肺癌患者失志综合征相关因素的计算机模拟网络分析及护理启示

doi:10.3761/j.issn.0254-1769.2026.17.014

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (17): 2404-2410.DOI: 10.3761/j.issn.0254-1769.2026.17.014

肺癌患者失志综合征相关因素的计算机模拟网络分析及护理启示

陈琳琳¹(), 林以扬², 罗文婷³, 陈付红⁴^,^*()

¹ 厦门大学附属第一医院健康管理中心厦门市 361000
² 福建医科大学护理学院福州市 350000
³ 厦门大学附属第一医院科研部厦门市 361000
⁴ 厦门大学附属第一医院护理部厦门市 361000

收稿日期:2026-03-29 出版日期:2026-09-10 发布日期:2026-09-03
*通讯作者: 陈付红，E-mail：1134007653@qq.com
作者简介:陈琳琳：女，硕士，副主任护师，护士长，E-mail：1046291322@qq.com
第一联系人：作者贡献声明
陈琳琳：研究设计、问卷调查、数据收集、论文撰写与修改；林以扬：统计学分析、数据整理；罗文婷：资料收集与分析、基金支持；陈付红：研究指导、论文审阅和修改
基金资助:
厦门市医疗卫生指导性项目(3502Z20244ZD1028)

Computer simulation network analysis of related factors of demoralization syndrome in lung cancer patients and nursing inspiration

CHEN Linlin¹(), LIN Yiyang², LUO Wenting³, CHEN Fuhong⁴^,^*()

¹ Health Management Center， the First Affiliated Hospital of Xiamen University， Xiamen 361000， China
² School of Nursing， Fujian Medical University， Fuzhou 350000， China
³ Research Department， the First Affiliated Hospital of Xiamen University， Xiamen 361000， China
⁴ Nursing Department， the First Affiliated Hospital of Xiamen University， Xiamen 361000， China

Received:2026-03-29 Online:2026-09-10 Published:2026-09-03
* Corresponding author: CHEN Fuhong，E-mail：1134007653@qq.com
Funding program:
Guiding Project of Xiamen Medical and Health Research(3502Z20244ZD1028)

摘要/Abstract

摘要：

目的构建肺癌患者失志综合征及心理弹性、应对方式与家庭关怀的网络关系模型，并识别核心节点、桥梁节点、潜在干预节点与预防节点，为临床实施相应干预提供参考。方法采用便利抽样方法，选取2024年12月—2025年10月，在厦门市某3所三级甲等综合医院胸外科、肿瘤科、呼吸科和放疗科就诊的471例肺癌患者为调查对象，采用一般资料调查表、中文简版失志综合征量表、医学应对方式问卷、家庭关怀度指数问卷、中文简版心理弹性量表进行调查。通过高斯图模型识别网络核心与桥梁节点，随后通过基于伊辛模型的计算机模拟网络分析识别出潜在干预节点与预防节点。结果最后共纳入460例肺癌患者。肺癌患者失志综合征得分为（8.62±7.33）分，医学应对中面对应对得分为（19.04±3.68）分、回避应对得分为（15.40±3.45）分、屈服应对得分为（9.60±3.30）分，家庭关怀得分为（8.67±1.99）分，心理弹性得分为（22.67±9.33）分。我容易觉得受到伤害是核心症状（强度中心性为2.187），屈服应对是桥梁症状（桥梁强度为0.804）。计算机模拟网络分析显示，我不再觉得能控制情绪是潜在干预节点，我宁愿不要活着是潜在预防节点。结论临床医护人员应优先关注患者的情绪易感性，建立自杀意念筛查机制，通过认知重评训练或正念减压疗法提升肺癌患者的情绪调节能力，并实施“筛查—评估—干预”闭环管理，阻断“无望—无价值—自杀意念”的恶性循环，为肺癌患者失志综合征的早期识别与精准护理提供参考。

关键词: 肺癌, 失志综合征, 网络分析, 计算机模拟, 肿瘤护理

Abstract:

