Study On The Relationship Between Symptom Burden,Spiritual Health And Subjective Well-Being In Patients With Esophageal Cancer

Purpose:To understand the status quo of symptom burden,spiritual health and subjective well-being of patients with esophageal cancer,clarify the relationship between symptom burden,spiritual health and subjective well-being,analyze the influencing factors of subjective well-being in patients with esophageal cancer,explore whether spiritual health mediates the relationship between symptom burden and subjective well-being.Methods:A total of 316 patients with esophageal cancer who received inpatient treatment in4 third-grade grade A hospitals in Chengdu from November 2021 to October 2022 were selected as research objects by convenience sampling method.The questionnaire included the general information questionnaire,the Chinese Version of MD Anderson Symptom Inventory for Gastrointestinal Cancer,the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale-12 and the General Well-being Schedule.Epi Data3.1 software was used to input the data,and IBM SPSS26.0 software and Process V3.3 plug-in were used to analyze the data.Descriptive statistics analysis,independent sample t test,one-way analysis of variance,Pearson correlation analysis,multiple-factor analysis and mediation effect analysis were used to analyze the data.Result:1.The total score of symptom burden,spiritual health and subjective well-being of patients with esophageal cancer were(26.96±9.66)points,(60.12±34.58)points and(61.73±13.26)points.2.The symptom burden score of patients with esophageal cancer showed statistically significant differences in gender,BMI,hobbies in life,payment method of medical expenses,disease stage,disease metastasis,type of chronic disease and current treatment(P<0.05).3.The spiritual health scores of patients with esophageal cancer showed statistically significant differences in residence,hobbies,number of children,disease stage,disease metastasis and type of chronic disease(P<0.05).4.There were statistically significant differences in the subjective well-being scores of patients with esophageal cancer in BMI,residence,hobbies,number of children,payment method of medical expenses,disease stage,disease metastasis,type of chronic disease and current treatment(P<0.05).5.Symptom burden of esophageal cancer was negatively correlated with spiritual health(r=-0.573,P<0.01),symptom burden was negatively correlated with subjective well-being(r=-0.599,P<0.01),spiritual health was positively correlated with subjective well-being(r=0.661,P<0.01).6.Multiple stepwise linear regression analysis of the subjective well-being of patients with esophageal cancer showed that spiritual health,symptom burden,type of chronic disease,the number of children,residence,current treatment(radiotherapy and other treatments)jointly explained 54.5%of the variation of subjective well-being(P<0.05).7.The mediating effect analysis showed that spiritual health had a mediating effect between symptom burden and subjective well-being,accounting for 44.32%.Conclusion:1.The symptom burden of patients with esophageal cancer is at a mild level;Among them,the first three items with high severity were dysphagia,distress and sleep disturbance.The top three items of symptom distress were mood,work(including housework),and general activities.Esophageal cancer patients who were female,had no hobbies in life,had a BMI of 28(kg/m~2)or greater,purchased the new rural cooperative medical insurance,the later the disease stage,the more types of chronic diseases,disease metastasis,and received chemotherapy had a higher symptom burden.2.The spiritual health of patients with esophageal cancer was in the middle level,and the spiritual health of patients with esophageal cancer who lived in cities,had interests in life,had more children,had stage III disease,had no metastasis,and had fewer types of chronic diseases was higher.3.The subjective well-being of patients with esophageal cancer was in the middle level,and the important factors affecting the subjective well-being included spiritual health,symptom burden,chronic disease type,number of children,residence,and current treatment(other treatments and radiotherapy).The higher the level of spiritual health,the lower the burden of symptoms,the fewer types of chronic diseases,number of children,urban living,and received other treatments and radiotherapy the higher the level of subjective well-being.4.There is a positive correlation between spiritual health and subjective well-being in patients with esophageal cancer,and a negative correlation between symptom burden and spiritual health and subjective well-being,and spiritual health has an intermediary effect between symptom burden and subjective well-being.Symptom burden can not only directly affect subjective well-being,but also indirectly affect subjective well-being through spiritual health.It suggests that we should implement intervention measures such as symptom management and spiritual care for patients with esophageal cancer,and jointly promote the improvement of subjective well-being of patients with esophageal cancer.