| Objective1.To understand the current situation,measurement tools and main influencing factors of demoralization syndrome in patients with malignant tumors through the scoping review,and to provide a theoretical basis for the investigation of the subject.2.Under the guidance of the stress system model,combined with the results of the scoping review,the current situation of demoralization syndrome in patients with malignant tumors in Yunnan Provincial Hospital was investigated,and the influencing factors were further analyzed to provide reference for the development of targeted interventions in the future.Methods1.Based on the scoping review methodology of Arksey and O’Malley,Pub Med,Web of Science,CINAHL,Embase,Cochrane library,Psyc INFO,Scopus,Sino Med,CN KI,VIP and Wanfang databases were searched from inception to May 4,2022.According to the inclusion and exclusion criteria,the literature was screened,and the literature on demoralization syndrome in patients with malignant tumors was comprehensively collected.The authors,year of publication,country,research object,measurement tools,sample size and influencing factors were extracted and sorted out.2.In this study,from August 2022 to December 2022,convenient sampling method was used to select malignant tumor patients who met the inclusion and exclusion criteria from 7 hospitals in Yunnan Province as the research object.The survey tools i ncluded general information questionnaire,the Demoralization Scale II,the Sense of C oherence Scale-13,the Ten-Item Personality Inventory in China,the Social Support Rating Scale,and the Medical Coping Modes Questionnaire.SPSS 26.0 software was used for statistical analysis.Independent samplet-test and ANOVA were used to compar e the differences between demoralization syndrome and general data and disease-related data in patients with malignant tumors.Pearson correlation analysis was used to analyze the correlation between demoralization syndrome and sense of coherence,personality traits,coping modes and social support in patients with malignant tumors.Multiple linear regression analysis was used to explore the influencing factors of demoralizat ion syndrome in patients with malignant tumors.Amos 26.0 software was used to construct a structural equation model of the influencing factors of demoralization syndrome in patients with malignant tumors,and the path effect between each factor and demoralization syndrome was analyzed.Results1.A total of 1087 literatures were obtained by preliminary search,and 58 literatures were finally included.The included studies showed that the incidence of malignant tumor patients was different in different studies.The most commonly used measurement tools for the evaluation of demoralization syndrome in patients with malignant tumors were 24-item Demoralization scale(DS)and 16-item Demoralization scale II(DS-II),but the criteria for the severity of demoralization syndrome were quite different.The main influencing factors include demographic factors,disease-related factors,other psychological reactions,sense of coherence,coping modes,social support,and personality traits.2.(1)A total of 330 patients with malignant tumors were investigated in this study.The score of demoralization syndrome was(10.79±6.30),49.4% were moderate demoralization(10～19 points),and 6.7% were severe demoralization(≥ 20 points).(2)The results of univariate analysis showed that there were statistically significant differences in age,nationality,occupation,tumor type,tumor stage,time from the first diagnosis to the present,time from the operation to the present,radiotherapy,chemotherapy,metastasis,recurrence and hospitalization times(P<0.05).(3)Correlation analysis showed that the patient’s demoralization syndrome was negatively correlated with extraversion(r =-0.370,P < 0.01),agreeableness(r =-0.263,P < 0.01),conscientiousness(r =-0.323,P < 0.01),emotional stability(r =-0.366,P < 0.01),and openness(r =-0.238,P < 0.01).It was negatively correlated with sense of coherence(r =-0.574,P < 0.01),comprehensibility(r =-0.501,P< 0.01),manageability(r =-0.492,P < 0.01)and meaningfulness(r =-0.527,P < 0.01).It was negatively correlated with confronting(r =-0.139,P < 0.05),and positively correlated with avoidance(r = 0.112,P < 0.05)and resignation(r = 0.528,P < 0.01).It was negatively correlated with social support(r =-0.312,P < 0.01),objective support(r =-0.210,P < 0.01),subjective support(r =-0.235,P < 0.01)support rate(r =-0.297,P <0.01).(4)Multiple linear regression results showed that sense of coherence,resignation,extraversion,tumor stage and emotional stability were the influencing factors of demoralization syndrome in patients with malignant tumors,which explained 41.2 % of the variation of demoralization syndrome.(5)Path analysis showed that sense of coherence had a direct negative effect on demoralization syndrome,and the effect value was-0.418;resignation played a mediating role between sense of coherence and demoralization syndrome,and the effect value was-0.137,accounting for 24.7 % of the overall effect.Extraversion can directly and negatively predict demoralization syndrome,with an effect value of-0.171;the mediating effect of sense of coherence between extraversion and demoralization syndrome was-0.088,accounting for 34.0 % of the overall effect.The mediating effect of sense of coherence between emotional stability and demoralization syndrome was-0.178,accounting for 75.4 % of the total effect.Sense of coherence and resignation also played a chain mediating role between emotional stability and demoralization syndrome.The effect value was-0.058,accounting for 24.6 % of the overall effect.Conclusion1.The results of the scoping review showed that the total incidence of demoralization syndrome in patients with malignant tumors ranged from 21 % to 86.57 %.The most commonly used measurement tools for demoralization syndrome in patients with malignant tumors were 24 items DS and 16 items DS-II.Defining the classification criteria of measurement tools and using measurement tools scientifically are the premises for effectively identifying patients with demoralization syndrome.The main influencing factors of demoralization syndrome in patients with malignant tumors include demographic factors,disease-related factors,other psychological reactions,sense of coherence,coping modes,social support,and personality traits.It is suggested that future research should systematically and comprehensively analyze the influencing factors of demoralization syndrome in patients with malignant tumors,and further explore the action path between influencing factors.2.The results of cross-sectional study showed that 49.4 % and 6.7 % of patients with malignant tumors had moderate and severe demoralization,respectively,suggesting that medical staff should pay attention to the occurrence of demoralization syndrome.The influencing factors of demoralization syndrome in patients with malignant tumors mainly include : sense of coherence,resignation,extroversion,emotional stability,and tumor stage.It is suggested that medical staff should identify the patient ’s demoralization syndrome in time according to the patient ’s different diseases and individual characteristics,focus on the patient ’s social psychological variables,and implement targeted interventions for patients from the aspects of cognition,emotion and environment.The results of path analysis showed that sense of coherence had a direct negative effect on demoralization syndrome,and could also indirectly affect demoralization syndrome through resignation.Extraversion can directly and negatively predict demoralization syndrome,and can also affect demoralization syndrome through sense of coherence.Emotional stability can affect demoralization syndrome through sense of coherence;sense of coherence and resignation also play a chain mediating role between emotional stability and demoralization syndrome.It is suggested that medical staff can develop targeted measures to help patients identify their own internal and external resources,and train patients to change negative coping,so as to reduce the level of demoralization syndrome,based on personality traits and from the perspective of sense of coherence. |
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