目的 采取主客体互倚模型分析初诊癌症患者及配偶感知到的家庭回避癌症沟通对积极心理健康的影响机制及差异性。方法 2023年1月至2024年7月，便利抽样法选取某三级甲等综合性医院肿瘤血液科收治的初次确诊癌症患者及配偶（209对）为研究对象，采用家庭回避癌症沟通量表和积极心理健康量表对其进行调查。建立患者和配偶感知到的家庭回避癌症沟通对积极心理健康的主客体互倚模型。结果 初诊癌症患者及配偶感知到的家庭回避癌症沟通得分分别为（66.22±6.71）分、（61.33±5.69）分；积极心理健康得分分别为（13.64±4.02）分、（13.85±4.75）分。主体效应显示，初诊癌症患者（β=-0.213）和配偶（β=-0.293）感知到的家庭回避癌症沟通均能负向预测自身积极心理健康（均P＜0.05）；客体效应显示，初诊癌症患者（β=-0.177）和配偶（β=-0.148）感知到的家庭回避癌症沟通均能负向预测对方积极心理健康（均P＜0.05）。结论 初诊癌症患者和配偶感知到的家庭回避癌症沟通能负面影响自身及对方的积极心理健康，护理人员应积极鼓励患者及配偶主动与对方或家庭其他成员积极沟通癌症病情，提升二者之间积极心理健康水平。

Objective To analyze the influence mechanism and differences of perceived family avoidance of communication about cancer on positive mental health in newly diagnosed cancer patients and their spouses using the Actor-Partner Interdependence Model (APIM). Methods From January 2023 to July 2024, 209 newly diagnosed cancer patients and their spouses admitted to the oncology/hematology department of a tertiary A general hospital were selected by convenience sampling, and surveyed using the Family Avoidance of Communication about Cancer Scale and the Positive Mental Health Scale. An APIM was established to examine the effects of such avoidance of communication in both patients and spouses.Results The scores for the avoidance of communication were (66.22±6.71) for patients and (61.33±5.69) for spouses; the positive mental health scores were (13.64±4.02) for patients and (13.85±4.75) for spouses. Actor effects showed that such avoidance of communication negatively predicted one’s own positive mental health for both patients（β=-0.213） and spouses (β=-0.293, both P＜0.05). Partner effects showed that such avoidance of communication negatively predicted the partner’s positive mental health for both patients（β=-0.177） and spouses (β=-0.148, both P＜0.05).Conclusions Perceived family avoidance of communication about cancer in newly diagnosed cancer patients and their spouses negatively affects their own and their partner’s positive mental health. Nursing staff should actively encourage patients and their spouses to proactively communicate about the cancer with each other or other family members to enhance their mutual positive mental health levels.

R473.73

苏州市科技发展计划（SYSD2020138）