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

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