Abstract: Objective To explore the factors influencing stigmatization in patients with malignant breast cancer wounds, identify its core predictive factors, and construct and validate a clinical predictive model for stigmatization. Methods A cross-sectional survey was conducted on 67 patients using the following instruments： general information questionnaire, Stigma Scale for Chronic Illnesses 8-item version （SSCI-8）, Toronto Wound Symptom Assessment System-Wounds（TSAS-W）, Self-Rating Anxiety Scale （SAS）, Self-Rating Depression Scale （SDS）, Social Support Rating Scale （SSRS）, and Quality of Life Instruments for Cancer Patients-Breast Cancer（QLICP-BR）. Data analysis was performed using univariate analysis, Pearson correlation, and multiple linear regression analysis. Results The overall score for stigmatization was 13.3±5.76 points. Correlation analysis showed that stigmatization was significantly positively correlated with anxiety （r=0.537） and depression （r=0.464）, and wound symptoms （r=0.389） （all P<0.05）, strongly negatively correlated with quality of life （r=-0.718, P<0.01）, and marginally significantly negatively correlated with social support （r=-0.229, P=0.062）. Multivariate linear regression analysis showed that： Quality of life （β=-0.666, P<0.01） was the strongest negative predictor of stigma, while anxiety （β=0.234, P=0.088） and depression （β=-0.251, P=0.095） had marginal predictive effects. The final model explained 51.5% of the variance in stigmatization （adjusted R³=0.515, F=15.003, P<0.01）. Conclusion Stigmatization in patients with breast cancer wounds has a significant statistical association with quality of life, and a marginally significant association with anxiety and depression levels. Wound management can be combined with a focus on enhancing patient quality of life and alleviating anxiety and depression, in order to reduce patients' level of stigmatization.

Key words: breast cancer wounds, stigma, influencing factors, predictive mode

摘要： 目的 调查乳腺癌癌性伤口患者病耻感现状,并探讨病耻感的影响因素,明确其核心预测因子,构建病耻感的临床预测模型。方法 采用一般资料问卷、慢性病病耻感量表（SSCI-8）、多伦多伤口症状评估系统（TSAS-W）、焦虑自评量表（SAS）、抑郁自评量表（SDS）、社会支持评定量表（SSRS）、乳腺癌患者生命质量测定量表（QLICP-BR）对67例患者进行横断面调查。数据分析采用单因素分析、Pearson相关及多元线性回归分析。结果 病耻感总体得分（13.3±5.76）分;相关性分析显示,病耻感与焦虑（r=0.537）、抑郁（r=0.464）及伤口症状（r=0.389）呈显著正相关（均P<0.05）,与生活质量呈强负相关（r=-0.718,P<0.01）,与社会支持呈边缘显著负相关（r=-0.229,P=0.062）。多元线性回归分析显示：生活质量（β=-0.666,P<0.01）是病耻感最强的负向预测因子,焦虑（β=0.234,P=0.088）、抑郁（β=-0.251,P=0.095）呈边缘预测作用。最终模型解释病耻感51.5%变异（调整R²=0.515,F=15.003,P<0.01）。结论 对于乳腺癌癌性伤口患者,其病耻感与生活质量存在显著的统计关联,与焦虑和抑郁水平则存在边缘显著关联。处理伤口的同时可结合关注提升患者生活质量和缓解焦虑抑郁情绪,以降低患者的病耻感水平。

关键词: 乳腺癌性伤口, 病耻感, 影响因素, 预测模型