Study On The Relationship Between Cancer Pain Belief,Self-efficacy And Coping Strategies Of Elderly Cancer Patients At Home

PurposeTo clarify the current situation of cancer pain belief,self-efficacy and coping strategies of elderly cancer patients at home;the effects of general sociodemographic data,cancer pain belief and self-efficacy on coping strategies were analyzed;to study the relationship between coping strategies and cancer pain belief,self-efficacy of elderly cancer patients at home;to explore the mediating effect of self-efficacy of elderly cancer patients at home between coping strategies and cancer pain beliefs,in order to provide reference for pain management and coping of elderly cancer patients,and provide reference for clinical and home nursing.MethodUsing cross-sectional study,278 elderly patients with cancer pain,including lung cancer,colon cancer,gastric cancer,breast cancer,cholangiocarcinoma and pancreatic cancer,were selected for convenience sampling,from May 2020 to August 2021.All patients were discharged after hospitalization and recovered at home.SPSS22.0 software was used for statistical processing.The data related to population sociology and diseases were expressed by frequency and composition ratio.The scores of pain belief,self-efficacy and coping strategies were mean ± standard deviation(x±s).The coping strategies of sociological and disease-related data of different populations were analyzed by independent sample t-test and one-way ANOVA.Spearman correlation analysis was used to analyze the correlation between pain belief,self-efficacy and pain coping style.The influencing factors of pain coping were analyzed by multiple stepwise regression.The relationship between pain belief,self-efficacy and pain coping was analyzed by structural equation model with AMOS26.0.Results1.Status survey: The score of coping strategies was(56.42 ± 9.92).The scores of each dimension were: distraction(14.58 ± 5.72),sense of Doom(6.22 ± 3.04),ignoring pain(11.85 ± 3.36),avoiding pain(7.06 ± 2.76),facing bravely(7.65 ± 2.64)and praying(4.89 ± 2.25).The score of cancer pain belief of elderly cancer patients at home was 2(-7,9).Among them,the scores of perceived persistent pain were the highest 3(-5.5,4.5),and the scores of self blame and perceived pain as irresolvable were the lowest,respectively-2.5(-2,4),-2.5(-2.5,4).The score of self-efficacy was(48.95 ± 9.38).2.Influencing factors of pain coping strategies: the results of single factor analysis showed that there were significant differences for coping strategies in terms of age,education level,income level,whether they had received pain knowledge and the length of diagnosis(P<0.05).The results of multivariate analysis showed that self-efficacy,education level,whether to accept pain knowledge,family monthly income level,age and cancer pain belief were the main influencing factors of pain coping strategies.These factors could explain 31.2% of the variation of coping strategies scores of elderly home cancer patients.3.Correlation between cancer pain belief,self-efficacy and coping strategies: the coping strategies was negatively correlated with cancer pain belief,feeling pain mysterious,self blame,thinking pain can not be relieved and thinking it will last(P<0.01).The pain belief was negatively correlated with the dimensions of distraction,neglect of pain,avoidance of pain and brave face(P<0.01 or P<0.05).The coping strategies were positively correlated with the self-efficacy,pain management self-efficacy,physical function self-efficacy and symptom coping self-efficacy(P<0.01 or P<0.05).The self-efficacy was positively correlated with the dimensions of facing bravely,ignoring pain,avoiding pain and distraction(P<0.01 or P<0.05).4.The results of structural equation model analysis showed that the cancer pain belief(β=-0.383),self-efficacy(β=0.269)impacted coping strategies directly.Meanwhile,the cancer pain belief(β=-0.146)had an indirect impact on coping strategies with self-efficacy as the mediating variable.The total effect of cancer pain belief on coping strategies was β=-0.529,and the intermediary effect accounting for 27.60% of the total effect.Conclusion1.Elderly cancer patients at home had more positive coping strategies,the total score of pain belief was pessimistic,and their self-efficacy was at a medium low level.2.Self efficacy,educational level,whether they have received pain knowledge,family monthly income level,age and cancer pain belief were the main influencing factors of cancer pain coping strategies of elderly home cancer patients.3.Cancer pain belief,self-efficacy and coping strategies of elderly cancer patients at home were correlated.Cancer pain coping strategies were negatively correlated with cancer pain belief and positively correlated with self-efficacy.That was,higher cancer pain belief score,higher frequency of adopting negative coping strategies;higher self-efficacy score,higher frequency of adopting positive coping strategies.4.As an intermediate variable,self-efficacy of elderly cancer patients at home played an intermediary role in the relationship between cancer pain beliefs and coping strategies.In the pain management and intervention of elderly cancer patients at home,nurses or patients’ families could indirectly promote patients to adopt positive and effective pain coping strategies by reducing patients’ pessimistic cancer pain beliefs and improving self-efficacy.