| Objectives1.To investigate the status of psychological distress among patients with gynecological cancer and to analyze its influencing factors.2.To construct the result equation model of the influencing factors of psychological distress among patients with gynecological cancer.3.To explore the potential classification and characteristics of psychological distress among patients with gynecological cancer by latent class analysis.Methods1.Study on the current situation and influencing factors of psychological distress patients with gynecological cancerFrom March 2022 to December 2022,a questionnaire survey was conducted among 246 gy necological cancer patients who met the inclusion criteria in two public tertiary hospitals in Yangzhou City,Jiangsu Province by convenient sampling.General information questionnaire,10-item Kessler Psychological Distress Scale(K10),Brief Illness Perception Questionnaire(B-IPQ),Fear of Progression Questionnaire-Short Form(FoP-Q-SF),Medical Coping Modes Questionnaire(MCMQ)and Perceived Social Support Scale(PSSS)were used.Epidata 3.1 was used to input data,establish a database,and use SPSS 26.0 software for data analysis.Descriptive statistical methods were used.The count data were described by frequency(f)and percentage(%).The measurement data that met the normal distribution were described by mean plus-minus standard deviation.The measurement data that did not meet the normal distribution were expressed by median and quartile.T test,one-way analysis of variance,Pearson correlation analysis(measurement data with normal distribution),Spearman correlation analysis(measurement data with non-normal distribution)and multiple linear regression analysis were used to explore the effects of related influencing factors on the psychological distress of gynecological cancer patients.2.Construction of structural equation model of influencing factors of psychological distress patients with gynecological cancerBased on the results of the first part,SPSS 26.0 software and AMOS 24.0 software were used to construct the structural equation model of the influencing factors of psychological distress patients with gynecological cancer.The results of correlation analysis showed that there was a significant correlation between psychological distress,illness perception,fear of recurrence,coping style and social support.AMOS 24.0 software was used to construct the structural equation model of the influencing factors of psychological distress patients with gynecological cancer,and the maximum likelihood method was used to estimate the parameters of the model fitting,and the model was adjusted according to the correction index of the model.The 95%confidence interval(CI)was corrected by performing the Bootstrap Bias-corrected Method 5000 times and the mediating effect between the relevant variables was tested.The criteria for statistically significant results were P≤0.05,and the upper and lower limits of 95%CI corrected by Bootstrap did not include 0.3.The potential classification and characteristics of psychological distress patients with gynecological cancerBased on the results of the first two parts,MPLUS 8.7 software was used to analyze the heterogeneity of psychological distress patients with gynecological cancer.To explore the potential classification and characteristics of psychological distress patients with gynecological cancer.Results1.Study on the current situation and influencing factors of psychological distress patients with gynecological cancerThe average score of psychological distress patients with gynecological cancer was 23.67±7.58.The psychological distress of gynecological cancer patients was statistically significant in different pathological diagnosis,cancer stage,operation,surgical methods,chemotherapy course,age,education level,working status and family average monthly income(t/F/H=4.156,9.311,3.091,11.640,14.005,3.145,3.851,4.589,19.045,P<0.05).The psychological distress of gynecological cancer patients was positively correlated with illness perception-patient emotion,fear of recurrence,fear of recurrence-social family,fear of recurrence-physical health and coping style-yield(r=0.458,0.364,0.449,0.231,0.467,P<0.05).It was significantly negatively correlated with illness perception-disease understanding,coping style,coping style-face,coping style-avoidance,social support,social support-friend support and social support-other support(r=-0.291,-0.200,-0.368,-0.188,-0.458,-0.499,-0.487,P<0.05).Multiple linear regression analysis showed that fear of cancer recurrence(β=0.265),social support(β=-0.268),coping style(β=-0.253),disease diagnosis(β=-0.119)and cancer stage(β=-0.170)entered the regression equation,explaining 34.4%of the total variation.2.Construction of structural equation model of influencing factors of psychological distress patients with gynecological cancerThe fitting results of the modified model are good:χ2=51.642,df=18,NC=2.869,GFI=0.949,AGFI=0.905,NFI=0.936,RFI=0.901,IFI=0.958,TLI=0.933,RMSEA=0.067.The direct effect of illness perception on psychological distress was significant,with an effect size of 2.073,accounting for 79.1%of the total effect.Illness perception can also indirectly affect psychological distress through fear of recurrence,with an effect size of 0.44,accounting for 16.8%of the total effect.Secondly,illness perception can also indirectly affect psychological distress through social support,with an effect size of 0.107,accounting for 4.1%of the total effect.3.The potential classification and characteristics of psychological distress patients with gynecological cancerThe psychological distress of gynecological cancer patients can be divided into three potential categories:high psychological distress group(106,43.1%),moderate psychological distress group(83,33.7%)and low psychological distress group(57,23.2%).There were significant differences in disease diagnosis,cancer stage,surgical methods,age,education level,working status,family average monthly income,illness perception-disease cognition,illness perception-patient emotion,illness perception-disease understanding,fear of recurrence,fear of recurrence-social family,coping style-face,coping style-avoidance,coping style-yield,social support,social support-friend support and social support-other support(t/F/H=5.040,6.362,10.099,2.884,3.788,5.859,10.304,3.676,15.210,11.347,7.353,14.558,12.832,31.455,10.394,23.312,29.569,41.391,29.975).Conclusions1.The degree of psychological distress of gynecological cancer patients is generally high,and their mental health is poor.Patients with breast cancer,lower cancer stage,surgery,chemotherapy and in the I-III chemotherapy cycles,lower education level,resignation or suspension,and lower average monthly family income have higher psychological distress.Medical staff should pay attention to the degree of psychological pain of patients,contact the general demographic and disease-related data of patients,identify patients with higher degree of psychological pain as soon as possible,and alleviate the psychological pain of patients from controllable factors.2.The structural equation model of the influencing factors of psychological distress patients with gynecological cancer is well fitted.Illness perception can directly predict the psychological distress of patients,and can also indirectly affect the psychological distress of patients through fear of recurrence and social support.Medical staff should timely identify the patient’s fear of recurrence and the use of social support.Provide patients with disease-related knowledge guidance,timely assessment of the patient’s social support utilization,encourage patients to fully mobilize their internal and external social support resources,so as to obtain more psychological support to reduce the level of psychological distress.3.The psychological distress of gynecological cancer patients has significant heterogeneity,which can be divided into high psychological distress group,moderate psychological distress group and low psychological distress group.It is suggested that clinical medical staff should formulate targeted intervention measures according to the heterogeneity characteristics of patients while nursing patients. |
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