Study On Spiritual Well-being Of Advanced Lung Cancer Based On Cognitive Adaptation Theory And Its Influencing Factors

Objective The purpose of this study was to investigate the Spiritual Well-being status of patients with advanced lung cance,and from the aspects of socio-demographic characteristics,disease-related information and cognitive adaptation process to analysis the factors which can influence the Spiritual Well-being.Through validation and analysis of structural equation model to explore the cognitive adaptation process of Spiritual Well-being effects,from the perspective of positive psychology to explain the Spiritual Well-being causes,conducive to the further understanding of the internal Spiritual Well-being in patients with advanced lung cancer.It also provides strategies and guidance for the effective clinical intervention of spiritual care for cancer patients.Method Cross-sectional survey was used in this study,319 patients with advance lung cancer in a questionnaire survey was conducted in two grade Ⅲ-a hosptials in a province between September,2017 to October,2018 were investigate general characteristic and related disease information.The Spiritual Well-being level was measured by FACIT-SP-12,use BFS to assess patients’ benefit finding level,C-MLQ to assess sense of life meaning level,LOT-R to assess the level of optimism level,MHLC-C to measure sense of the locus of control,and SES to assess self-esteem level.EpiData3.1 was used to establish the database,and IBM SPSS 24.0 was used for statistical description,single factor and correlation analysis of Spiritual Well-being and its scores in all dimensions.AMOS17.0 was used to construct the measurement model and structural equation model of Spiritual Well-being influencing factors,and to conduct confirmatory factor analysis on the measurement model and path analysis on the structural equation model.Result 1.The total score of Spiritual Well-being of patients with advanced lung cancer was(25.11±7.69),in which the score of peace dimension was(10.03±5.31),the score of meaning dimension was(9.03±7.82),and the score of belief dimension was(5.79±1.67).2.The single factor analysis,according to the results of patients with advanced lung cancer spiritual well-being on age,religion or not,occupation,family income level,distance from diagnosis,disease stage,whether surgery,treatment time and the number of chemotherapy on the differences(P<0.05,P<0.01,P<0.01,P<0.01,P<0.01,P<0.05,P<0.05,P<0.05,P<0.01).Correlation analysis showed that Spiritual Well-being and its dimensions were significantly positively correlated with the internal control,meaning of life,optimism,self-esteem and benefits finding(all P < 0.01).There was a significant negative correlation between the belief dimension and the powerful others of health locus of control(P<0.01).Significant negative correlation was found between the meaning dimension and the peace dimension and the opportunity of health locus of control(all P<0.05).3.The confirmatory factor analysis results showed that the basic adaptation index and the overall adaptation index of the measurement model of "spiritual well-being influencing factors" were up to the standard,and the internal quality of the model was good.The composite reliability of the four potential variables of spiritual well-being,the search of meaning,self-enhancement and locus of control was 0.866,0.719,0.839 and 0.670,respectively(all greater than 0.60).4.The results of structural equation model analysis showed that the two constructs of the search of meaning and self-enhancement in cognitive adaptation were the influencing factors of spiritual well being(r=0.627,r=0.292,all P < 0.05).Conclusion The overall level of spiritual well-being of patients with advanced lung cancer is relatively low,among which,the score of peace dimension and meaning dimension is high,and the score of belief dimension is low.Spiritual well-being level was influenced by age,religious belief,occupation,family monthly income level,distance from diagnosis,disease stage,whether surgery,treatment plan and the number of chemotherapy.Special attention should be paid to the significant impact of the search of meaning and self-enhancement processes on spiritual well-being.To explore the influencing factors of spiritual well-being can provide guidance and scientific basis for the construction of spiritual care for patients with advanced lung cancer.In clinical work,medical staff can formulate spiritual care intervention program from these two aspects to improve the spiritual well-being level of patients and improve the quality of life.