乳腺癌患者创伤后成长、心理弹性与注意偏向的相关性研究
Mediating Role of Attention Bias in Posttraumatic Growth and Resilience of Breast Cancer Patients

目的：探讨乳腺癌患者的创伤后成长、心理弹性、注意偏向三者之间的关系，分析注意偏向在创伤后成长和心理弹性中的中介作用。方法：采用创伤后成长量表(PTGI)、心理弹性量表简化版(CD-RISC)、注意偏向量表(APNI)对2019年6月~2019年12月泰安市三所综合医院302名乳腺癌患者进行横断面调查；使用结构方程模型探讨注意偏向在创伤后成长及心理弹性中的中介作用。结果：乳腺癌患者PTGI得分与心理弹性得分呈正相关(r = 0.491, P < 0.01)；正性注意偏向与PTGI呈正相关(r = 0.314, P < 0.01)，负性注意偏向与PTGI呈负相关(r = ？0.207, P < 0.01)。中介效应检验显示，假设模型拟合良好。路径分析表明，心理弹性可以直接正向预测创伤后成长(r = 0.45, P < 0.05)，并通过正性注意偏向与负性注意偏向间接作用于创伤后成长，其间接效应分别占总效应的22.10%。结论：乳腺癌患者创伤后成长和心理弹性、注意偏向密切相关，注意偏向在创伤后成长和心理弹性间起部分中介作用。临床工作中医务人员注意提高乳腺癌患者的心理弹性，引导患者关注积极的心理和事件，降低不良负性情绪的影响和关注，可促进患者的创伤后成长。
Objective: To study the relationship between posttraumatic growth, resilience, attention bias for patients with breast cancer, and to provide evidence for improving the level of posttraumatic growth. Methods: A total of 302 breast cancer patients were recruited by using the Posttraumatic Growth Inventory (PTGI), Connor-Davidson Resilience Scale (CD-RISC), Attention to Positive and Negative Inventory (APNI). Results: The total score of the PTGI was 64.43 ± 14.45, the CD-RISC score was 25.57 ± 7.03, the positive attention bias score was 43.18 ± 8.66, the negative attention bias score was 26.29 ± 8.26. Resilience and posttraumatic growth were positively correlated (r = 0.491, P < 0.01); attention to positive and posttraumatic growth were positively correlated (r = 0.314, P < 0.01); attention to negative and posttraumatic growth were negatively correlated (r = ？0.207, P < 0.01). Structural equation model analysis showed that resilience on posttraumatic growth has a direct effect (r = 0.45, P < 0.05) and through the positive and negative attention bias indirectly effect on posttraumatic growth, the indirect effects were accounted for 22.10% of the total effects. Conclusions: The level of posttraumatic growth of breast cancer patient was medium. Attention to positive could play a mediation role between posttraumatic growth and resilience of patients with breast cancer. In the clinical nursing work, medical staff can improve the resilience of breast cancer patients, guide patients to pay attention to the positive information of the disease, reduce the negative adverse emotions and the impact of information on patients, so as to promote the posttraumatic growth of patients.