Objective To construct a network model of demoralization syndrome，resilience，coping styles，and family care in lung cancer patients，and to identify core nodes，bridge nodes，potential intervention nodes，and prevention nodes，so as to provide references for clinical intervention. Methods A total of 471 lung cancer patients who visited the departments of thoracic surgery，oncology，respiratory medicine，and radiotherapy in 3 tertiary grade A general hospitals in Xiamen from December 2024 to October 2025 were selected by convenience sampling method. The Chinese Brief Demoralization Scale，Medical Coping Modes Questionnaire，Family Care Index，and Chinese Brief Resilience Scale were used for investigation. The Gaussian graphical model was used to identify core and bridge nodes in the network，and then computer simulation analysis based on the Ising model was conducted to identify potential intervention and preventions nodes. Results A total of 460 lung cancer patients were finally enrolled. The mean score of demoralization syndrome among lung cancer patients was（8.62±7.33）points，with confrontation coping at（19.04±3.68）points，avoidance coping at（15.40±3.45）points，and yielding coping at（9.60±3.30）points in medical coping modes. The family care score was （8.67±1.99）points，and the psychological resilience score was（22.67±9.33）points.“I am easily hurt” was the core symptom（strength centrality 2.187）. Resignation coping was the bridge symptom（bridge strength 0.804）. Computer simulation analysis showed that “I no longer feel in control of my emotions” was the potential intervention node，and “I would rather not be alive” was a potential prevention node. Conclusion Clinically，the priority should be given to patients’ emotional vulnerability，and a screening mechanism for suicidal ideation should be established. Emotional regulation ability should be improved through cognitive reappraisal training or mindfulness-based stress reduction（MBSR），and a closed-loop management of “screening-assessment-intervention” should be implemented to block the vicious cycle of “hopelessness-worthlessness-suicidal ideation”，so as to provide references for early identification and precise psychological nursing of demoralization syndrome in lung cancer patients.

Key words: Lung Cancer, Demoralization Syndrome, Network Analysis, Computer Simulation, Oncology Nursing

陈琳琳, 林以扬, 罗文婷, 陈付红. 肺癌患者失志综合征相关因素的计算机模拟网络分析及护理启示[J]. 中华护理杂志, 2026, 61(17): 2404-2410.

CHEN Linlin, LIN Yiyang, LUO Wenting, CHEN Fuhong. Computer simulation network analysis of related factors of demoralization syndrome in lung cancer patients and nursing inspiration[J]. Chinese Journal of Nursing, 2026, 61(17): 2404-2410.

图/表 4

表1 调查对象的一般资料（n=460）

Table 1 General data of the subjects（n=460）

图1 肺癌患者失志综合征及心理弹性、应对方式与家庭关怀的网络模型注：M1为面对应对，M2为回避应对，M3为屈服应对。A为家庭关怀。C为心理弹性。D1为我能提供给别人的价值很少；D2为我的人生似乎毫无意义；D3为我不再觉得能控制情绪；D4为没有人帮得了我；D5为我觉得无望；D6为我觉得烦躁；D7为我不能很好地应对生活； D8为我的人生有许多遗憾；D9为我容易觉得受到伤害；D10为我对发生在我身上的事感到痛苦； D11为我不是一个有用的人； D12为我宁愿不要活着； D13为我感到很孤独；D14为我觉得被发生在我身上的事困住。

Figure 1 Network model of demoralization syndrome and its associations with psychological resilience，coping style，and family care in lung cancer patients

表2 肺癌患者缓解性干预下各变量节点识别R算法效应值排序（降低症状激活）

Table 2 NIRA effect values for variables under allevia-ting interventions（symptom activation reduction）

表3 肺癌患者加重性干预下各变量节点识别R算法效应值排序（升高症状激活）

Table 3 NIRA effect values for variables under aggra-vating interventions（symptom activation increase）

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肺癌患者失志综合征相关因素的计算机模拟网络分析及护理启示

Computer simulation network analysis of related factors of demoralization syndrome in lung cancer patients and nursing inspiration

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