A prospective examination of perceived stress as a mediator of the relationship between life-events and QOL following breast cancer
A prospective examination of perceived stress as a mediator of the relationship between life-events and QOL following breast cancer
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DOI：
10.1348/135910709x412459
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发表时间：
2009-11-01
影响因子：
7.9
通讯作者：
Wade, Tracey D.
中科院分区：
文献类型：
--
作者：
Beatty, Lisa;Lee, Christina;Wade, Tracey D.
目标。本研究以癌症压力的生物行为模型为框架，前瞻性地调查了乳腺癌诊断后的生活事件、感知压力和生活质量 (QOL) 之间的关系。使用纵向自我报告设计。方法。作为基于人口的调查的一部分，我们在 5 年内收集了来自 10,543 名中年澳大利亚女性（调查 1 中年龄为 45-50 岁）的三波数据。从该组中确定了一个子样本（N = 140），他们在调查 1 时没有患乳腺癌，但随后患上了乳腺癌。随机回归生长曲线分析用于调查感知压力是否介导初始生活事件与随时间推移的生活质量功能变化之间的关系。结果。为测试调解的三个标准中的每一个标准生成了前瞻性证据。随着乳腺癌发生前生活事件数量的增加，女性在 5 年期间感受到的压力明显更有可能相应增加。随着乳腺癌发生前感知到的压力水平增加，女性在情绪角色、身体角色、活力、身体疼痛、身体功能和社会功能方面更有可能经历恶化。随着乳腺癌发生前生活事件数量的增加，女性在身体疼痛、社会功能、角色情绪和活力方面面临着随着时间推移而恶化的巨大风险。中介分析表明，感知压力完全调节了初始生活事件和两个生活质量领域之间的关系；角色情绪和社会功能。结论。结果部分支持癌症应激的生物行为模型，但该模型似乎与数据和预测不相符，可能需要修改。
Objectives. This study prospectively investigated the relationship between life-events, perceived stress, and quality of life (QOL) following breast cancer diagnosis, using the bio-behavioural model of cancer stress as a framework.Design. A longitudinal, self-report design was used.Methods. Three waves of data from 10,543 mid-aged Australian women (aged 45-50 at Survey 1) were collected over 5 years as part of a population-based survey. From this group a subsample (N = 140) were identified who did not have breast cancer at Survey 1, but who subsequently developed breast cancer. Random regression growth curve analyses were used to investigate whether perceived stress mediated the relationship between initial life-events and change in QOL functioning overtime.Results. Prospective evidence was generated for each of the three criteria for testing mediation. As the number of life-events before breast cancer increased, women were significantly more likely to experience corresponding increases in perceived stress over the 5-year period. As the level of perceived stress before breast cancer increased, women were more likely to experience deteriorations overtime in role emotional, role physical, vitality, bodily pain, physical functioning, and social functioning. As the number of life-events before breast cancer increased, women were at significant risk of experiencing deteriorations overtime in bodily pain, social functioning, role emotional, and vitality. Mediational analyses revealed that perceived stress fully mediated the relationship between initial life-events and two QOL domains; role-emotional and social functioning.Conclusion. Results partially supported the bio-behavioural model of cancer stress, but the model does not appear to fit the data as well as predicted, and may require revision.