Positive Adjustment In Long-Term Breast Cancer Survivors

描述(由申请人提供)： 在美国170万乳腺癌幸存者中，估计70%的人将报告癌症以积极的方式影响了他们的生活，尽管诊断和治疗存在负面影响。尽管NCI的生存办公室呼吁对癌症的长期积极影响进行研究，但我们对这一现象仍然知之甚少。这一新的研究人员小额拨款申请(R03)关注的是患者对乳腺癌带来积极生活变化(利益发现和成长；BFG)的看法。女性通常报告说，癌症是一种变革性的经历，挑战她们找到新的生活使命感，并增强了她们在许多领域的功能。到目前为止，还没有研究系统地研究这些个体BFG的发展和维持的长期模式。事实上，人们对乳腺癌经过直接诊断和治疗阶段后促进积极调整的因素知之甚少。在NCI资助的压力管理干预研究中，我们对200多名参与者进行了跟踪评估。所有女性都患有早期乳腺癌，并在手术后8周内、术后3个月(对应于干预后随访)、6个月、12个月和5年随访(视为长期幸存者)内进行评估。使用结构方程模型和潜在生长曲线模型，我们将研究BFG，因为女性从手术时间到长期生存都经历了有时崎岖的癌症经历。到这个项目结束时，我们将能够回答相关的问题，如BFG如何随着时间的推移而变化，哪些人将从他们的经历中获得积极的意义，以及哪些特征可以预测这种变化(例如，社会人口变量、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BFG发展和维护理论的关键方面进行实证测试。我们还将了解BFG与传统终点的关系(生理：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术后五年的积极适应。

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.