The Relationship Among Coping Style, Hope And Quality Of Life In The Pituitary Tumor Patients After Surgery

Objective To investigate the coping style, the level ofhope and quality of life in pituitary tumor patients who were received surgery. To analysis the relationship among the coping style,hope and quality of life, and to build a structural equation model among these factors,thus giving evidence for imporving quality of life,using the correct response and improving the level of hope in the pituitary tumor patients after surgery.Methods:409 pituitary tumor after surgery(postoperative time> 3 months) of patients from the First Affiliated Hospital of Soochow University, between January 2010 to September 2014 were enrolled in our research.The questionnaires contained demographic information sheet, The Medical Outcomes study 36-Item Short-Form Health survey,(SF-36).Medical Coping Modes Questionnaire(MCMQ), Herth Hope Index(HHI),409 valid questionnaires were finalized.Using SPSS17.0 statistical software packages and AMOS17.0 analyzed statistical data,using descriptive statistics, analysis of variance, correlation analysis, multiple linear regression analysis and structural equation modeling analysis.Results:1.A total of 550 questionnaires were returned of 438 copies, the recovery was79.36%, of which 29 unified option or not complete answer a questionnaire is considered invalid, finally received 409 valid questionnaires, the effective rate was 93.38%.2. Postoperative quality of life scores in patients with pituitary tumors, eight dimensions of the SF-36 scale score were(84.59±11.69),(33.44±12.33),(43.97± 10.90),(45.53±12.29),(53.64±11.45),(57.97±18.13),(41.73±17.86),(53.57±11.40).Compare d with the norm, 8 scores were lower than the norm, with a statistically significant difference(P <0.05).SF-36 scores in the physiological field and psychological fields were(51.84 ± 10.75),(51.65 ± 12.40), they were both lower than the national norm reference value, the difference was statistically significant(P <0.05).3.Univariate analysis of variance showed:Different ages and level of education, different occupations, different marital status, different living conditions, different reproductive status, blood sugar and the electrolyte within six months after surgery is abnormal or not, if there is underlying disease, whether readmissions, surgical approach, pituitary tumor type and pituitary tumor size affecting the quality of life of each dimension, the difference was statistically significant(P <0.05).4. Multiple linear regression analysis showed : Age, educational level, marital status(widowed), fertility status, pituitary tumor size, type of pituitary tumor(ACTH), type of surgical(Frontal lobe Craniotomysurgery), blood glucose, electrolytes(during hospitalization or discharge within six months) is abnormal and readmission are the factors of QOL.5. Pearson correlation analysis showed:(1) Confrontation scores had positive correlationwith 6 dimensions(Physical Functioning, Role Physical, Bodily Pain, Vitality, Social Functioning, Role Emotional)of quality of life(r=0.236; r=0.255; r=0.194; r=0.187; r=0.286; r=0.178,Pvalues all<0.01);Avoidancescores had positive correlationwith 3 dimensions(Physical Functioning, Role Physical, Vitality)of quality of life( r=0.141; r=0.124; r=0.110, Pvalues all <0.05),Avoidancescores had negative correlation with Mental Health dimension of quality of life(r=-0.150, P<0.05); Resignationscores had negative correlation with all dimensions of quality of life.(r=-0.346; r=-0.395; r=-0.320; r=-0.377; r=-0.272; r=-0.356; r=-0.246; r=-0.298,Pvalues all<0.01).(2) Hope score had positive correlationwith 6 dimensions(Physical Functioning, Bodily Pain, General Health, Social Functioning, Role Emotional, Mental Health)of quality of life, the difference was statistically significant(r=0.218;r=0.132;r=0.164;r=0.107;r=0.118;r=0.162;Pvalues all<0.05).(3) Confrontation scores had positive correlation with avoidance scores(r=0.231,P<0.05),had negative correlation with resignation scores(r=-0.201,P<0.05),had positive correlationwith hope score(r=0.137,P<0.05);Avoidance scoreshad negative correlation with resignation scores(r=-0.097,P<0.05);Resignationscores had negative correlation with hope score(r=-0.143,P<0.05).8 dimensions scores of quality of life had correlation with each other(Pvalues all<0.05)6.Structural equation modeling analysis showed:Structural equation of the Fit Index respectively: χ2 / df = 2.228; GFI = 0.952; AGFI = 0.924; RMSEA = 0.056; NFI = 0.908; IFI = 0.946; CFI = 0.945.Confrontation scores have positive effect with the level of hope(β = 0.053, P <0.01),Confrontation scores have direct positive effect with quality of life(β = 0.491, P <0.01);Resignation scores have direct negative effect with the level of hope(β =-0.049, P <0.05),Resignation scores have direct negative effect with quality of life(β =-1.456, P <0.01);The level of hope have direct positive effect with quality of life(β = 1.512, P <0.01).Conclusion1. Age, educational level, marital status(widowed), fertility status, pituitary tumor size, type of pituitary tumor(ACTH), type of surgical(Frontal lobe Craniotomysurgery), blood glucose, electrolytes(during hospitalization or discharge within six months) is abnormal and readmission are the factors of the quality of life in patients with pituitary tumors.2. Confrontation scores and avoidance scores had positive correlation with the scores of quality of life; Resignation scores had negative correlation with the scores of quality of life. Hope score had positive correlationwith the scores of quality of life.Confrontation scores had positive correlationwith avoidancescores, Confrontation scores had negative correlation with resignationscores, Confrontation scores had positive correlationwith hope scores.Avoidancescores had negative correlation with resignation scores. Resignation scores had negative correlation with hope score.3. The level of hope can directly affect the quality of life.Confrontation scores may directly or indirectly affect the quality of life through the hope; Resignation scores may directly or indirectly affect the quality of life through the hope. Therefore, the level of hope both the direct variable and mediating variables.