A Correlation Study Of Demoralization Syndrome With Social Support And Coping Style In Primary Hepatic Cancer Patients

Objective:To determine the prevalence and level of demoralization syndrome in primary hepatic carcinoma(PHC)patients.Discuss the relationship between demoralization syndrome and social support,coping style.In order to reduce the incidence of demoralization syndrome and provide theoretical references for promoting PHC patients' physical and mental health.Methods:Use demoralization scale mandarin version(DS-MV),Chinese mandarin version of the medical outcomes study social support survey(MOS-SSS-CM),medical coping modes questionnaire(MCMQ),demographic and clinical characteristics questionnaire for cross-sectional survey.It was conducted among 260 PHC patients,who were hospitalized in the first affiliated hospital of Xi'an Jiaotong University from July to December,2017.Data was established by Epidata 3.1,SPSS 22.0 was used for statistical descriptive analysis,single factor analysis and multiple linear regression analysis.Results:(1)The present condition of demoralization syndrome.The score of demoralization for patients with PHC was(34.13±13.44),that was higher than cancer patients norm in Taiwan.Loss of meaning and purpose score was(5.51±3.64),helplessness score was(5.51±3.64),sense of failure score was(8.60±2.86),disheartenment score was(8.46±3.68),dysphoria score was(6.10±2.95).The former three compared with Taiwan cancer patients' norm had significant statistically differences(P<0.01),but two of latter were not(P>0.05).87.69% PHC patients with moderate or severe demoralization syndrome symptom.(2)The status quo of social support.The medical social support of PHC patients was(67.92+13.12).It was significantly lower than gynecological cancer patients'(P<0.01).Emotional/informational support was(26.03±6.24),tangible support was(16.40±2.67),social interaction was(14.17±3.77),affectionate support was(11.32±2.44).(3)The current situation of coping style.In this survey the most frequtly coping style used by patients in PHC was avoid approach,it was up to 45.4%.The second was face coping styles at 39.2%,the least was yield respond only at 15.4%.The scores of avoid,face and yield coping strategies respectively was(16.28±3.40),(17.32±4.04)and(8.70±3.33).The face coping style was lower than the patients' norm(P<0.01),but avoid coping style was higher than that norm(P<0.01).(4)Factors affecting the demoralization syndrome?.Factors that affect the demoralization syndrome.Univariate analysis showed that demoralization syndrome was associated with all factors related to medical social support and medical coping styles,education,residence,occupation,work status,monthly income,medical insurance and inform status of disease(P<0.05).Multivariate regression analysis shows that the social support total score,yield,education three factors affect the level of demoralization syndrome,those can explain 42.40% of the total variance of PHC patients' demoralization syndrome.?.Factors that affect the meaning and purpose.Univariate analysis showed that all factors related to social support,face and avoid coping styles,education,residence,occupation,work status,monthly income and inform status of disease,were associated with loss of meaning and purpose(P<0.05).Multivariate regression analysis shows that the affectionate support score,yield,education affected the level of loss of meaning and purpose,those can explain 29.17% of the total variance of loss of meaning and purpose in patients with PHC.?.Factors associated with dysphoria.All factors with social support and coping style educational,residence,occupation,working status and monthly income were associate with dysphoria(P<0.05).Social interaction score,educational and yield response were into dysphoria multiple stepwise regression equation,the prediction of dysphoria was 25.84%.?.Factors affecting disheartenment.All the relevant variables associated with social support and coping styles,education,residence,occupation,work status,monthly income and medical insurance can affect score of disheartenment(P<0.05).The multivariate stepwise regression analysis showed that the education,yield response and the total social support questionnaire score had an impact on the level of disheartenment,which together explained 38.95% of the total variation of it.?.Factors with sense of helplessness.Single factor analysis showed that all the relevant variables related to social support and coping styles,age,education,residence,occupation,work status,main caregiver,monthly income and inform status of disease can impact helplessness(P<0.05).In multivariate regression analysis social interaction activities,yield and avoid coping styles,education and monthly income were associated with helplessness,the prediction of helplessness was 33.14%.?.The factors that influence sense of failure.All the relevant variables of social support,the face and yield coping styles,education,monthly income,residence,occupation,current treatment-related and duration of initial diagnosis associated with the sense of failure in the univariate analysis(P<0.05).A range of factors were consistently associated with sense of failure: social interaction activities score,the yield coping styles,education and operation treatment group compared with other treatment group into the multiple stepwise regression equation,Shared the sense of failure's total variance in 24.72%.Conclusion:(1)Demoralization syndrome in Xi'an PHC patients at a high level,that was higher than Taiwan cancer patients'.The level of social support was lower than gynecological cancer patients'.Avoid and face coping style were main coping style that taken by PHC patients.Among of these avoid coping style was higher than the patient norm,face coping style was lower.(2)The factors those were influenced demoralization syndrome included total score of social support,variables associated with social support,three coping styles,age,education,residence,occupation,work status,monthly income,inform status of disease and medical insurance.Five dimension related to score of variables associated with social support,yield and avoid coping styles,age,education,residence,occupation,work status,monthly income and medical insurance,inform status of disease,the main caregivers,treatment at present stage and time-since-diagnosis.(3)Education and score of total social support had a negative predictive effect on the demoralization syndrome,and the yield response had a positive predictive effect.Score of total social support,interaction activities,affectionate support,yield and avoid coping styles,education,monthly income,treatment at present stage had predictive for five dimension.