社会资源实施针对性措施，减轻患者病耻感、促进自我表露，以降低孤独感，提升整体生活质量。

Mediating effect of self-disclosure between stigma and loneliness in breast cancer survivors

ObjectiveTo explore the mediating effect of self-disclosure between stigma and loneliness in breast cancer survivors based on the theory of social penetration, and provide theoretical support for carrying out intervention plan.MethodsA total of 220 breast cancer survivors who meeting criteria in the First Affiliated Hospital of Bengbu Medical College from November 2021 to April 2022 were selected as research subjects by convenience sampling method.The general data questionnaire, social impact scale (SIS), distress disclosure (DDI) index and loneliness scale (UCLA-8) were used to conduct a questionnaire survey, the correlation between various variables was analyzed, and the mediating effect of self-disclosure was tested.ResultsThe score of SIS, DDI and UCLA-8 of breast cancer survivors were 63.24±7.28, 38.28±8.76 and 18.59±4.37 points, respectively.Stigma was positively correlated with loneliness (r=0.595, P < 0.01), and self-disclosure was negatively correlated with stigma and loneliness (r=-0.405, -0.487, P < 0.01).Self-disclosure had some mediating effect between the stigma and loneliness, and the amount of mediating effect was 21%.ConclusionsLoneliness is common among breast cancer survivors, and self-disclosure and stigma are closely related to it.Medical staff should cooperate with family and social resources to take measures to reduce stigma and promote self-disclosure, so as to reduce loneliness and improve the overall quality of life.