Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Sep 19, 2024; 14(9): 1326-1334
Published online Sep 19, 2024. doi: 10.5498/wjp.v14.i9.1326
Study on psychological resilience and associated influencing factors in lung cancer patients with bone metastases
Chao-Fan Guo, Li-Li Wu, Zhong-Zhong Peng, Hua-Long Lin, Jie-Ni Feng
Chao-Fan Guo, Department of Orthopedics, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325200, Zhejiang Province, China
Li-Li Wu, Hua-Long Lin, Jie-Ni Feng, Department of Medical Oncology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325200, Zhejiang Province, China
Zhong-Zhong Peng, Department of Medical Oncology, Ningbo Hangzhou Bay Hospital, Ningbo 315336, Zhejiang Province, China
Co-first authors: Chao-Fan Guo and Li-Li Wu.
Author contributions: Guo CF and Wu LL contributed to this manuscript equally, they are co-first authors of this manuscript. Guo CF and Wu LL designed the research study; Guo CF, Wu LL, Peng ZZ, Lin HL, and Feng JN analyzed the data; and all authors wrote the manuscript and have approved the final manuscript.
Supported by Zhejiang Provincial Medical and Health Science and Technology Plan Project, No. 2024KY401; Zhejiang Provincial Traditional Chinese Medicine Science and Technology Plan Project, No. 2024ZF136; and Zhejiang Province Traditional Chinese Medicine Science and Technology Project, No. 2023ZL170.
Institutional review board statement: This study was approved by the Ethic Committee of the Third Affiliated Hospital of Wenzhou Medical University, approval number: YJ2024113.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The original anonymous dataset is available on reasonable request from the corresponding author at fengjienitdyy@126.com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jie-Ni Feng, MMed, Attending Doctor, Department of Medical Oncology, The Third Affiliated Hospital of Wenzhou Medical University, No. 168 Ruifeng Avenue, Wenzhou 325200, Zhejiang Province, China. fengjienitdyy@126.com
Received: July 23, 2024
Revised: August 17, 2024
Accepted: August 27, 2024
Published online: September 19, 2024
Processing time: 49 Days and 19.2 Hours
Abstract
BACKGROUND

Evaluating the psychological resilience of lung cancer (LC) patients helps understand their mental state and guides future treatment. However, there is limited research on the psychological resilience of LC patients with bone metastases.

AIM

To explore the psychological resilience of LC patients with bone metastases and identify factors that may influence psychological resilience.

METHODS

LC patients with bone metastases who met the inclusion criteria were screened from those admitted to the Third Affiliated Hospital of Wenzhou Medical University. The psychological scores of the enrolled patients were collected. They were then grouped based on the mean psychological score: Those with scores lower than the mean value were placed in the low-score group and those with scores equal to or greater than the mean value was placed in the high-score group. The baseline data (age, gender, education level, marital status, residence, monthly income, and religious beliefs), along with self-efficacy and medical coping mode scores, were compared.

RESULTS

This study included 142 LC patients with bone metastases admitted to our hospital from June 2022 to December 2023, with an average psychological resilience score of 63.24 ± 9.96 points. After grouping, the low-score group consisted of 69 patients, including 42 males and 27 females, with an average age of 67.38 ± 9.55 years. The high-score group consisted of 73 patients, including 49 males and 24 females, with a mean age of 61.97 ± 5.00 years. χ2 analysis revealed significant differences between the two groups in education level (χ2 = 6.604, P = 0.037), residence (χ2 = 12.950, P = 0.002), monthly income (χ2 = 9.375, P = 0.009), and medical coping modes (χ2 = 19.150, P = 0.000). Independent sample t-test showed that the high-score group had significantly higher self-efficacy scores (t = 3.383, P = 0.001) and lower age than the low-score group (t = 4.256, P < 0.001). Furthermore, multivariate logistic regression hazard analysis confirmed that self-efficacy is an independent protective factor for psychological resilience [odds ratio (OR) = 0.926, P = 0.035, 95% confidence interval (CI): 0.862-0.995], while age (OR = 1.099, P = 0.003, 95%CI: 1.034-1.169) and medical coping modes (avoidance vs confrontation: OR = 3.767, P = 0.012, 95%CI: 1.342-10.570; resignation vs confrontation: OR = 5.687, P = 0.001, 95%CI: 1.974-16.385) were identified as independent risk factors. A predictive model based on self-efficacy, age, and medical coping modes was developed. The receiver operating characteristic analysis showed an area under the curve value of 0.778 (95%CI: 0.701-0.856, P < 0.001), indicating that the model has good predictive performance.

CONCLUSION

LC patients with bone metastases are less psychologically resilient than the general population. Factors such as self-efficacy, age, and medical coping modes influence their psychological resilience. Patients with low self-efficacy, old age, and avoidance/resignation coping modes should be closely observed.

Keywords: Lung cancer; Bone metastases; Psychological resilience; Influencing factors; Clinical evaluation

Core Tip: We surveyed psychological resilience on lung cancer patients with bone metastases and found that their resilience level was low. It is confirmed that high self-efficacy is an independent protective factor for psychological resilience, while advanced age and poor medical coping modes are independent risk factors. The prediction model constructed based on these factors can be used to predict the psychological resilience of patients, providing a strong reference basis for clinical treatment and management.