| Objective:In this study,the self-compassion level of patients with postoperative adjuvant chemotherapy for colorectal cancer was investigated longitudinally at four time points:(T1),after the first chemotherapy(T2),after the third chemotherapy(T3),and after the sixth chemotherapy(T4):(1)to understand the self-compassion level and change trend of colorectal cancer patients with chemotherapy at four time points;(2)to analyze the correlation between self-compassion and anxiety and depression during T1~T4 in colorectal cancer patients;(3)identify the development trajectory and potential subgroups of self-compassion of colorectal cancer chemotherapy patients;(4)To explore the predictors of the self-compassion development trajectory subgroup of colorectal cancer chemotherapy patients.It provides a reference for formulating targeted intervention strategies in the early clinical stage and improving patients’ self-compassion.Methods:Using the convenience sampling method,the research subjects were patients with postoperative adjuvant chemotherapy for colorectal cancer in a tertiary hospital from February 2022 to July 2022.The general information questionnaire,self-compassion scale(SCS)and hospital anxiety and depression scale(HADS)were used to investigate longitudinally,SPSS 26.0 statistical software was used to analyze the data,and the statistical methods of descriptive statistics and repeated measure ANOVA,latent category growth model,Spearman correlation analysis,Friedman test,Kruskal-Wallis H test and multivariate logistic regression analysis were used,and the test level was α=0.05.Results:1.Self-compassion level and development trend of colorectal cancer chemotherapy patientsThe average self-compassion of colorectal cancer chemotherapy patients at T1~T4 was 77.0(66.0,86.0),76.0(72.0,86.0),80.0(76.0,86.0),83.0(78.0,89.0),the lowest scores at T1 and T2,gradually increased at T3 and T4,positive correlation between self-compassion scores at four measurement points(all P<0.05),and negative correlation between self-compassion and anxiety and depression levels at four measurement time points(all P < 0.05).2.A subgroup analysis of the trajectory of self-compassion in colorectal cancer chemotherapy patientsThe results of latent category growth model analysis showed that the self-compassion of colorectal cancer chemotherapy patients showed three types of heterogeneous development trajectories: "low-level rising group","high-level stable group" and "moderate-level reduction group",of which "low-level ascending group" accounted for 46.3%,"high-level stable group" accounted for 23.4%,and "moderate-level reduction group" accounted for 30.4%.3.Univariate analysis of subgroup of self-compassion development trajectories in colorectal cancer chemotherapy patientsThe differences in the demographic and medical characteristics of each subgroup of patients with the self-compassion development trajectory of colorectal cancer chemotherapy patients were tested by chi-square test,and the results showed that there were differences between the three subgroups in terms of age,place of residence,education level,per capita monthly household income,clinical stage of tumor,presence or absence of stoma,and presence or absence of comorbidities(all P<0.05).4.Multivariate analysis of the subgroup of self-compassion development trajectory of colorectal cancer chemotherapy patientsThe results of multivariate logistic regression analysis showed that age,education level,per capita monthly household income,clinical stage of tumor,and presence or absence of stoma were predictors of self-compassion in colorectal cancer chemotherapy patients(all P<0.05).Compared with the low-level rising group,the probability of patients aged < 45 years old,age 45~59 years old,education level junior high school/secondary school,family per capita monthly income of <3000yuan,clinical stage I,and no stoma in the high-level stable group was 0.111 times(OR=0.111,P=0.004),0.109 times(OR=0.109,P=0.001),0.141 times(OR=0.141,P=0.005),0.144 times(OR= 0.144,P=0.019),20.303 times(OR=20.303,P=0.006),5.156 times(OR=5.156,P=0.012),the probability of patients without an astoma in the moderate-level declining group was 2.187 times that of the low-level ascending group(OR=2.187,P=0.046);Compared with the moderate-level decline group,the probability of age < 45 years old and 45~59 years old,education level primary school and below,junior high school/technical secondary school,and tumor stage I in the high-level stable group was 0.184 times(OR=0.184,P=0.029),0.129 times(OR=0.129,P=0.003),0.161 times(OR=0.161,P=0.009),0.108 times(OR=0.108,P=0.002),respectively,8.928 times(OR=8.928,P=0.042).Conclusion:1.The level of self-compassion in colorectal cancer chemotherapy patients from before chemotherapy to after the 6th chemotherapy(T1~T4 four time points)changed dynamically,with the increase of chemotherapy cycle,and self-compassion was negatively correlated with anxiety and depression in the four chemotherapy stages.There were three different trajectories of the change of self-compassion level,namely the low level rising group(46.3%),the high level stable group(23.4%),and the moderate level reduction group(30.4%),and there was group heterogeneity in self-compassion.The change in self-compassion in most patients is in line with the overall development trend,and there is still a small number of self-compassion levels that continue to decrease as chemotherapy progresses.2.The age,place of residence,education level,per capita monthly household income,clinical stage of tumor,presence or absence of stoma,and comorbidities of colorectal cancer chemotherapy patients will affect the development trajectory of self-compassion,while age,education level,per capita monthly household income,tumor clinical stage,and stoma have important distinguishing and predicting effects on different types of self-compassion development trajectories,which provides a reference for early identification and intervention of patients with low level of self-compassion. |
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