Construction Of Structural Equation Model Of Rumination And Its Influencing Factors In Young And Middle-Aged Patients With Lung Cancer

ObjectiveTo investigate the status quo of rumination in young and middle-aged patients with lung cancer,analyze its influencing factors,construct the structural equation model of influencing factors of rumination,and explore the path relationship between related variables.It is expected to arouse the attention of clinical nursing staff to rumination in young and middle-aged patients with lung cancer,to carry out psychological nursing intervention for clinical nursing staff,guide patients to carry out purpose-based rumination,to promote the physical and mental health of patients to provide a certain theoretical basis and reference.MethodsA total of 243 young and middle-aged patients with lung cancer who met the standard of nanation were selected from the oncology wards of 2 third-grade grade A hospitals in Jinan City,Shandong Province from January to October 2022 by using the cross-sectional investigation method.The General Data Questionnaire,the simplified Chinese version of the Event Related Rumination Questionnaire,the Anderson Symptom Assessment Scale Modified Lung Cancer Module Scale,the General Self-efficacy Scale,the Medical Coping Style Questionnaire,and the perceptive Social Support Scale were used to conduct the survey.Excel was used to establish a database for data entry,and SPSS21.0 was used for statistical analysis of the data.The statistical methods mainly included descriptive analysis,independent sample t test,one-way analysis of variance,Pearson correlation analysis and multiple linear regression analysis.The structural equation model of rumination in young and middle-aged patients with lung cancer was established by AMOS26.0.Results1.The total score of rumination in young and middle-aged patients with lung cancer was(30.93±8.29)points,the score of invasive rumination was(16.62±5.04)points,and the score of purposeful rumination was(14.31±5.65)points.2.The results of independent sample T-test and one-way analysis of variance showed that marital status,educational level and pathological stage of young and middle-aged patients with lung cancer had significant differences in the scores of invasive rumination(P<0.05).There were significant differences in the scores of purposive rumination among young and middle-aged patients with lung cancer in gender,marital status,education level,per capita monthly family income and course of disease(P<0.05).3.Symptom burden score of young and middle-aged patients with lung cancer(21.36±9.13),self-efficacy score(23.45±6.21),face coping score(15.32±4.48),avoidance coping score(16.21±2.56),yield coping score(9.94±2.18).Social support score(49.04±13.60).Invasive rumination was positively correlated with symptom burden(r=0.543),avoidance coping(r=0.578),and submission coping(r=0.577),(P<0.01).It was negatively correlated with self-efficacy(r=-0.527),coping(r=-0.509)and social support(r=-0.512),(P<0.01).Purposeful rumination was positively correlated with self-efficacy(r=0.509),coping(r=0.488)and social support(r=0.540),(P<0.01).It was negatively correlated with symptom burden(r=-0.540),avoidance coping(r=-0.588)and yield coping(r=-0.589),(P<0.01).4.Multiple linear regression analysis showed that marital status,pathological stage,symptom burden,self-efficacy,face coping,avoidance coping,submission coping and social support were predictive factors of invasive rumination in young and middle-aged patients with lung cancer(F=32.572,P=0.000),collectively accounting for 54.0%of the variance.Marital status,family per capita monthly income,course of disease,symptom burden,self-efficacy,face coping,avoidance coping,surrender coping,and social support were the predictors of purposive rumination in young and middle-aged patients with lung cancer(F=31.409,P=0.000),collectively accounting for 58.0%of the variance.5.The structural equation model was constructed with symptom burden,self-efficacy,facing coping,avoidance coping,submission coping and social support as independent variables,and invasive rumination and purposeful rumination as dependent variables.Finally,the final model fitting indexes of invasive rumination in young and middle-aged lung cancer patients were as follows:GFI=0.993,AGFI=0.931,RMSER=0.068,NFI=0.990,IFI=0.995,CFI=0.995,X~2/df=2.120,the model was well fitted.The final model adaptation indexes of purposive rumination in young and middle-aged lung cancer patients were:GFI=0.993,AGFI=0.931,RMSER=0.068,NFI=0.990,IFI=0.995,CFI=0.995,X~2/df=2.120,the model is well fitted.The results showed that invasive rumination and purposeful rumination in young and middle-aged patients with lung cancer should affect the route relationship among the factors.Conclusion1.Rumination in young and middle-aged patients with lung cancer was at a medium level,and the score of invasive rumination was higher than that of purposive rumination.2.Marital status,pathological stage,symptom burden,self-efficacy,face coping,avoidance coping,submission coping,and social support were the influencing factors of intrusive rumination.Marital status,family per capita monthly income,disease course,symptom burden,self-efficacy,face coping,avoidance coping,submission coping,and social support were the influencing factors of purposeful rumination.3.In young and middle-aged patients with lung cancer,invasive rumination was positively correlated with symptom burden,avoidance coping and submission coping,and negatively correlated with self-efficacy,facing coping and social support;Purposeful rumination was positively correlated with self-efficacy,face coping and social support,but negatively correlated with symptom burden,avoidance coping and submission coping.4.Symptom burden,self-efficacy and social support have direct and indirect effects on invasive rumination and purposeful rumination in young and middle-aged patients with lung cancer,and face coping,avoidance coping and submission coping have direct effects on invasive rumination and purposeful rumination.In addition,symptom burden can indirectly affect intrusive rumination and purposeful rumination through self-efficacy,face coping,avoidance coping and submission coping.Self-efficacy can indirectly affect intrusive rumination and purposeful rumination through confronting coping,avoiding coping and yielding coping.Social support can indirectly influence intrusive rumination and purposeful rumination through symptom burden,self-efficacy,facing coping,avoidance coping,and submission coping.