Research On Spiritual Well-being And Influencing Factors Of Patients With Esophageal Cancer

Objective1.To investigate the status and analyze the effects of general demographic data,disease-related conditions,social support,rumination and benefit finding on spiritual well-being.2.To explore the effect path of social support,rumination and benefit finding on spiritual well-being of patients with esophageal cancer.Methods1.From December 2020 to December 2021,a total of 281 patients with esophageal cancer were investigated by the general information questionnaire,the Functional Assessment of Chronic Illness Therapy-Spiritual Scale,the Perceived Social Support Scale,the Event-Related Rumination Inventory and the Benefit Finding Scale in two tertiary A hospitals in Jiangsu Province.2.Excel was used to establish the database and SPSS 26.0 software was used to analyze the data.Frequency and percentage were used to describe counting data,and the measurement data were described by mean±standard deviation.Independent sample t-test and one-way ANOVA were used to test the influence of general information of esophageal cancer patients on spiritual well-being.Pearson correlation analysis was used to test the correlation between social support,rumination,benefit finding and spiritual well-being in patients with esophageal cancer.Multiple linear regression method was used to analyze the influencing factors of spiritual well-being in patients with esophageal cancer.AMOS 24.0 was used to construct the structural equation model of the impact of social support,rumination and benefit finding on spiritual well-being of patients with esophageal cancer.Results1.Status and influencing factors of spiritual well-being in patients with esophageal cancer（1）The total score of spiritual well-being of patients with esophageal cancer was（26.73±6.95）,the scores of three dimensions were as follows:peace（10.44±2.86）,meaning（8.59±2.68）and faith（7.70±2.92）.The total score of social support was（58.77±8.58）,the score of family support,other support and friends support were（23.47±2.87）,（17.96±3.30）and（17.34±3.80）respectively.The total score of rumination was（26.91 ±5.94）,the score of intrusive rumination and deliberate rumination were（12.85±4.95）and（14.06±4.36）respectively.The score of benefit finding was（46.21 ±8.71）.（2）The results of univariate analysis showed that there were statistically significant differences in spiritual well-being among family’s average monthly income,educational level,religious belief,personality type,disease course and disease stage（P<0.05）.（3）The results of correlation analysis showed that spiritual well-being was positively correlated with the total score and each dimension score of social support（r=0.366～0.499,P<0.01）,deliberate rumination（r=0.404,P<0.01）,benefit finding（r=0.454,P<0.01）,and was negatively correlated with intrusive rumination（r=-0.436,P<0.01）,but not correlated with the total score of rumination（r=-0.067,P>0.05）.（4）The results of multiple linear regression analysis showed that the family’s average monthly income,educational level,religious belief,disease course,family support,intrusive rumination,deliberate rumination and benefit finding explained 50.1%of the total variation of spiritual well-being.2.The effect path of social support,rumination and benefit finding on spiritual well-being of patients with esophageal cancer.（1）After modification,the structural equation model of social support,intrusive rumination,benefit finding and spiritual well-being fitted well,and the fitting indicators were as follows:χ2/df=2.565,RMSEA=0.075,AGFI=0.920,GFI=0.969S CFI=0.972,NFI=0.956.Intrusive rumination and benefit finding mediated the relationship between social support and spiritual well-being,with a total indirect effect of 0.192,accounting for 32.38%of the total effect.Social support had an indirect effect on spiritual well-being through the following three paths:indirect path 1:social support→intrusive rumination→spiritual well-being,indirect effect value was 0.069（11.63%）;indirect path 2:social support→benefit finding→spiritual well-being,indirect effect value was 0.106（17.88%）;indirect path 3:social support→ intrusive rumination→ benefit finding→ spiritual well-being,indirect effect value was 0.017（2.87%）.（2）After modification,the structural equation model of social support,deliberate rumination,benefit finding and spiritual well-being fitted well,and the fitting indicators were as follows:χ2/df=2.475,RMSEA=0.073,AGFI=0.926,GFI=0.969,CFI=0.971,NFI=0.954.Deliberate rumination and benefit finding mediated the relationship between social support and spiritual well-being,with a total indirect effect of 0.216,accounting for 38.64%of the total effect.Social support had an indirect effect on spiritual well-being through the following three paths:indirect path 1:social support→deliberate rumination→spiritual well-being,indirect effect value was 0.092（16.46%）;indirect path 2:social support→benefit finding→spiritual well-being,indirect effect value was 0.106（18.96%）;indirect path 3:social support→deliberate rumination→benefit finding→ spiritual well-being,indirect effect value was 0.018（3.22%）.Conclusion1.Spiritual well-being of patients with esophageal cancer was in the lower middle level.Family’s average monthly income,educational level,religious belief,disease course,family support,intrusive rumination,deliberate rumination and benefit finding were the influencing factors of spiritual well-being of patients with esophageal cancer.It suggested that medical staff should pay attention to spiritual well-being of patients with esophageal cancer,and formulate targeted intervention measures to improve their spiritual well-being.2.Intrusive rumination-benefit finding and deliberate rumination-benefit finding both played a chain mediating role in the relationship between social support and spiritual well-being in patients with esophageal cancer.It suggested that by strengthening patients’social support,medical staff can encourage patients to engage in positive rumination,help them experience more benefits,and ultimately improve their spiritual well-being.