Effects Of Self-disclosure On Psychological Distress In Patients With Early Gastrointestinal Cancer:The Mediating Role Of Positive Coping Style And Benefit Finding

ObjectivesBy investigating the status quo of psychological distress,self-disclosure,positive coping style and benefit finding in patients with early gastrointestinal cancer,the correlation between the four variables and the influencing factors of psychological distress were analyzed,so as to further explore the path relationship among self-disclosure,positive coping style,benefit finding and psychological distress in patients with early gastrointestinal cancer.Using the structural equation model,we investigated the pathway relationships and the mediation mechanism of self-disclosure,positive coping style,benefit finding and psychological distress,which provided theoretical reference for the development of psychological distress intervention measures for patients with early gastrointestinal cancer,and help to improve patients’ mental health and quality of life.MethodsFrom May 2022 to November 2022,a total of 272 inpatients with early gastrointestinal cancer were selected from a Grade-A tertiary hospital in Jinan,Shandong Province by convenience sampling.The general information questionnaire,distress disclosure index scale,simple coping style questionnaire,benefit finding scale and the 10-item Kessler psychological distress scale were used to collect general information,self-disclosure,positive coping style,benefit finding and psychological distress data of patients.Data were entered in Excel 2010,descriptive statistics,independent samples t-test/one-way ANOVA,Pearson correlation analysis and multiple linear regression analysis were performed using SPSS26.0 software,and structural equation models were constructed using AMOS26.0 software.Results1.The results showed that the total psychological distress score of patients with early gastrointestinal cancer was(24.33±4.54),which was at the level of moderate psychological distress.The total self-disclosure score was(36.82±9.40),which was in the medium level.The total score of positive coping style was(35.22±6.77).The total score of patients’ benefit finding was(69.41±14.41),which was at the medium level,and the average score of all dimensions were health behavior(3.64±0.85),family relations(3.36±0.98),world outlook(3.25±0.87),acceptance(3.20±0.90),personal growth(2.93±0.88)and social relations(2.88±1.04).2.Univariate analysis indicated that age,educational level,family per capita monthly income,family economic burden,medical payment method,lesion location,pathological diagnosis and postoperative complications could significantly affect the psychological distress level of patients with early gastrointestinal cancer,with statistical significance(P<0.05).3.The results of multiple linear regression analysis showed that the main influencing factors of psychological distress in patients with early gastrointestinal cancer were age,education level and family per capita monthly income(P<0.05),which may account for 22.3%of the variance of psychological distress.4.Correlation analysis indicated that self-disclosure,positive coping style and benefit finding were negatively correlated with psychological distress(r=-0.341,-0.289,-0.308,P<0.01),while self-disclosure was positively correlated with positive coping style and benefit finding(r=0.282,0.226,P<0.01).5.The results of structural equation model indicated that CMIN/DF(χ2/df)=2.154,GFI=0.957,AGFI=0.922,IFI=0.947,CFI=0.946,TLI=0.922,RMSEA=0.065,and the model fit well.The results of mediating effect test showed that the 95%confidence interval of direct effect C[-0.381,-0.101],excluding 0,indicating that self-disclosure could directly and negatively affect psychological distress,and the direct effect accounted for 71.43%.The 95%confidence interval of the mediation effect M1 is[-0.101,-0.014],excluding 0,which indicates that the mediation effect of positive coping style is significant,and self-disclosure can reduce the psychological distress of patients by affecting positive coping style,accounting for 13.99%of the mediating effect.The 95%confidence interval of the mediation effect M2 is[-0.107,-0.016],excluding 0,which indicates that the mediation effect of benefit finding is significant,and self-disclosure can reduce the psychological distress of patients by affecting the level of benefit finding,accounting for 14.58%of the mediating effect.Conclusions1.The psychological distress of patients with early gastrointestinal cancer is at a moderate level and still needs to be alleviated.Clinical workers should pay attention to and formulate corresponding intervention measures to further reduce the level of psychological distress,so as to improve the mental health outcome and quality of life of patients.2.Age,educational level and per capita monthly family income are the main influencing factors causing psychological distress in patients with early gastrointestinal cancer.The younger the patients are,the lower the education level and the less per capita monthly family income,the more serious the psychological distress they experience.3.There is a correlation between self-disclosure,positive coping style,benefit finding and psychological distress in patients with early gastrointestinal cancer;The higher the level of self-disclosure of patients,the more inclined they are to adopt positive coping style and improve their personal benefit finding level,thereby further reducing their own psychological distress.4.The self-disclosure of patients with early gastrointestinal cancer can not only directly affect the level of psychological distress,but also affect the level of psychological distress through the parallel mediation effect of positive coping style and benefit finding.The mediating effect is partially mediated.