| ObjectiveTo investigate the status of psychological distress among young adult cancer patients and to explore the chain mediating effects of social support and resilience on the relationship between psychological distress and health-related quality of life,which would provide a valuable approach to improving quality of life.MethodsThe present study used the convenience sampling method and recruited 322 young adult cancer patients from two 3A hospitals in Jinan,Shandong province from November 2020 to August 2021.The Distress Management Screening Measure(DMSM),Multidimensional Scale of Perceived Social Support(MSPSS).10-item version of the Connor-Davidson Resilience(CD-RISC-10),and 36-Item Short Form Survey(SF-36)were used to collect data.The database was established using Excel,and analyzed by SPSS21.0 and Process3.0.The Bootstrap method was used to test the mediation effect.Results337 questionnaires were distributed,and 322 valid questionnaires were collected,with response rates of 95.55%.The mean age of young adult cancer patients in this study was 34.35(SD=5.75)years.1.The mean score of the distress thermometer was 3.03(SD=2.22).According to the score of a distress thermometer larger than 4 indicating significant psychological distress,the prevalence of psychological distress among young adult cancer patients in this study was 34.16%(n=110).Patients with no psychological distress,mild,moderate,severe and very severe psychological distress were 31(9.63%),181(56.21%),87(27.02%),16(4.97%),and 7(2.17%),respectively.The top three psychological distress related problems of young adult cancer patients were practical:economic problems(49.69%),practical problems:lack of time and energy to take care of children(46.89%),and emotional problems:worry(44.10%).2.The results of the independent sample T-test analysis showed that the difference between the non-distress group and significant-distress group in eight dimensions of quality of life were significant,and scores of all dimensions in the significant-distress group were lower than those in the non-distress group.For physical health and mental health,the scores in the non-distress group were significantly higher than those in the significant-distress group.3.The results of one-way ANOVA showed that there were significant differences for physical health of young adult cancer patients in terms of working status,cancer types,and cancer stages.The results of one-way ANOVA showed that there were significant differences for mental health of young adult cancer patients in terms of gender and work status.There was no significant difference in terms of disease characteristics for mental health.4.Pearson correlation analysis showed that psychological distress was negatively significantly related to social support(r=-0.206,P<0.01),psychological resilience(r=-0.285,P<0.01),physical health(r=-0.420,P<0.01),and mental health(r=-0.491,P<0.01);social support was positively significantly related to resilience(r=0.451,P<0.01),physical health(r=0.124,P<0.05),and mental health(r=0.346,P<0.01);resilience was positively significantly related to physical health(r=0.304,P<0.01)and mental health(r=0.463,P<0.01).5.The results of the chain mediation model analysis showed that social support and resilience had a significant chain mediating effect on the relationship between psychological distress and physical health(indirect effect=-0.018,95%CI:-0.035,-0.006).Similarly,social support and resilience had a significant chain mediating effect on the relationship between psychological distress and mental health(indirect effect=-0.024,95%CI:-0.035,-0.006).Conclusion1.The incidence of psychological distress in young adult cancer patients is relatively high,and the quality of life of patients in the significant-distress group is worse.Therefore,more attentions should be paid to young adult cancer patients that have the significant psychological distress.2.The psychological distress of young adult cancer patients can not only directly effect the quality of life,but also indirectly effect the quality of life through the chain mediating effect of social support and resilience.Therefore,in order to improve the quality of life of young adult cancer patients,attention should be paid to the improvement of social support and resilience of patients when they have the significant psychological distress,so as to reduce the negative impact of psychological distress on the quality of life. |
