The association between social support, intrusive thoughts, avoidance, and adjustment following an experimental cancer treatment
The association between social support, intrusive thoughts, avoidance, and adjustment following an experimental cancer treatment
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DOI：
10.1002/pon.656
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发表时间：
2003-07-01
期刊：
影响因子：
3.6
通讯作者：
Cohen, L
中科院分区：
文献类型：
--
作者：
Devine, D;Parker, PA;Cohen, L
在接受转移性黑色素瘤(n=24)或转移性肾细胞癌(n=29)实验疫苗治疗的53名患者中，使用社会认知处理模型来检验社会支持与侵入性思维和回避在预测调整中的关联。在第一次治疗当天、最后一次治疗当天和治疗结束后1个月进行常规随访，评定社会支持、侵犯性思维/回避、心理困扰和生活质量。治疗开始时的社会支持与治疗后1个月的心理健康生活质量(QOL)呈负相关，与心理健康生活质量(QOL)呈正相关，这些关系在治疗结束时的侵入性思维/回避中起中介作用。在治疗1个月后，社会支持与治疗开始时的侵入性思维/回避之间也存在交互作用，可以预测心理痛苦和精神健康生活质量。具体地说，对于支持水平较低的患者，更多的侵入性想法/回避与治疗后1个月更大的心理痛苦和更差的心理健康生活质量相关。然而，在社会支持水平较高的患者中，侵入性思维/回避与适应之间没有关联。这些结果表明，社会支持缓冲了侵扰性思维/回避与心理适应之间的负关联。总体而言，这些结果与癌症患者创伤后反应的社会认知处理模型是一致的。我们的结果强调了评估患者感知到的支持的必要性，并进一步开发和评估干预措施的益处，以增加患者的支持网络，促进对癌症体验的认知处理。版权所有(C)2003 John Wiley Sons，Ltd.
A social-cognitive processing model was used to examine the association of social support with intrusive thoughts and avoidance in predicting adjustment in 53 patients receiving an experimental vaccine for the treatment of either metastatic melanoma (n = 24) or metastatic renal cell cancer (n = 29). Social support, intrusive thoughts/avoidance, psychological distress and quality of life were assessed on the day of the first treatment, on the day of the final treatment, and 1 month after the end of treatment during a routine follow-up visit. Social support at the beginning of treatment was negatively associated with psychological distress and positively associated with mental health quality of life (QOL) 1 month after treatment, and these associations were mediated by intrusive thoughts/avoidance at the end of treatment. There was also an interaction between social support and intrusive thoughts/avoidance at the beginning of treatment in predicting both psychological distress and mental health QOL 1 month after treatment. Specifically, for patients with lower levels of support, greater intrusive thoughts/avoidance was associated with greater psychological distress and poorer mental health QOL 1 month after treatment. However, there was no association between intrusive thoughts/avoidance and adjustment in patients with high levels of social support. These results suggest that social support buffers the negative association between intrusive thoughts/avoidance and psychological adjustment. Overall, the results are consistent with a social-cognitive processing model of post-trauma reactions among cancer patients. Our results highlight the need to assess patients' perceived support and to further develop and assess the benefits of interventions to increase patients' supportive networks and to facilitate cognitive processing of the cancer experience. Copyright (C) 2003 John Wiley Sons, Ltd.