护理研究2026，Vol.40Issue(16)：2781-2789,9.DOI:10.12102/j.issn.1009-6493.2026.16.003
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
Configurational effects mechanism of the psychological ecosystem in advanced lung cancer patients and its implications for death education
摘要
Abstract
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.关键词
晚期肺癌/死亡教育/模糊集定性比较分析/死亡焦虑/死亡态度/安宁疗护Key words
advanced lung cancer/death education/fuzzy-set qualitative comparative analysis,fsQCA/death anxiety/death attitude/hospice care引用本文复制引用
张丁懿,李月琳,王云华,刘芮杉,张纤,卢玉林..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[J].护理研究,2026,40(16):2781-2789,9.基金项目
云南省教育厅老年慢性疾病综合照护重点实验室资助项目 （）
昆明医科大学成人与老年护理学科团队资助项目,编号:2024XKTDPY15 （）
昆明医科大学2025年硕士研究生教育创新基金项目,编号:2025S026 （）
