乳腺癌患者同伴教育者总体幸福感现状及影响因素研究

doi:10.3761/j.issn.0254-1769.2024.02.009

摘要/Abstract

摘要：

目的调查乳腺癌患者同伴教育者的总体幸福感现状并分析其影响因素。方法采用便利抽样法，于2023年1月—2月选取8所三级医院的210例乳腺癌患者同伴教育者作为调查对象，采用一般资料问卷、总体幸福感量表、心理韧性量表、社会支持评定量表进行调查，采用多重线性回归分析乳腺癌患者同伴教育者总体幸福感的影响因素。结果共回收206例乳腺癌患者同伴教育者资料，总体幸福感得分为（86.70±14.08）分；多重线性回归分析结果显示，心理韧性、对支持的利用度和目前每月治疗自费是总体幸福感的影响因素（P<0.001）。结论乳腺癌患者同伴教育者的总体幸福感水平较高，完善乳腺癌患者的社会支持系统，遴选心理韧性较强、善于利用社会支持和目前治疗自费金额低的同伴教育者，关注同伴教育者的心理状态，及时给予积极的心理干预，有助于有提高乳腺癌患者同伴教育者的总体幸福感，保障同伴教育的质量和可持续性。

关键词: 乳腺肿瘤, 同伴教育者, 总体幸福感, 心理韧性, 社会支持, 护理

Abstract:

Objective To investigate the general well-being of breast cancer peer educators and to analyze its influencing factors. Methods Convenience sampling method was used to select 210 breast cancer peer educators from 8 tertiary hospitals in China from January to February 2023. General information questionnaires，General Well-Being Scale，Cornor-Davidson Resilience Scale，and Social Support Rating Scale were used for investigation. Multiple linear regression analysis was used to explore the influencing factors of the general well-being in peer educators of breast cancer. Results A total of 206 breast cancer peer educators were investigated. The general well-being score was（86.70±14.08）. The results of multiple linear regression analysis showed that psychological resilience，the utilization of social support and the current self-funded treatment of less than 1，000 yuan per month were the influencing factors of general well-being（P<0.001）. Conclusion The general well-being of breast cancer peer educators is at a high level. Improving the social support system for breast cancer patients，selecting peer educators with strong psychological resilience，high utilization of social support and low self-funded treatment，and paying attention to the psychologic status of peer educators，providing timely and positive psychological interventions will help to raise the general well-being of breast cancer peer educators and ensure the quality and continuity of peer education.

Key words: Breast Neoplasms, Peer Educator, General Well-Being, Resilience, Social Support, Nursing Care

王悦, 刘飞, 朱丹, 王影新, 谷洪涛, 万巧琴. 乳腺癌患者同伴教育者总体幸福感现状及影响因素研究[J]. 中华护理杂志, 2024, 59(2): 191-196.

WANG Yue, LIU Fei, ZHU Dan, WANG Yingxin, GU Hongtao, WAN Qiaoqin. General well-being and its influencing factors in peer educators of breast cancer[J]. Chinese Journal of Nursing, 2024, 59(2): 191-196.

图/表 4

表1 乳腺癌患者同伴教育者总体幸福感得分的单因素分析（n=206）

Table 1 Univariate analysis of general well-being scores in breast cancer peer educators（n=206）

表2 乳腺癌患者同伴教育者的心理韧性量表得分、社会支持评定量表得分与总体幸福感量表得分的相关分析（n=206）

Table 2 Correlation analysis between the scores of psychological resilience， social support and general well-being of breast cancer peer educators（n=206）

表3 自变量赋值

Table 3 Assignment of independent variables

表4 乳腺癌患者同伴教育者总体幸福感的多重线性回归分析（n=206）

Table 4 Multiple linear regression analysis of general well-being in breast cancer peer educators（n=206）

