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晚期肺癌病人心理生态的组态效应机制 研究及其对死亡教育的启示.

Objective: To explore the multiple influencing pathways of death anxiety and death attitude in patients with advanced lung cancer, so as to provide a reference for formulating precise death education strategies. Methods: A cross - sectional survey design was adopted. A total of 164 patients with adv...

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Publicado en:Chinese Nursing Research Vol. 40; no. 16; pp. 2781 - 2790
Autores principales: 张丁懿, 李月琳, 王云华, 刘芮杉, 张纤, 卢玉林
Formato: research tables/charts Journal Article
Publicado: Chinese Nursing Research Editorial Office Aug2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2026
      vid: 40
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      pub: Chinese Nursing Research Editorial Office
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        10.12102/j.issn.1009-6493.2026.16.003
        196377408
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        atl: 晚期肺癌病人心理生态的组态效应机制 研究及其对死亡教育的启示.
      aug:
        au:
          张丁懿
          李月琳
          王云华
          刘芮杉
          张纤
          卢玉林
        affil: 昆明医科大学护理学院, 云南 650500
      sug:
        subj:
          Lung Neoplasms Psychosocial Factors
          Death Psychosocial Factors
          Attitude to Death
          China
          Human
          Cancer Patients
          Cross Sectional Studies
          Tertiary Health Care
          Cancer Care Facilities
          Questionnaires
          Scales
          Qualitative Studies
          Comparative Studies
          Social Isolation
          Communication
          Lung Neoplasms Prognosis
          Fear
          Aphasia
          Adaptation, Psychological
          Death Education
      ab:
        Objective: To explore the multiple influencing pathways of death anxiety and death attitude in patients with advanced lung cancer, so as to provide a reference for formulating precise death education strategies. Methods: A cross - sectional survey design was adopted. A total of 164 patients with advanced lung cancer from a tertiary grade A cancer specialty hospital in Yunnan province were selected as the research subjects. General information questionnaires, the Chinese version of the Death Anxiety Scale(CT-DAS), and the Chinese version of the Death Attitude Profile -Revised(DAP -R) were used for the investigation. Data analysis was conducted using the fuzzy - set qualitative comparative analysis(fsQCA) method to identify the antecedent condition configurations leading to high levels of death anxiety, negative and positive death attitudes. Results:There were 6 configuration paths of death anxiety in patients with advanced lung cancer, presenting 5 different patterns, namely long-term isolation-communication deficiency type, high load-silence type, prognosis fear type, traumatic notification type, and spiritual struggle - silence negative type. Negative death attitudes had 8 configuration paths, presenting 5 different patterns, namely exhaustion silence type, early shock type, sudden high malignancy type, high malignancy load type, long - term aphasia type. Positive death attitudes had 6 configuration paths, presenting 4 different patterns, namely open communication type, long - term adaptation type, positive planning type, and focused on the present type. Conclusion: The death anxiety and death attitudes of patients with advanced lung cancer are the result of multiple factors coupling. The multiple causal paths discovered in this study could provide a basis for formulating precise death education strategies based on the combination of patients' individual characteristics, and are of great significance for promoting the development of clinical death education.
        目的:探究晚期肺癌病人死亡焦虑与死亡态度的多元影响路径, 以期为制定精准化死亡教育策略提供参考。方法:采用横断 面调查设计, 选取云南省某肿瘤专科三级甲等医院晚期肺癌病人164 例作为研究对象。采用一般资料调查表、中文版死亡焦虑量表 （CT-DAS）和中文版死亡态度描绘量表（DAP-R）进行调查。采用模糊集定性比较分析（fsQCA）方法进行数据分析, 识别导致高水 平死亡焦虑、负向及正向死亡态度的前因条件组态。结果:晚期肺癌病人死亡焦虑存在6 条组态路径, 呈现出5 种不同模式, 即长期 孤立-沟通缺失型、高负荷-沉默型、预后恐惧型、创伤性告知型、灵性挣扎-沉默负重型;负向死亡态度存在8 条组态路径, 呈现出5 种 不同模式, 即耗竭沉默型、早期冲击型、迅发高恶型、高恶性负荷型、长期失语型;正向死亡态度存在6 条组态路径, 呈现出4 种不同模 式, 即开放沟通型、长期适应型、积极规划型、专注当下型。结论:晚期肺癌病人的死亡焦虑与死亡态度是多重因素耦合作用的结果, 研究发现的多元因果路径可为制定基于病人个体特征的精准化死亡教育策略提供依据, 对推动临床死亡教育发展具有重要意义.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: Chinese
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