Research On The Current Situation And Influencing Factors Of The Spiritual Care Needs Of Lung Cancer Patients

ObjectiveThe purpose of this study is to investigate the current situation and influencing factors of spiritual care needs of lung cancer patients;Based on Newman system theory,this paper puts forward the hypothesis of influencing factors and analyzes the influencing factors of spiritual care needs.Based on the theory of psychological stress,explore the influence mechanism of spiritual care needs.Guided by Maslow’s needs theory,the semi-structured interview method is adopted to deeply understand the current situation,themes and influencing factors of spiritual care needs,improve and supplement the questionnaire survey results,provide empirical basis for medical staff to improve patients’ spiritual health and improve the quality of life,and lay a theoretical foundation for subsequent research on spiritual care.MethodsThis study is a non experimental study,which is divided into two stages:1.The first stage:Using the cross-sectional survey method,from August 2019 to July 2020,329 patients with lung cancer in two comprehensive class III class A hospitals(four hospital districts)in Qingdao,Shandong Province were selected by convenient sampling method to carry out a questionnaire survey.The survey tools include: general information and disease-related information questionnaire,Chinese version of patients’ demand scale for spiritual care provided by nurses,Chinese version of chronic disease treatment function assessment-Spiritual scale,social support scale and hospital anxiety and depression scale.The data of this study are spss23.0 statistical software.The statistical methods mainly include: descriptive statistical analysis,independent sample t-test,one-way analysis of variance,Pearson correlation analysis,multiple linear regression analysis and adjusted intermediary effect analysis.2.The second stage:According to the research results of the first stage,the interpretative phenomenological research method in the qualitative research is used,and the interview outline is drawn up on the basis of literature analysis and consulting experts.From October 2021 to December 2021,17 patients with lung cancer in a class III class a general hospital in Qingdao are selected by objective sampling method for one-to-half structured interview,and the data are analyzed by Colaizzi method,Deeply explore the spiritual care needs of lung cancer patients,and further interpret and improve the influencing factors of their spiritual care needs.Results1.Cross sectional survey results:(1)In this study,the average score of spiritual care needs of lung cancer patients is(33.99±7.56),and the scores of each dimension from high to low were: "creating a good atmosphere"(2.97±0.72),"sharing self perception"(2.84±0.66),"exploring spiritual belief"(2.71±0.95),"helping thinking"(2.62±0.74)and "helping religious practice"(2.46±0.91).(2)Gender,education level medical payment method,religious belief,pain and self-care ability have a statistically significant impact on the spiritual care needs of lung cancer patients(P<0.01).(3)Pearson correlation analysis showed that the spiritual care needs of lung cancer patients were positively correlated with anxiety and depression symptoms(r=0.415,p<0.01),spiritual health(r=0.717,p<0.01)and spiritual level(r=0.362,p<0.01),and negatively correlated with social support(r=-0.285,p<0.01).(4)Multiple linear regression analysis shows that after excluding the relevant confounding factors such as general demography,spiritual health(β=0.562,P<0.01),anxiety and depression symptoms(β=0.163,P<0.01),social support(β=-0.481,P<0.01),mild pain(β=0.102,P<0.01)and moderate self-care ability(β=0.172,P<0.01)is the influencing factor of spiritual care for lung cancer patients,which could explain 73.3% of the total variation.(5)Process mediation model test results shows that the total effect of spiritual health on spiritual care needs of lung cancer patients is 0.205(p<0.01),and the direct effect is0.187(p<0.01).Anxiety and depression symptoms partially mediate the relationship between spiritual health and spiritual care needs,and the indirect effect should be 0.018(95% ci:0.009 ～ 0.030,p<0.01).Anxiety and depression symptoms playe an intermediary role in the relationship between spiritual health and spiritual care needs,the mediating effect accounted for 8.7% of the total effect.The results of process mediated model test showes that the interaction of spiritual health and social support have a significant predictive effect on anxiety and depression symptoms(B=-0.005,95% CI:-0.007 ～-0.003,p<0.01).Social support could regulate the predictive effect of spiritual health on anxiety and depression symptoms;The interaction of social support between spiritual health and spiritual care needs is also significant(B=0.003,95% CI:0.001 ～ 0.003,p<0.05).Social support can adjust the direct effect of spiritual health on spiritual care needs.Social support plays a moderating role in the mediating effect of anxiety and depression.2.Qualitative research results:Based on Maslow’s needs theory and literature review,four themes of spiritual care needs for lung cancer patients are obtained: the need for information support,the need to love and be loved,the need to explore the meaning of life,and the need to achieve peace and transcendence;Ten sub themes were extracted: disease knowledge,treatment information,prognosis information,family support,social care,environmental well-being,self-identity,respect and being respected,speaking and listening,and positive death.Gender,education level,self-care ability,social support and treatment plan have certain impact on the spiritual care needs of lung cancer patients.Conclusions1.Current situation of spiritual care needs of lung cancer patients: the spiritual care needs of lung cancer patients are at a medium level.The spiritual care needs of lung cancer patients during treatment are multi-level,and their spiritual care needs are mainly reflected in: the need for information support,the need to love and be loved,the need to explore the meaning of life,and the need to obtain peace and transcendence.2.Influencing factors of spiritual care needs of lung cancer patients: the degree of spiritual care needs of lung cancer patients is affected by spiritual health,anxiety and depression symptoms,social support,gender,education level,occupation,treatment methods,pain and self-care ability.3.The influence mechanism of spiritual care needs of lung cancer patients: spiritual care needs of lung cancer patients are positively correlated with spiritual health,anxiety and depression symptoms,and negatively correlated with social support.Anxiety and depression symptoms play a mediating role in the demand of spiritual health for spiritual care,and social support plays a regulatory role in the demand of spiritual health for spiritual care and anxiety and depression symptoms.