| Objective:This study aims to explore the current situation of patie nt activation,stigma,anxiety and depression in cervical cancer.Based on the discomfort symptom theory,it analyzes the risk predictors of patient activation,stigma,anxiety and depression,and establishes a structural equat ion model among patient activation,stigma,anxiety and depression to exp lore the action path and mediating effect among them.This is not only the further verification and development of the theory,but also provides relevant theoretical basis for improving the negative emotions of cervica l cancer patients,reducing stigma and improving the positive degree of patients in the future.Methods:This study was a cross-sectional study.Patients with cervi cal cancer who were hospitalized in Department of Gynecology and On cology of Ruikang Hospital and the First Affiliated Hospital of Guangxi University of Chinese Medicine from January 2020 to December 2020 were selected strictly according to the intake and discharge and diagnos tic criteria.The self-made "General Information Questionnaire"," Patient Activation Scale","Social Influence Scale" and "Hospital Anxiety and De pression Scale" were used to carry out related questionnaires.A total of250 questionnaires were sent out,and 234 valid questionnaires were col lected through the questionnaire exclusion criteria in this study.To collec tdata by using SPSS and AMOSS statistical software for data analysis,st atistical methods mainly include for describing the descriptive analysis o f the status quo,explore the related factors affecting patients with positi ve degrees t test,single factor analysis,nonparametric test,multiple linear regression analysis,and shame,patients with positive and mutual relation between and among anxiety,depression of Spearman correlation analysis and structural equation model.Results:1.The positive score of cervical cancer patients was 49.528±16.014 points,at the second activation level,and the scores of each ite m were 3.810±1.232 points.The average score of each dimension of pat ients’ patient activation from high to bottom was cognition(4.806±1.372 points),skill(3.743±1.265 points),action(3.533±1.250 points)and belief (3.340±1.491 points).2.The average score of the total items of stigma of cervical cancer was 2.583 points,which was at the medium level.The average score of each dimension item was economic discrimination(3 points),internal sh ame(2.8 points),social isolation(2.58 points),and social exclusion(2.333) from the highest to the lowest.3.The incidence of anxiety and depression in cervical cancer patien ts was 30.77%,42.6%,and 33.3%,respectively.The incidence of anxiety w as higher than that of depression,and the difference was statistically si gnificant(P<0.05).4.Through to the cervical cancer patients with positive degree of si ngle factor analysis and multiple linear regression analysis showed that the main influencing factors of family ties,record of formal schooling,with chronic diseases,worker health,presence of disease family history,ag e,can explain the active degree of 65.3% of the variance of the depend ent variable patients,of which explanation for positive degrees in patient s with the highest family relations.5.Through correlation analysis,the positive degree and its dimension s were significantly negatively correlated with stigma and its dimensions(r=-0.218～-0.801),and the positive degree and its dimensions were signi ficantly negatively correlated with anxiety and depression and its dimen sions(r=-0.499～-0.654).There was a significant positive correlation bet ween the scores of stigma and the scores of anxiety and depression(r=0.297～0.654),and the differences were statistically significant(P<0.05).6.Path analysis showed that:(1)Anxiety and depression had a direc t positive effect on stigma in cervical cancer patients(β=0.618);(2)Stig ma had a direct negative effect on patient activation(β=-0.431).(3)Anxi ety and depression had a direct negative effect on patient activation(β=-0.386).(4)In the path of anxiety and depression→stigma→patient activa tion,anxiety and depression had a mediating effect on patient activation(β=-0.266),the mediating effect accounted for 40.8% of the total effect,a nd stigma was the mediating variable.Conclusion:1.This study found that the positive degree of cervical cancer patients was at a low level,the stigma was at a medium level,an d the incidence of anxiety and depression was high,and the degree of a nxiety was higher than the degree of depression.Therefore,we need to i mprove the positive degree of cervical cancer patients and reduce the le vel of stigma and anxiety and depression.2.Socioeconomic status(education level,health insurance),family rela tionship,whether patients with chronic disease and whether there is a fa mily history of disease affect patients’ level of patient activation.Medical staff should pay attention to the population with the above high-risk inf luencing factors,and take individualized intervention measures to improv e the level of patient activation.3.Anxiety and depression in cervical cancer patients can directly an d negative affect thositive degree of patients;Anxiety and depression hav e a direct negative effect on the positive degree of patients with cervic al cancer.Anxiety and depression can indirectly affect patient activation through stigma.This suggests that we can improve the level of patient a ctivation of cervical cancer patients by improving their stigma and anxi ety and depression. |
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