参考文献 23

[1]	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3):209-249. DOI URL
[2]	Hu J, Wang X, Guo S, et al. Peer support interventions for breast cancer patients:a systematic review[J]. Breast Cancer Res Treat, 2019, 174(2):325-341. DOI
[3]	Tan Y, Qin M, Liao B, et al. Effectiveness of peer support on quality of life and anxiety in breast cancer patients:a systematic review and meta-analysis[J]. Breast Care(Basel), 2023, 18(1):49-59.
[4]	吴媛, 张玉玺, 王楠楠, 等. 乳腺癌患者参与同伴支持体验质性研究的Meta整合[J]. 中华护理杂志, 2023, 58(7):800-808. DOI
	Wu Y, Zhang YX, Wang NN, et al. Meta-synthesis of qualitative research on the experience of peer support for breast cancer patients[J]. Chin J Nurs, 2023, 58(7):800-808. DOI
[5]	Rebeiro GK, LaCarte S, Calixte S. Authentic peer support work:challenges and opportunities for an evolving occupation[J]. J Ment Health, 2016, 25(1):78-86. DOI PMID
[6]	Mirrielees JA, Breckheimer KR, White TA, et al. Breast cancer survivor advocacy at a university hospital:development of a peer support program with evaluation by patients,advocates,and clinicians[J]. J Cancer Educ, 2017, 32(1):97-104. DOI PMID
[7]	邹莹, 陈达英, 梁瑞晨, 等. 正念在乳腺癌患者婚姻质量和主观幸福感间的中介作用[J]. 重庆医学, 2022, 51(20):3487-3492.
	Zou Y, Chen DY, Liang RC, et al. Mediating role of mindful-ness between marital quality and subjective well-being in pa-tients with breast cancer[J]. Chongqing Med, 2022, 51(20):3487-3492.
[8]	刘宇, 余一彤, 史铁英, 等. 癌症患者主观幸福感的研究进展[J]. 护理学杂志, 2019, 34(16):110-112.
	Liu Y, Yu YT, Shi TY, et al. Subjective well-being among cancer patients:a literature review[J]. J Nurs Sci, 2019, 34(16):110-112.
[9]	Kowitt SD, Ellis KR, Carlisle V, et al. Peer support opportunities across the cancer care continuum:a systematic scoping review of recent peer-reviewed literature[J]. Support Care Can-cer, 2019, 27(1):97-108.
[10]	国家卫生健康委. 国家卫生健康委办公厅关于印发肿瘤和血液病相关病种诊疗指南(2022年版)的通知[EB/OL]. (2022-04-11)[2022-05-10]. http://www.nhc.gov.cn/yzygj/s2911/202204/a0e67177df1f439898683e1333957c74.shtml.
	National Health Commission of the People’s Republic of China. Circular of the general office of the national health commission on issuing the diagnosis and treatment guidelines for tumors and hematological diseases(2022 edition)[EB/OL].(2022-04-11)[2022-05-10]. http://www.nhc.gov.cn/yzygj/s2911/202204/a0e67177df1f439898683e1333957c74.shtml.
[11]	章雅青, 王志稳. 护理研究[M]. 2版. 北京: 北京大学医学出版社, 2016:168-172.
	Zhang YQ, Wang ZW. Nursing research[M]. 2nd ed. Beijing: Pek-ing University Medical Press, 2016:168-172.
[12]	Fazio AF. A concurrent validational study of the NCHS Gen-eral Well-Being Schedule[J]. Vital Health Stat 2, 1977(73):1-53. PMID
[13]	段建华. 总体幸福感量表在我国大学生中的试用结果与分析[J]. 中国临床心理学杂志, 1996(1):56-57.
	Duan JH. The trial results and analysis of the General Well-Being Scale in Chinese college students[J]. Chin J Clin Psychol, 1996(1):56-57.
[14]	汪向东, 王希林, 马弘. 心理卫生评定量表手册[M]. 北京: 中国心理卫生杂志社, 1999:83-86.
	Wang XD, Wang XL, Ma H. Manual of mental health rating scale[M]. Beijing: Chin J Mental Health, 1999:83-86.
[15]	Campbell-Sills L, Stein MB. Psychometric analysis and refinement of the Connor-Davidson Resilience Scale(CD-RISC):validation of a 10-item measure of resilience[J]. J Trauma Stress, 2007, 20(6):1019-1028. DOI PMID
[16]	叶增杰, 阮小丽, 曾珍, 等. 中文版10条目心理韧性量表在护生群体中的信效度分析[J]. 护理学报, 2016, 23(21):9-13.
	Ye ZJ, Ruan XL, Zeng Z, et al. Psychometric properties of 10-item Connor-Davidson Resilience Scale among nursing students[J]. J Nurs, 2016, 23(21):9-13.
[17]	肖水源. 《社会支持评定量表》的理论基础与研究应用[J]. 临床精神医学杂志, 1994(2):98-100.
	Xiao SY. The theoretical basis and research application of Social Support Rating Scale[J]. J Clin Mental Med, 1994(2):98-100.
[18]	Mollica MA, Nemeth LS, Newman SD, et al. Peer navigation in African American breast cancer survivors[J]. Patient Relat Outcome Meas, 2014, 5:131-144. DOI PMID
[19]	Chudzicka-Czupała A, Zalewska-Łunkiewicz K. Subjective well-being,general self-efficacy and coping with stress in former psychiatric patients preparing for the peer support role:an ex-ploratory study[J]. Health Qual Life Outcomes, 2020, 18(1):98. DOI
[20]	师雅杰, 刘宇, 史铁英. 乳腺癌患者同伴支持研究进展[J]. 中华现代护理杂志, 2020, 26(11):1532-1536.
	Shi YJ, Liu Y, Shi TY. Research progress of peer support for breast cancer patients[J]. Chin J Mod Nurs, 2020, 26(11):1532-1536.
[21]	张晨. 乳腺癌术后患者医疗社会支持与主观幸福感的相关性研究[D]. 咸阳: 陕西中医药大学, 2020.
	Zhang C. The correlation between medical social support and subjective well-being in patients with breast cancer after surgery[D]. Xianyang: Shaanxi University of Chinese Medici-ne, 2020.
[22]	张璠, 孟鑫, 叶萍. 乳腺癌患者心理弹性及影响因素的研究[J]. 中华护理杂志, 2015, 50(9):1087-1090.
	Zhang P, Meng X, Ye P. Survey of resilience and its influencing factors among breast cancer patients[J]. Chin J Nurs, 2015, 50(9):1087-1090.
[23]	McDonough MH, Sabiston CM, Wrosch C. Predicting changes in posttraumatic growth and subjective well-being among breast cancer survivors:the role of social support and stress[J]. Psychooncology, 2014, 23(1):114-120. DOI PMID