The Relationship Between Self-compassion And Subjective Well-being Among Patients With Gynecological Malignant Tumors And Its Mediating Mechanism

Objectives1.To investigate the status quo and main influencing factors of self-Compassion and subjective well-being in patients with gynecological malignant tumors,and to explore the interaction mechanism between each major influencing factor and self-compassion and subjective well-being.2.Qualitative research is used to deeply analyze the true subjective well-being experience of gynecological malignant tumor patients,further validating and enriching previous quantitative research.MethodsQuantitative research: A cross-sectional survey was conducted on 506 patients with gynecological malignant tumors in the gynecological wards and tumor wards of two tertiary hospitals in Henan Province from October 2021 to September 2022 using the General and Disease data questionnaire,the Self-Compassion Scale,the Cancer Self‐Perceived Discrimination Scale,the Impact of Event Scale Revised,and the Index of Well-being.Epidata 3.1 software was used for data entry,while SPSS 23.0 and Amos 22.0 software were used for statistical analysis.Descriptive analysis,single factor analysis,multiple stepwise regression analysis,Pearson correlation analysis were performed on the data using SPSS 23.0software.Amos 22.0 was used to construct a chain mediated effect model,and used the Bootstrap to test the mediating effect.Qualitative research: A face-to-face semi structured interview was conducted with 10 patients with gynecological malignant tumors who met the criteria.The interview data were collated and analyzed using Nvivo 11 software.Results1.Quantitative research(1)Descriptive analysis: The subjective well-being score of 506 patients with gynecological malignant tumors investigated in this study was(8.07±1.70),with the scores of general emotional index and life satisfaction being(4.03±0.31)and(4.05±1.69),respectively;The score of self-compassion was(78.67 ±16.49),with the scores of self-friendliness,self-criticism,universal humanity,sense of isolation,mindfulness,and excessive addiction being(15.26±4.14),(15.12±4.12),(12.05±3.32),(12.11±3.29),(12.17±3.43),and(11.96±3.25),respectively;The score of the patient’s sense of stigma was(55.02 ± 9.54),including a score of social withdrawal dimension of(27.32±5.22),a score of stigma dimension of(15.99±3.22),and a score of self-deprecation dimension of(11.71±2.44);The score of intrusive thoughts was(19.37 ± 7.05).(2)Analysis of demographic differences: The results of univariate analysis showed that there were significant differences in subjective well-being scores among patients with different age,marital status,residence,educational level,monthly income per capita,tumor stage,and chemotherapy frequency(<0.05).(3)Correlation analysis: Pearson correlation analysis results showed that there was a significant negative correlation between self-compassion,stigma,intrusive thoughts,and subjective well-being in patients with gynecological malignant tumors(=-0.446,<0.01;=-0.501,P<0.01),and a significant positive correlation with subjective well-being(=0.427,P<0.01);There was a significant positive correlation between stigma and intrusive thoughts(=0.495,P<0.01),and a significant negative correlation between stigma and subjective well-being(=-0.538,P<0.01);intrusive thoughts was negatively correlated with subjective well-being(=-0.554,P<0.01)(4)Multiple stepwise regression analysis: The main influencing factors of subjective well-being in patients with gynecological malignant tumors are age,educational level,marital status,self-compassion,stigma,and intrusive thoughts.(5)Mediating effect analysis: Self-compassion can not only directly affect the subjective well-being of patients with gynecological malignant tumors,but also indirectly affect subjective well-being through the mediating effect of stigma and intrusive thoughts,as well as chain mediating.Stigma has a mediating effect between self-compassion and subjective well-being,with the mediating effect accounting for 55.92%.intrusive thoughts has a mediating effect between Self-compassion and subjective well-being in patients,with the mediating effect accounting for 48.01%.Stigma and intrusive thoughts play a chain mediating role between self-compassion and subjective well-being,with the chain mediating effect accounting for 11.37%of the total effect.2.Qualitative researchThe interview data analyzed the true feelings of subjective well-being of patients with gynecological malignant tumors,and extracted 2 themes and 6 sub themes.The protective factors of subjective well-being include positive personality traits and family support;Harmful factors include symptoms of stigma,stigma affecting disease cognition,stigma affecting disease coping styles,and intrusive thought affecting inner beliefs.Conclusions1.The subjective well-being of gynecological malignant tumor patients is at a moderate to low level,and the main influencing factors are age,marital status,place of residence,educational level,per capita monthly income of the family,tumor staging,chemotherapy frequency,self-compassion,stigma,and intrusive thought.2.Patients with gynecological malignant tumors have a significant positive correlation between their subjective well-being and self-compassion,while a significant negative correlation is found between their sense of stigma and intrusive thought.3.Self-compassion,stigma,intrusive thoughts,age,marital status,and educational level are significant influencing factors on the subjective well-being of gynecological malignant tumor patients,and have a predictive effect on the subjective well-being of gynecological malignant tumor patients.4.The stigma plays a partial mediating role between self-compassion and subjective well-being in gynecological malignant tumor patients,while intrusive thought plays a partial mediating role between self-compassion and subjective well-being in gynecological malignant tumor patients.The sense of stigma and intrusive thought play a chain mediating role between self-compassion and subjective well-being.5.Qualitative research has found that patients with gynecological malignancies who have a high sense of stigma may have incorrect disease cognition,and may also adopt avoidance coping strategies,which can affect their subjective well-being;Patients with gynecological malignant tumors who have a high frequency of intrusive thought mainly affect their inner beliefs and hinder the improvement of subjective well-being.