恐惧疾病进展对结直肠癌幸存者社会疏离感的影响：家庭坚韧力与自我超越的链式中介作用-现代医学

恐惧疾病进展对结直肠癌幸存者社会疏离感的影响：家庭坚韧力与自我超越的链式中介作用

单位：安徽医科大学护理学院, 安徽合肥 231200

分类号：R735

出版年·卷·期（页码）：2026·45·第四期（655-663）

摘要：

目的： 探讨结直肠癌幸存者恐惧疾病进展对其社会疏离感的影响以及家庭坚韧力与自我超越在其中的链式中介作用，为制定缓解结直肠癌幸存者社会疏离感的干预措施提供依据。方法： 2024年11月至2025年9月，采用便利抽样法选取安徽医科大学第一附属医院就诊的304例结直肠癌幸存者作为研究对象,采用一般资料调查表、恐惧疾病进展量表、家庭坚韧力量表、自我超越量表、结直肠癌幸存者社会疏离感量表进行调查，运用AMOS 28.0软件构建结构方程模型并进行路径分析及中介效应检验。结果： 结直肠癌幸存者恐惧疾病进展、家庭坚韧力、自我超越、社会疏离感得分分别为(34.49±12.44)、(54.00±15.23)、(39.48±13.78)、(43.37±14.30)分。结直肠癌幸存者社会疏离感与家庭坚韧力和自我超越得分呈负相关，与恐惧疾病进展得分呈正相关(均P＜0.01)；其中家庭坚韧力和自我超越的中介效应分别占11.38%和10.98%,两者的链式中介效应占2.55%。结论： 恐惧疾病进展可以直接影响社会疏离感，也可通过家庭坚韧力、自我超越的中介作用及二者的链式中介3种路径间接影响社会疏离感。

Objective: To explore the effect of fear of disease progression on social isolation among colorectal cancer survivors and the chain mediating roles of family resilience and self-transcendence, providing evidence for interventions to alleviate social isolation in this population. Methods: A total of 304 colorectal cancer survivors were recruited from the First Affiliated Hospital of Anhui Medical University between November 2024 and September 2025 using convenience sampling. Participants were assessed using a general information questionnaire, the Fear of Progression Questionnaire, the Family Hardiness Scale, the Self-Transcendence Scale, and the Social Isolation Scale for Colorectal Cancer Survivors. AMOS 28.0 software was used to construct a structural equation model and conduct path analysis and mediation effect tests. Results: The scores for fear of disease progression, family resilience, self-transcendence, and social isolation were(34.49±12.44),(54.00±15.23),(39.48±13.78), and(43.37±14.30), respectively. The social isolation score was negatively correlated with the scores of family resilience and self-transcendence, and positively correlated with the score of fear of disease progression(all P<0.01); among them, the mediating effects of family resilience and self-transcendence accounted for 11.38% and 10.98%, respectively, and their chain mediating effect accounted for 2.55%. Conclusion: Fear of disease progression can directly affect social isolation, and can also indirectly affect social isolation through the mediating effects of family resilience and self-transcendence, as well as their chain mediating effect(all P<0.01).

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