Cancer patients' mental health and family functioning-a longitudinal study on psychosocial factors among breast cancer survivors and their family members-

背景技术背景：研究发现，早期乳癌病患的家庭功能，尤其是沟通不良，与癌症的负面心理调适有显著相关。然而，只有少数研究探讨了乳腺癌患者在无病期的心理适应变化以及家庭功能与这些变化的关系。目的：探讨乳腺癌患者在无病期的心理适应在各种心理社会因素如家庭功能的影响下如何变化。受试者为广岛大学附属医院乳腺防治所乳腺切除术后的72名非卧床乳腺癌幸存者。从每例患者及其丈夫处获得研究的书面知情同意书。受试者在间隔至少3个月（时间1）和3年后（时间2）完成癌症心理适应量表（MAC）、家庭评估量表（FAD）、Zung抑郁自评量表（SDS）和Zung焦虑自评量表（SAS）。丈夫还在时间1和时间2完成了FAD、SDS和SAS。在时间2，55名幸存者和他们的丈夫是eligible.RESULTS：较高水平的病人认为在时间1的家庭凝聚力显着相关，减少在时间2的战斗精神应对。患者感知的家庭沟通水平越高、宿命主义应对越少，患者感知的家庭沟通水平越高、宿命主义应对越少，患者感知的无助/绝望应对越少。一种家庭干预方法，可以支持病人的希望思维，减少宿命的适应，促进家庭沟通和家庭凝聚力，有助于保持战斗精神，应对和减少无助感。乳腺癌幸存者的绝望应对，

BACKGROUND : We have reported that family functioning, especially poor mutual communication, significantly correlated with negative psychological adjustment to cancer among early-stage breast cancer patients. However, only few studies exists that investigate how mental adjustment changes during disease-free period of breast cancer survivors suffering from uncertainty of recurrence risk and how family functioning correlates with those changes.PURPOSE : To investigate how mental adjustment changes under the influence of diverse psychosocial factors such as family functioning during disease-free period of breast cancer survivors.METHODS : The subjects were 72 ambulatory breast cancer survivors after mastectomy at the Mammary Gland Dispensary of Hiroshima University Hospital. Documented informed consent for the study was obtained from each patient and her husband. The subjects completed the Mental Adjustment to Cancer scale(MAC), Family Assessment Device(FAD), the Zung Self-rating Depression Scale(SDS), and the Zung Self-rating Anxiety Scale(SAS) after interval of at least three months (Time 1) and three years later (Time 2). Husbands also completed FAD, SDS, and SAS at Time 1 and Time 2. At Time 2, 55 survivors and their husbands were eligible.RESULTS : Higher level of patient-perceived family cohesion at Time 1 significantly correlated with less reduction of Fighting Spirit coping at Time 2. Higher level of patient-perceived family communication and less Fatalism coping at Time 1 significantly correlated with less Helplessness/Hopelessness coping at Time 2.CONCLUSION : A family intervention approach which could support patients' hopeful thinking and diminish fatalistic adjustment, and could facilitate family communication and family cohesion might contribute for maintaining Fighting Spirit coping and reducing Helplessness/Hopelessness coping among breast cancer survivors,