Research On Correlation Among Family Care,Rumination And Post-traumatic Growth In Breast Cancer Patients

Objective:To understand the status quo of family care,rumination,and post-traumatic growth of breast cancer patients,analyze the correlation between them,explore the influencing factors of post-traumatic growth of breast cancer patients,and further test the mediating effect of rumination on family care and post-traumatic growth.We were taking family care and rumination as the starting point,exploring the feasible ways to improve the posttraumatic growth of breast cancer patients,putting forward reasonable suggestions and measures to improve the mental health of breast cancer patients,and discussing and solving the related psychological problems of breast cancer patients after trauma.Methods:Using the cross-sectional survey method,230 breast cancer patients who met the inclusion and exclusion criteria in the breast department of three Grade A hospitals in Jinan City were selected as research objects by convenient sampling from February 2022 to July2022.The survey used the general information questionnaire,the family APGAR index,the Chinese version of the event related ruminations inventory,and the Chinese version of the post-traumatic growth inventory.SPSS21.0 and AMOS24.0 were used to establish the database and conduct statistical analysis.In descriptive analysis,frequency and percentage were used to analyze the general demographic data of breast cancer patients;The scores of family care,rumination and post-traumatic growth of breast cancer patients were analyzed by means of mean ± standard deviation,frequency and percentage;The independent sample T-test and one-way analysis of variance were used to examine whether there were significant differences in the effects of general demographic data on post-traumatic growth of breast cancer patients;Pearson correlation analysis was used to analyze the relationship between the post-traumatic growth of breast cancer patients and family care,rumination;With the post-traumatic growth of breast cancer patients as the dependent variable,and the general demographic data,family care and rumination as the independent variable,a multiple linear regression analysis was conducted;Finally,using AMOS 24.0 to construct SEM structural equation,further explore and verify the relationship between family care,rumination and post-traumatic growth,and use Bootstrap method to analyze the intermediary role of rumination.Results:1.The total score of post-traumatic growth of patients with breast cancer is(56.78 ±16.27),which is at the middle level.The average score of the total items is(2.84 ± 0.81).The scores of the five dimensions from high to low are personal strength(3.37 ± 0.95),life perception(3.28 ± 0.86),relationship with others(3.13 ± 1.10),self-transformation(2.35 ±1.07),and new possibility(2.05 ± 1.06);The total average score of family care is(6.68 ±2.02),and the family function is moderately impaired.The scores of each dimension from high to low are intimacy(1.48 ± 0.53),fitness(1.41 ± 0.58),growth(1.34 ± 0.57),cooperation(1.23 ± 0.62),and emotion(1.22 ± 0.64).The total average score of rumination in breast cancer patients was(28.19 ± 6.38)points,of which the score of intrusive rumination was(12.11 ± 3.55)points,and the score of purposeful rumination was(16.08 ± 6.41)points.2.Pearson correlation analysis showed that the total score and each dimension of the post-traumatic growth level of breast cancer patients were significantly positively correlated with the total score and each dimension of family care(P<0.05);The total score and dimensions of post-traumatic growth were significantly positively correlated with the total score of rumination and the total score of purposeful rumination,but negatively correlated with the total score of intrusive rumination(P<0.05);The total score of rumination and purposeful rumination were significantly positively correlated with the total score of family care,but negatively correlated with the total score of intrusive rumination(P<0.05).3.The results of the independent sample t-test and one-way ANOVA showed that the family’s educational level,occupation,per capita monthly income,and personality characteristics of breast cancer patients were the influencing factors of the post-traumatic growth level of breast cancer patients(P<0.05).4.The multiple linear stepwise regression analysis results showed that the educational level,personality characteristics,time of disease diagnosis,family care,intrusive rumination,and rumination predicted post-traumatic growth in breast cancer patients(P<0.05),which together explained 72.5% of the variance.5.The structural equation model is constructed with rumination as the intermediary variable.The fitness index CMIN/DF=1.672(<3),GFI=0.942(>0.9),AGFI=0.911(>0.9),NFI=0.934(>0.9),CFI=0.972(>0.9),IFI=0.972(>0.9),RMSEA=0.055(<0.08).The 95% confidence interval of indirect effect 1(family care → intrusive rumination → post-traumatic growth)obtained by the Bootstrap method is(0.011,0.103).The 95% confidence interval of indirect effect 2(family care → purposeful rumination →post-traumatic growth)is(0.192,0.539),and the 95% confidence interval of direct effect is(0.180,0.725).The standardized direct effect value of family care directly predicting posttraumatic growth is 0.428.Rumination uses intrusive rumination and purposeful rumination as intermediary variables to have an indirect impact on post-traumatic growth.The total indirect effect value is(-0.440 *-0.118)+(0.787 * 0.467)≈ 0.419,of which the effect value of indirect effect 1 is 0.052,and the practical value of indirect effect 2 is 0.367,The total effect value of family care on post-traumatic growth was0.052+0.367+0.428=0.847.The intermediary effect accounted for 49.47% of the total effect,of which intrusive rumination accounted for 6.14% and purposeful rumination accounted for 43.33%.Conclusion:1.Breast cancer patients had moderate post-traumatic growth,with the highest personal strength score and the lowest new possibility score in the average score of all dimensions.There are differences in the level of post-traumatic growth of breast cancer patients with different individual characteristics.Education level and personality characteristics and time of diagnosis of disease are significant predictors of individual posttraumatic growth level.2.Breast cancer patients have moderate family care and rumination,among which family care was above the medium level and rumination was below the medium level.There is a significant correlation between family care,rumination,and post-traumatic growth.Family care and rumination are essential predictors of post-traumatic growth.3.Rumination plays a part in the intermediary effect between family care and posttraumatic growth through invasive rumination and purposeful ruminant meditation.Family care can directly affect the post-traumatic growth level or indirectly affect the posttraumatic growth level through rumination.