| Objectives：This study was to analyze the level of symptom burden, coping modes, quality oflife (QOL) and its influencing factors in gastrointestinal cancer patients who were undergoingchemotherapy; and to test the mediator of coping modes between symptom burden andquality of life.Methods：The cross-sectional study design was used in the current survey. Based on twotheories, a conceptual framework was developed. A convenient sample of494gastrointestinalcancer patients undergoing chemotherapy in Shanghai were recruited.Symptom burden wasidentified by using Memorial Symptom Assessment Scale, coping modes using MedicalCoping Modes Questionnaire, and quality of life using Functional Assessment of CancerTherapy-General. Statistical analyses were performed using the Statistical Package for SocialScience17.0(SPSS17.0) and Analysis of Moment Structure7.0(AMOS7.0) softwares.Measurement data was statistically descripted using mean standard deviation, andenumeration data using frequency, percentage. T-test, one-way analysis of variance,Mann-Whitney U test, Kruskal-Wallis H test，and Multiple stepwise regression were used toananlyze the influencing factors of symptom burden, coping modes and quality of life,respectively. Path analysis was employed to test the mediator of coping modes betweensymptom burden and quality of life.Results： The Mean±SD of the PHYS, PSYCH, GDI, andTMSAS scores were1.15±0.58,0.62±0.36,1.35±0.62, and0.92±0.45, respectively.There were average13.23±6.57symptomsin patients;symptom incidence between15.2%to85.6%; influcing factors were gender,educational level, course of the disease, model of living, chemotherapy treatment, familyeconomic status, and white blood cell count. The Mean±SD of the Confrontation,Avoidanceand and Resignation dimensions were19.03±3.52,14.81±2.93,11.59±4.01,respectively; in addition to the confrontation dimension below the norm, the other twodimensions scores were higher than the norm; influcing factors were age, religion, informedor not, educational level,,model of living, work status, family economic status, and courseof the disease. In this study, the quality of life of gastrointestinal cancer at the middle level,the mean item score was2.61; and mean item score of FACT-G were3.31,2.93,2.32,2.03,respectively for social and family well-being, emotional well-being, physical well-being, andfunction well-being; influcing factors were gender, family economic status, education, medical expenses, and the course of the disease. Effect of symptom burden on quality oflife was mediated partially or fully by coping modes. And in this study, there were threestructural equation modelings could explain the quality of life of the total variance was5.8%to49.6%. The mediating effect of confrontation dimensions was7%to9.04%of the totaleffect; the mediating effect of avoidance dimensions was32.7%to100%of the total effect;the mediating effect of resignationn dimensions were12.9%,35.34%,54.26%, and100%ofthe total effect, respectively.Conclusions：In this study, gastronintestinal cancer patients have a fairly heavy symptomburden, and take a variety of coping modes to cope with their illness and treatment. Therewere interconnected relationship between symptom burden, coping modes, and quality of life.Both symptom burden and coping modes can directly predict quality of life. The threevariables were influced by demographic and disease data. The coping modes has mediatingeffect between symptom burden and quality of life, and the mediating effect of resignationcoping mode is most significant. Resignation coping modes could enhance the negative effectof symptom burden on quality of life; confrontation and avoidance coping modes couldalleviate the negative effect of symptom burden on quality of life. |
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