Effects of decisional conflict, decision regret and self-stigma on quality of life for breast cancer survivors: A cross-sectional, multisite study in China
Effects of decisional conflict, decision regret and self-stigma on quality of life for breast cancer survivors: A cross-sectional, multisite study in China
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DOI：
10.1111/jan.15250
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发表时间：
2022-04-09
影响因子：
3.8
通讯作者：
Zhu，Jiemin
中科院分区：
文献类型：
--
作者：
Zhuang，Hezhu;Wang，Ling;Zhu，Jiemin
目的 探讨选择不同手术方式的乳腺癌幸存者决策冲突、决策后悔、自我耻辱和生活质量的差异，以及决策冲突、决策后悔和自我耻辱对生活质量的影响。设计观察性研究。方法采用纸质调查和网络调查收集2020年3月至9月的数据。中文版决策冲突量表、决策后悔量表、自我耻辱形式和功能癌症治疗评估-B 用于测量从三所大学附属医院选择不同手术的乳腺癌幸存者的相应健康结果。采用单因素方差分析、Pearson相关系数和层次多元回归分析进行数据分析。结果在448名参与者中，只有21%的人选择乳房保守手术，而79%的人选择乳房切除术伴或不伴重建。与选择乳房保守手术的女性相比，选择乳房切除术并重建的女性报告了更高的决策冲突 (p=.028) 和更多的决策后悔 (p=.013)；与选择乳房保守手术的女性相比，选择乳房切除术而不重建的女性表现出更高的决策冲突 (p=.015)、更多的决策后悔 (p< .001) 和更高的自我耻辱感 (p=.034)。决策冲突 (r=−.430)、决策后悔 (r=−.495) 和自我耻辱 (r=−.561) 与生活质量呈负相关。在控需要在手术前制定决策支持策略，以告知女性手术选择的风险和益处。此外，术后心理支持有必要减轻女性的自我耻辱，从而提高她们的生活质量。
AimsTo examine the differences in decisional conflict, decision regret, self‐stigma and quality of life among breast cancer survivors who chose different surgeries, as well as the effects of decisional conflict, decision regret and self‐stigma on quality of life.DesignObservational study.MethodsPaper and online surveys were used to collect data from March to September 2020. The Chinese version of the Decisional Conflict Scale, Decision Regret Scale, Self‐Stigma Form and Functional Assessment of Cancer Treatment‐B were used to measure the corresponding health outcomes for breast cancer survivors who chose different surgeries from three university‐affiliated hospitals. One‐way analysis of variance, Pearson's correlation coefficient and hierarchical multiple regression analysis were used for data analysis.ResultsAmong the 448 participants, only 21% chose breast conservative surgery, while 79% chose mastectomy with or without reconstruction. Women who chose mastectomy with reconstruction reported higher decisional conflict (p= .028) and more decision regret (p= .013) than women who chose breast conservative surgery; women who chose mastectomy without reconstruction indicated higher decisional conflict (p= .015), more decision regret (p< .001), and higher self‐stigma (p= .034) than women who chose breast conservative surgery. Decisional conflict (r= −.430), decision regret (r= −.495), and self‐stigma (r= −.561) were negatively correlated with quality of life. After controlling for sociodemographic and clinical variables, decisional conflict and decision regret explained 19.7% and self‐stigma explained 12.9% of the variance in quality of life.ConclusionDecisional conflict, decision regret and self‐stigma vary according to different breast surgeries and are greatly associated with the quality of life of breast cancer survivors.ImpactFuture studies are warranted to investigate the decision‐making process and the underlying reasons for surgical choices. Decision support strategies pre‐surgery are needed to inform women about the risks and benefits of surgery options. Moreover, psychosocial support post‐surgery is warranted to relieve women's self‐stigma, thus improving their quality of life.