Positive Adjustment In Long-Term Breast Cancer Survivors

描述（由申请人提供）： 据估计，在美国170万乳腺癌幸存者中，70%的人将报告癌症以积极的方式影响他们的生活，尽管诊断和治疗的负面影响。尽管NCI的生存办公室呼吁研究癌症的长期积极影响，但我们对这种现象仍然知之甚少。这项新的研究者小额赠款申请（R 03）侧重于患者对乳腺癌导致积极生活变化的看法（获益发现和增长; BFG）。女性普遍报告说，癌症是一种变革性的经历，挑战她们找到新的生活目标，并增强了她们在许多领域的功能。迄今为止，没有研究系统地研究了这些人的BFG的发展和维持的长期模式。事实上，人们对促进乳腺癌积极调整的因素知之甚少，而不是直接诊断和治疗阶段。我们对200多名参与NCI资助的压力管理干预研究的参与者进行了随访评估。所有女性均患有早期乳腺癌，并在手术后8周内，手术后3个月（对应于干预后随访），6个月，12个月和5年随访（视为长期生存者）进行评估。使用结构方程模型和潜在增长曲线模型，我们将研究BFG作为女性导航有时岩石地形的癌症经历从手术到长期生存的时间。在这个项目结束时，我们将能够回答有关BFG如何随着时间的推移而变化的相关问题，哪些人将从他们的经验中获得积极的意义，以及哪些特征预测这种变化（例如，社会人口学变量、疾病相关变量和心理社会特征：应对、乐观、社会支持、情绪处理）。将对高炉煤气的发展和维护理论的关键方面进行实证检验。我们还将了解BFG与传统终点的关系（身体：疲劳，身体功能，健康状况和随后的癌症事件/复发;心理：生活质量，痛苦;经济：重返工作/就业），并确定压力管理干预如何影响乳腺癌手术后五年的积极调整。

DESCRIPTION (provided by applicant): Of the 1.7 million breast cancer survivors in the US, it is estimated that 70% will report that cancer impacted their lives in a positive manner, despite the negative aspects of diagnosis and treatment. In spite of the NCI's Office of Survivorship's call for studies to investigate long-term positive effects of cancer, we still know very little about this phenomenon. This new investigator small grant application (R03) focuses on patients' perceptions that having breast cancer led to positive life changes (Benefit-Finding and Growth; BFG). Women commonly report that cancer was a transformative experience that has challenged them to find a new sense of purpose in life and has enhanced their functioning across a number of domains. To date, no study has systematically examined the long-term pattern of development and maintenance of BFG in these individuals. In fact, there is little understanding of the factors that promote positive adjustment to breast cancer past the immediate diagnosis and treatment phase. We conducted follow-up assessments with over 200 participants in an NCI-funded stress management intervention study. All women had early stage breast cancer and were assessed within 8 weeks of surgery, 3-months post-surgery (corresponding to post-intervention follow-up), 6-month, 12-month and 5-year follow-ups (considered long-term survivors). Using structural equation modeling and latent growth curve modeling, we will examine BFG as women navigate the sometimes rocky terrain of the cancer experience from the time of surgery to long-term survivorship. By the end of this project, we will be able to answer pertinent questions regarding how BFG changes over time, which people will derive positive meaning from their experience, and what characteristics predict such changes (e.g., sociodemographic variables, disease-related variables, and psychosocial characteristics: coping, optimism, social support, emotional processing). Empirical tests of critical aspects of the theory of the development and maintenance of BFG will be conducted. We will also understand BFG's relation to traditional endpoints (Physical: fatigue, physical functioning, health status, and subsequent cancer events/recurrence; Psychological: quality of life, distress; Economic: Return to Work/Employment), and determine how a stress management intervention can influence positive adjustment in the five years post-surgery for breast cancer.