作者：钱素莹1，郝伶俐2，魏秀芹1,2，孙帅2,3

单位：1.南通大学附属海安市人民医院 消化内科，江苏 南通 226600；2.首都医科大学附属北京康复医院 胃肠康复中心，北京 100144；3.解放军总医院京南医疗区 消化科，北京 100038

Authors: Qian Suying1，Hao Lingli2，Wei Xiuqin1,2，Sun Shuai2,3

Unit: 1.Department of Gastroenterology, Hai'an People's Hospital Affiliated to Nantong University, Nantong 226600, Jiangsu, China；2.Gastroenterology Rehabilitation Center, Beijing Rehabilitation Hospital, Beijing 100144, China；3.Gastroenterology of Jingnan Medical District, General Hospital of Chinese PLA, Beijing 100038, China

摘要：

目的 探讨胃癌患者负性自动思维、社会疏离感和抑郁的现状及相互间的关系。方法 采用一般资料问卷、自动思维问卷（ATQ）、一般疏离感量表（GAS）及抑郁自评量表（SDS）于2021年5月至12月对3家医院胃肠消化科收治的245例胃癌患者开展现场问卷调查。以SPSS 23.0及Mplus7.0软件进行数据分析和模型验证。结果 胃癌患者ATQ得分为（62.14±9.75）分，GAS得分为（45.62±5.44）分，SDS得分为（55.35±7.28）分。不同文化程度、家庭平均月收入及临床分期的胃癌患者ATQ及SDS得分差异有统计学意义（P<0.05），不同年龄、文化程度及临床分期胃癌患者的GAS得分差异有统计学意义（P<0.05）。相关分析结果 显示，ATQ、GAS与SDS得分呈两两正相关（均P<0.01）。结构方程模型分析显示，胃癌患者负性自动思维在社会疏离感与抑郁之间起部分中介作用，标准化中介效应值是0.121，占总效应比值为20.93%。结论 社会疏离感对胃癌患者抑郁状态有直接预测作用，负性自动思维在社会疏离感与抑郁间起部分中介作用。

关键词：胃癌；负性自动思维；社会疏离；抑郁；中介作用

Abstract：

Objective To explore the current situation and relationship of negative automatic thinking, social alienation and depression in patients with gastric cancer. Method A total of 245 gastric cancer patients from three hospitals were investigated by general information questionnaire , automatic thinking questionnaire （ATQ）, general alienation scale （GAS ） and self - rating depression scale （SDS） from May to December 2021. Based on SPSS 23.0 and Mplus 7.0 software for data analysis and model verification. Result The scores of ATQ, GAS and SDS were （62.14±9.75）, （45.62±5.44） and （55.35±7.28） respectively. There were significant differences in ATQ and SDS scores among gastric cancer patients with different educational levels, family average monthly income and clinical stages （P<0.05）, and there were significant differences in GAS scores among gastric cancer patients with different ages, educational levels and clinical stages （P<0.05）. The results of correlation analysis showed that ATQ, GAS and SDS scores were positively correlated （all P<0.01）. Structural equation model analysis showed that negative automatic thinking in patients with gastric cancer played a partial mediating role between social alienation and depression. The standardized mediating effect value was 0.121, accounting for 20.93% of the total effect ratio. Conclusion Social alien[1]ation can directly predict the depression of patients with gastric cancer, and negative automatic thinking plays a mediating role between social alienation and depression.

Key Words: Gastric cancer；Negative automatic thinking；Social alienation；;Depression；Mediation