国际口腔医学杂志

国际口腔医学杂志 ›› 2026, Vol. 53 ›› Issue (4): 545-553.doi: 10.7518/gjkq.2026225

• 论著 • 上一篇    

应对方式在口腔癌患者创伤后成长与癌症复发恐惧间的中介效应分析

张欣1(),袁梦1,岳玉凤1,段小燕2()   

  1. 1.重庆医科大学护理学院 重庆 400016
    2.重庆医科大学附属口腔医院 重庆 401147
  • 收稿日期:2024-12-04 修回日期:2025-11-25 出版日期:2026-07-01 发布日期:2026-06-25
  • 通讯作者: 段小燕
  • 作者简介:张欣，护师，硕士，Email：2511494331@qq.com

Mediating effect of coping strategies on post-traumatic growth and fear of cancer recurrence in individuals with oral cancer

Xin Zhang1(),Meng Yuan1,Yufeng Yue1,Xiaoyan Duan2()   

  1. 1.College of Nursing, Chongqing Medical University, Chongqing 400016, China
    2.Stomatological Hospital of Chong-qing Medical University, Chongqing 401147, China
  • Received:2024-12-04 Revised:2025-11-25 Online:2026-07-01 Published:2026-06-25
  • Contact: Xiaoyan Duan

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摘要：

目的 探讨口腔癌患者创伤后成长的现状，分析癌症复发恐惧、应对方式对创伤后成长的影响，为提高口腔癌患者创伤后成长水平提供依据。 方法 采用便利抽样法，于2023年9月—2024年4月从重庆市3所三级甲等医院招募255名口腔癌患者作为研究对象，使用创伤后成长评定量表、简易恐惧疾病进展量表、简易应对方式量表对口腔癌患者进行问卷调查。 结果 口腔癌患者的创伤后成长得分、癌症复发恐惧得分、积极应对方式得分和消极应对方式得分分别为56.88±18.69、32.55±9.77、19.86±9.82、8.72±6.76，创伤后成长与癌症复发恐惧、消极应对方式存在显著负相关（r=-0.646、-0.219，P<0.05），与积极应对方式呈显著正相关（r=0.482，P<0.05）。应对方式在癌症复发恐惧与创伤后成长之间起部分中介作用（P<0.05），中介效应值为0.132，占总效应的16.80%。 结论 口腔癌患者的创伤后成长水平有待提升，通过减轻癌症复发恐惧、倡导积极的应对方式，可以有效促进患者的创伤后成长。

关键词: 口腔癌, 创伤后成长, 癌症复发恐惧, 应对方式, 护理

Abstract:

Objective　This study aimed to investigate the current status of post-traumatic growth among patients with oral cancer and examine the influence of fear of cancer recurrence and coping mechanisms on post-traumatic development, providing a basis for improving post-traumatic growth in individuals with oral cancer. Methods　From September 2023 to April 2024, convenience sampling was used to select 255 patients with oral cancer from three hospitals in Chongqing for the study. This questionnaire survey was conducted utilizing the Post-traumatic Growth Inventory, the Fear of Progression Questionnaire-Short Form, and the Simplified Coping Style Questionnaire. Results　The overall scores for post-traumatic growth, fear of cancer recurrence, positive coping strategies, and negative coping strategies were 56.88±18.69, 32.55±9.77, 19.86±9.82, and 8.72±6.76, respectively. Post-traumatic growth was significantly negatively correlated with fear of cancer recurrence and negative coping strategies (r=-0.646, -0.219, P<0.05) but significantly positively correlated with positive coping strategies (r=0.482, P<0.05). The relationship between post-traumatic growth and fear of cancer recurrence was partially mediated by coping strategies, and the mediating effect was 0.132, which accounted for 16.79% of the total effect. Conclusion　Post-traumatic growth level among patients with oral cancer needs further improvement to reduce the fear of cancer recurrence. Encouraging patients to adopt positive coping strategies can enhance the degree of post-traumatic growth.

