社会支持对乳腺癌患者自我倡权中介效应分析

Mediation Effect Analysis of Social Support on Self-Advocacy in Breast Cancer Patients

摘要: 目的：探讨基本心理需求与自我效能感在乳腺癌患者社会支持与自我倡权间的链式中介效应。方法：便利选取2024年7月至2025年1月期间在烟台市某所三级甲等医院乳腺外科治疗的260例乳腺癌患者为调查对象，采用一般资料调查表、社会支持量表、基本心理需求量表、一般自我效能量表、女性癌症幸存者自我倡权量表进行调查，构建并验证链式中介模型。结果：本研究结果显示，自我倡权总分为(76.90 ± 9.09)分、社会支持总分为(39.31 ± 5.12)分、基本心理需求总分为(80.26 ± 14.71)分、自我效能总分为(27.23 ± 5.05)分。乳腺癌患者社会支持对自我倡权的间接效应成立(β = 0.328, P < 0.001)，总间接效应占比为48.0%；基本心理需求的特定中介效应值占比为17.4% (β = 0.119, P < 0.001)，自我效能的特定中介效应值占比为24.6% (β = 0.168, P < 0.001)，基本心理需求和自我效能在社会支持与自我倡权间的链式中介效应值占比为6.0% (β = 0.041, P < 0.001)。结论：基本心理需求与自我效能在乳腺癌患者社会支持与自我倡权间存在链式中介效应，建议医护人员采取措施提高患者社会支持水平，同时满足其基本心理需求和提升自我效能感，为促进乳腺癌患者自我倡权能力提供参考。

Abstract: Objective: To explore the mediating effect of basic psychological needs and self-efficacy on social support and self-advocacy in breast cancer patients. Methods: By using the convenience sampling method, 260 breast cancer patients who were treated in the breast surgery department of a tertiary grade A hospital in Yantai City from July 2024 to January 2025 were selected as the survey subjects. The general information questionnaire, social support scale, basic psychological need scale, general self-efficacy scale, and female cancer survivor self-advocacy scale were used for the investigation. A chain-mediated model was constructed and verified. Results: The results of this study show that the total score of self-assertion is (76.90 ± 9.09) points, the total score of social support is (39.31 ± 5.12) points, the total score of basic psychological needs is (80.26 ± 14.71) points, and the total score of self-efficacy is (27.23 ± 5.05) points. The indirect effect of social support on self-assertion in breast cancer patients is established (β = 0.328, P < 0.001), and the total indirect effect accounts for 48.0%; the specific mediating effect value of basic psychological needs accounts for 17.4% (β = 0.119, P < 0.001), the specific mediating effect value of self-efficacy accounts for 24.6% (β = 0.168, P < 0.001), and the chain mediating effect value of basic psychological needs and self-efficacy between social support and self-assertion accounts for 6.0% (β = 0.041, P < 0.001). Conclusion: Basic psychological needs and self-efficacy exert a chain mediating effect on the relationship between social support and self-advocacy in breast cancer patients. It is suggested that medical staff adopt targeted measures to improve patients’ social support level, while satisfying their basic psychological needs and enhancing their sense of self-efficacy, so as to provide a practical reference for promoting the self-advocacy ability of breast cancer patients.