Abstract
Background: self-perceived burden (SPB) is widespread in cancer patients, which is related to some physical symptoms, but more to psychological ones. Patients with lung cancer have a severe sense of self-burden and post-traumatic growth at different levels. As a protective factor of mental health, post-traumatic growth (PTG) how to influence SPB in cancer patients is rarely reported in the relevant literature. Purpose: To explore the effect of PTG on SPB and its influencing pathway of patients with lung cancer during chemotherapy, and to understand the potential mechanism, the indirect effect of PTG on SPB through illness perception and resilience was also studied. Methods: A total of 345 hospitalized chemotherapy patients with pathological diagnosis of lung cancer were enrolled as subjects. The level of illness perception, resilience, PTG and SPB were measured by the Brief Illness Perception Questionnaire (BIPQ), 10 item Connor Davidson Resilience Scale (CD RISC 10), Posttraumatic Growth Inventory (PTGI) and Self-Perceived Burden Scale for Cancer Patients (SPBS-CP), respectively. And they were analyzed that the effect of PTG on patients' SPB and its influence path. Results: Structural equation modeling results supported the hypothesis mediation model in predicting SPB (χ2=65.456, df=34, χ2/df=1.925, RMSEA=0.052, TLI=0.980, CFI=0.987) with fit indices. It showed that PTG had both direct effect (β=-0.437) and indirect effect via illness perception and resilience (95% confidence interval was - 1.183 to - 0.616, excluding 0, total indirect effect was - 0.212) on SPB of lung cancer patients during chemotherapy. Conclusions: PTG plays an obviously negative role in the SPB of patients with lung cancer during chemotherapy, and also has indirect effects on SPB through illness perception and resilience. It is necessary to strengthen multi-disciplinary cooperation and formulate relevant interventions to alleviate SPB by reducing patients' negative illness perception and improving their PTG and resilience.
Highlights
self-perceived burden (SPB) is a sense of “burden to others”, which is defined as care recipients’ empathic concern derived from the impact on others of their own illness and care needs, resulting in the feelings of guilt, distress, responsibility and the diminished sense of self [1].SPB is ubiquitous in cancer patients [2, 3]
The purpose of this study is to explore whether this hypothesis is true and to what extent post-traumatic growth (PTG) affects SPB in patients with lung cancer during chemotherapy
The results of this study showed that 98.8% of lung cancer patients experienced SPB of different degrees in chemotherapy stage, which was in the middle level, but higher than Ren Yanyan's investigations on the SPB of 330 mid-advanced cancer patients [28]
Summary
SPB is ubiquitous in cancer patients [2, 3]. It is related to some physical symptoms, but more commonly to psychological ones [2]. Other studies have shown that the SPB is more serious if the patient depended on the older caregivers or palliative treatment to maintain their lives, knew more about disease-related knowledge or perceived more equity-inequity [5, 9, 10]. SPB increases the physical, psychological risk and survival problems of patients, and affects the prognosis of cancer [3]. SPB can have a significant impact on patients' decisions making, inducing them to choose not to start treatment, refuse
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