Key words: oral cancer, post-traumatic growth, fear of cancer recurrence, coping strategies, nursing

中图分类号: 

  • R473.78

表 1

调查对象的一般资料以及不同人口学和疾病特征的口腔癌患者创伤后成长得分比较"

项目分类例数/n（%）PTGI得分t/F值P值
性别男142（55.69）56.68±18.92-0.1870.852
女113（44.31）57.12±18.47
年龄/岁<409（3.5）53.33±23.230.8810.451
40~5996（37.6）55.20±18.17
60~79144（56.5）58.45±18.64
≥806（2.4）51.33±22.05
婚姻状况已婚191（74.90）58.32±18.451.7240.163
未婚18（7.06）50.89±18.43
离异21（8.24）52.38±20.28
丧偶25（9.80）53.48±18.54
工作状态无业或退休188（73.73）58.20±18.571.9000.060
在职67（26.27）53.14±18.66
居住地城镇170（66.67）58.79±18.132.3350.020*
农村85（33.33）53.05±19.30
受教育程度小学及以下68（26.67）58.84±19.303.2020.024*
初中75（29.41）54.43±19.24
高中/职高/中专79（30.98）58.60±18.97
大专及以上33（12.94）64.58±12.52
家庭月收入/元≤2 00045（17.65）50.93±18.662.8630.037*
2 001~5 00079（30.98）57.83±19.38
5 001~10 00088（34.51）56.42±18.99
>10 00043（16.86）62.28±15.29
宗教信仰无241（94.51）57.00±18.800.4450.657
有14（5.49）54.71±17.08
疾病分期Ⅰ期67（26.27）63.04±15.213.9670.009*
Ⅱ期87（34.12）55.86±19.54
Ⅲ期57（22.35）55.26±19.62
Ⅳ期44（17.25）51.59±18.70
复发情况否208（81.57）58.25±18.012.3020.025*
是47（18.43）50.79±20.52
治疗方式手术156（61.18）59.84±17.989.315<0.001*
手术＋放疗22（8.63）59.27±18.42
手术＋化疗28（10.98）58.64±18.69
手术＋放疗＋化疗39（15.29）41.43±14.43
化疗10（3.92）61.90±17.00
病程/月≤1104（40.78）57.89±18.821.0590.367
>1，≤669（27.06）57.09±18.66
>6，≤1250（19.61）52.88±18.87
>1232（12.55）59.38±17.95

表 2

创伤后成长、癌症复发恐惧、应对方式在口腔癌患者中的得分情况"

项目条目数得分均值
创伤后成长2056.88±18.69
癌症复发恐惧1232.55±9.77
积极应对方式1219.86±9.82
消极应对方式88.72±6.76

表 3

口腔癌患者创伤后成长与癌症复发恐惧、应对方式的相关性分析结果"

变量创伤后成长癌症复发恐惧积极应对方式消极应对方式
创伤后成长1———
癌症复发恐惧-0.646*1——
积极应对方式0.482*-0.455*1—
消极应对方式-0.219*0.199*0.1041

表 4

口腔癌患者创伤后成长的多元线性回归分析结果"

自变量非标准化系数

标准化系数

Beta值

t值P值VIF值
B值标准误
常数84.5987.602—11.129<0.001—
手术+放化疗治疗方式-9.3012.671-0.179-3.4820.0011.320
癌症复发恐惧得分-0.8960.103-0.467-8.725<0.0011.424
积极应对方式得分0.4340.1040.2284.178<0.0011.477
消极应对方式得分-0.3310.132-0.119-2.4980.0131.135

表 5

口腔癌患者创伤后成长路径分析结果"

路径标准路径系数非标准路径系数标准误临界比值P值
FCR→PTG-0.654-0.9030.121-7.457<0.001
积极应对→PTG0.2040.220.0713.1050.002
消极应对→PTG-0.142-0.1690.062-2.7260.006

表 6

Bootstrap中介效应检验"

参数估计值标准误95%CIP值效应占比/%
总效应-0.7860.050-0.879~-0.6830.000
直接效应
FCR→PTG-0.6540.088-0.828~-0.4770.00183.20
中介效应
FCR→积极应对→PTG-0.1060.045-0.201~-0.0230.01713.49
FCR→消极应对→PTG-0.0260.014-0.065~-0.0050.0143.31
总中介效应-0.1320.050-0.233~-0.0400.00816.80

图 1

口腔癌患者创伤后成长影响因素的结构方程模型"

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