Trajectories of psychological distress among Chinese women diagnosed with breast cancer
Trajectories of psychological distress among Chinese women diagnosed with breast cancer
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DOI：
10.1002/pon.1658
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发表时间：
2010-10-01
期刊：
影响因子：
3.6
通讯作者：
Fielding, Richard
中科院分区：
文献类型：
--
作者：
Lam, Wendy W. T.;Bonanno, George A.;Fielding, Richard
背景资料：乳腺癌（BC）诊断后第一年的心理困扰的不同轨迹及其决定因素尚未探讨。方法：在405名接受BC手术的中国女性中，有285名在术后5天、1个月、4个月和8个月进行了心理困扰、乐观、治疗决策（TDM）困难、对治疗结果的满意度、医疗咨询满意度和身体症状困扰。潜在增长混合模型确定了对BC的心理反应轨迹。多项Logistic回归分析比较了TDM困难、治疗结果满意度、医疗咨询满意度、乐观和身体症状困扰，通过调整年龄、教育、就业状况和疾病阶段的困扰模式进行了调整。确定了四种不同的痛苦轨迹，即弹性（66%），慢性痛苦（15%），恢复（12%）和延迟恢复（7%）。TDM困难，乐观，满意度咨询，和身体症状困扰预测的痛苦轨迹。与其他痛苦模式的女性相比，心理弹性女性在术后早期的身体症状痛苦较少。与弹性组相比，恢复或慢性困扰组的妇女经历了更大的TDM困难，而延迟恢复组的妇女对最初的医疗咨询更不满意。妇女在慢性困扰组报告更大的悲观outlooks.Conclusion：乐观和更好的早期手术后治疗结果预测弹性的困扰。术前干预，帮助妇女建立一个现实的期望治疗结果可能会减少失望与治疗结果和由此产生的痛苦，而术后康复应侧重于症状管理。版权所有（C）2009约翰威利父子有限公司
Background: The distinct trajectories of psychological distress over the first year of the diagnosis with breast cancer (BC) and its determinants have not been explored.Methods: 285 of 405 Chinese women receiving surgery for BC were assessed at 5-day, 1-month, 4-month, and 8-month post-surgery on measures of psychological distress, optimism, treatment decision-making (TDM) difficulties, satisfaction with treatment outcome, satisfaction with medical consultation, and physical symptom distress. Latent growth mixture modelling identified trajectories of psychological response to BC. Multinominal logistic regression compared TDM difficulties, satisfaction with treatment outcome, satisfaction with medical consultation, optimism, and physical symptom distress, by distress pattern adjusted for age, education, employment status, and stage of disease.Results: Four distinct trajectories of distress were identified, namely, resilience (66%), chronic distress (15%), recovered (12%), and delayed-recovery (7%). TDM difficulties, optimism, satisfaction with consultation, and physical symptom distress predicted distress trajectories. Psychologically resilient women had less physical symptom distress at early post-surgery compared with women with other distress patterns. Compared with the resilient group, women in the recovered or chronic distress groups experienced greater TDM difficulties, whereas women in the delayed-recovery group reported greater dissatisfaction with the initial medical consultation. Women in the chronic distress group reported greater pessimistic outlook.Conclusion: Optimism and better early post-operative treatment outcomes predicted resilience to distress. Pre-operative interventions helping women to establish a realistic expectation of treatment outcome may minimize disappointment with treatment outcome and resultant distress, whereas post-operative rehabilitation should focus on symptom management. Copyright (C) 2009 John Wiley & Sons, Ltd.