The Relationship Among Social Support,Self-efficacy And Quality Of Life In Patients With Lung Cancer

Objective To investigate the status of quality of life(QOL)among patients with lung cancer,and to explore the relationships among social support,self-efficacy,and dimensions of QOL,to provide a empirical evidence for improving QOL in patients with lung cancer.Methods A convenience sampling of patients with lung cancer were enrolled from three tertiary hospitals in Jinan,Shandong Province.The Functional Assessment of Cancer Therapy-Lung(FACT-L),Social Support Rating Scale(SSRS),and Strategies Used by People to Promote Health(SUPPH)were used to assess QOL,social support,and self-efficacy,respectively.Data were analyzed using SPSS 22.0 software.The statistical methods included:descriptive statistics,independent sample t-test,one-way ANOVA,Pearson correlation,and multiple linear hierarchical regression analysis.Results1.Socio-demographic and clinical information among patients with lung cancer230 subjects completed the questionnaires.The average age of patients with lung cancer were 60.4(SD=9.6),ranging from 25 to 85.66.1%of patients were male,95.2%of patients were married.57.4%of patients received the junior school or below education,81.3%of patients had a normal BMI,92.2%of patients had medical insurance,49.1%of patients were farmers,36.5%patients received chemotherapy alone,52.6%patients had adenocarcinoma.The tumor stage accounting for 8.7%,19.6%,29.1%,and 42.6%ranging from Ⅰ to Ⅳ,respectively.2.Status of each dimension of QOL and its difference in socio-demographic and clinical informationThe average score of physical dimension was(17.68 ± 4,00),its item average score was(2.53 ± 0.57);the average score of family-social dimension was(20.74 ±3.77),its item average score was(2.96 ± 0.54);the average score of functional dimension was(11.08±4.55),its item average score was(1.58±0.65);the average score of emotional dimension was(14.01±3.89),its item average score was(2.34±0.65);the average score of dimension regarding specific symptom of lung cancer was(24.07± 4.80),its item average score was(2.67 ± 0.53).T-test and one-way ANOVA showed that patients with comobidities had a lower physical dimension score,functional dimension score,and emotional dimension’score than those without comorbidities(t=2.942,P=0.004;t=2.311,P=0.022;t=3.056,P=0.003).Divorced or widowed patients had a lower family-social dimension score than married patients(t=2.502,P=0.013).Patients with college or above education had a higher specific symptom dimension score than those w:ith other education levels(F=3.485,P=0.032).Patients with stage IV had a lower specific symptom dimension score than those with other tumor stage(F=7.922,P<0.001).3.Status of social support,self-efficacy and its correlations with each dimension of QOL among patients with lung cancerThe average score of social support was(37.73±4.03),ranging from 21 to 45;The average score of self-efficacy was(84.16±14.34),ranging from 30 to 137.Pearson correlation analysis indicated that social support was positively related to physical dimension(r=0.312,P<0.01),family-social dimension(r=0.259,P<0.01),functional dimension(r=0.322,P<0.01),emotional dimension(r=0.287,P<0.01),and specific symptom dimension(r=0.306,P<0.01).Self-efficacy was positively correlated with physical dimension(r=0.313,P<0.01),family-social dimension(r=0.269,P<0.01),functional dimension(r=0.336,P<0.01),emotional dimension(r=0.337,P<0.01),and specific symptom dimension(r=0.343,P<0.01).Social support was positively related to self-efficacy(r=0.402,P<0.01).4.The mediating effect of self-efficacy between social support and each dimension of QOLMediator model was conducted with each dimension of QOL as dependent variable.demographic and clinical information related to QOL as covariates,social support as independent variable.self-efficacy as mediating variable.Social support and self-efficacy were positively associated with physical dimension(β=0.223,β=0.207;both P<0.05).When self-efficacy was added,the regression coefficients for social support were reduced from β=0.306 to β=0.223,indicating that self-efficacy was the mediator between social support and physical dimension.The bootstrapping method revealed that the bias-corrected 95%confidence interval was(0.027,0.160).The mediation effect of self-efficacy was 0.083Social support and self-efficacy were positively associated with family-social dimension(β=0.151,β=0.205;both P<0.05).When self-efficacy was added,the regression coefficients for social support were reduced from β=0.236 to β=0.151,indicating that self-efficacy was the mediator between social support and family-social dimension.The bootstrapping method revealed that the bias-corrected 95%confidence interval was(0.018,0.165).The mediation effect of self-efficacy was 0.085.Social support and self-efficacy were positively associated with functional dimension β=0.224,β=0.235;both P=0.001).When self-efficacy was added,the regression coefficients for social support were reduced from β=0.317 to β=0.224,indicating that self-efficacy was the mediator between social support and functional dimension.The bootstrapping method revealed that the bias-corrected 95%confidence interval was(0.042,0.162).The mediation effect of self-efficacy was 0.094.Social support and self-efficacy were positively associated with emotional dimension(β=0.182,β=0.247;both β=0.001).When self-efficacy was added,the regression coefficients for social support were reduced from β=0.281 to β=0.182,indicating that self-efficacy was the mediator between social support and emotional dimension.The bootstrapping method revealed that the bias-corrected 95%confidence interval was(0.045,0.171).The mediation effect of self-efficacy was 0.099.Social support and self-efficacy were positively associated with specific symptom dimension(β=0.187,β=0.256;both P<0.001).When self-efficacy was added,the regression coefficients for social support were reduced from β=0.289 to β=0.187,indicating that self-efficacy was the mediator between social support and specific symptom dimension.The bootstrapping method revealed that the bias-corrected 95%confidence interval was(0.038,0.153).The mediation effect of self-efficacy was 0.102.Conclusions1.Patients with lung cancer reported relatively good family-social status,specific symptom status,and physical status.They had relatively poor emotional status and functional status.2.Patients with comobidities had relatively poor physical status,functional status,and emotional status.Divorced or widowed patients had relatively poor family-social status.Patients with college or above education and those with stage IV had comparatively adverse specific symptom.3.Social support was positively related to self-efficacy and each dimension of QOL.Self-efficacy was positively related to each dimension of QOL.Social support and self-efficacy could positively predict each dimension of QOL.4.Self-efficacy could partial mediate the relationship between social support and each dimension of QOL.