The Mediating Role of Hope in the Relationship Between Perceived Stress and Post-Traumatic Stress Disorder Among Chinese Patients with Oral Cancer: A Cross-Sectional Study

Abstract

Ying Zhang,1 Chunying Cui,1 Lie Wang,1 Xiaosong Yu,2 Yu Wang,1 Xiaoxi Wang3 1Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People’s Republic of China; 2Department of General Practice, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, People’s Republic of China; 3Medical Basic Experimental Teaching Center, China Medical University, Shenyang, Liaoning, People’s Republic of ChinaCorrespondence: Xiaoxi Wang Email [email protected]: Cancer diagnosis and treatment are long-term traumatic stressors. Depression and anxiety are known to be prevalent in patients with cancer, but post-traumatic disorder (PTSD) has been overlooked frequently in this population. This study aimed to estimate the prevalence of PTSD and examined the mediating role of hope in the relationship between perceived stress and PTSD symptoms in Chinese patients with oral cancer.Methods: A total of 230 oral cancer patients were recruited to complete a questionnaire including the Posttraumatic Stress Checklist-Civilian Version (PCL-C), the Perceived Stress Scale-10 (PSS-10) and the Herth Hope Index (HHI). Analysis of variances (ANOVA)/t-test, Person’s r and hierarchical linear regression analysis methods were conducted to assess the associations among perceived stress, hope and PTSD symptoms. Asymptotic and resampling strategies were used to explore the mediating role of hope.Results: The prevalence of PTSD symptoms was 6.05% in Chinese patients with oral cancer. Perceived stress was positively related to PTSD symptoms, explaining 39.9% of the variance. In addition, hope was negatively related to PTSD symptoms, explaining 5.9% of the variance. Besides, the proportion of mediation of hope was 30.06%.Conclusion: Perceived stress was positively associated with PTSD symptoms, and hope was negatively associated with PTSD symptoms. Furthermore, hope played partial mediating role in the relationship between perceived stress and PTSD symptoms. Thus, more attention should be paid to patients’ PTSD status, and take measures is to relieve stress and increase hope.Keywords: oral cancer, hope, perceived stress, post-traumatic disorder, PTSD

Keywords

• oral cancer
• hope
• perceived stress
• post-traumatic disorder
• ptsd.