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癌症康复的差异效应取决于诊断结果和患者的认知应对方式。

Differential effects of cancer rehabilitation depending on diagnosis and patients' cognitive coping style.

作者信息

Petersson Lena-Marie, Nordin Karin, Glimelius Bengt, Brekkan Einar, Sjödén Per-Olow, Berglund Gunilla

机构信息

Department of Public Health and Caring Sciences, Uppsala University, Uppsala Science Park, Sweden.

出版信息

Psychosom Med. 2002 Nov-Dec;64(6):971-80. doi: 10.1097/01.psy.0000028825.64279.f2.

Abstract

OBJECTIVE

The major aim was to explore the extent to which the Miller Behavioral Style Scale (MBSS) can be used to differentiate cancer patients who are likely to benefit from rehabilitation efforts with a strong information component from those who are not.

METHODS

Newly diagnosed patients with breast, gastrointestinal, or prostate cancer (N = 442) were included in a randomized, prospective study of the effects (on anxiety, depression, intrusion, avoidance) of rehabilitation approximately 4 months after diagnosis as compared with control patients. Patients were classified as "monitors" or "blunters" on the basis of the MBSS (368 patients, 83%, completed the MBSS).

RESULTS

The expected interaction at postintervention between coping style and experimental condition (ie, rehabilitation or control) was found only for avoidance among breast and prostate cancer patients. Assignment to the rehabilitation or control condition was of no importance for outcome among blunters. Among monitors, the response pattern differed between breast and prostate cancer patients. Prostate cancer monitors seemed to benefit from rehabilitation on all outcome measures, whereas intrusion and avoidance were reduced among breast cancer patients in the control condition. This interaction of diagnosis with condition (rehabilitation or control) among monitors is suggested to be due to demands for diagnosis-specific information during diagnostic work, in the period just after diagnosis, and before treatment decision.

CONCLUSIONS

Only the monitor concept seems useful for predicting response to cancer rehabilitation with a strong information component. However, whether rehabilitation is of benefit depends also on other factors.

摘要

目的

主要目的是探讨米勒行为风格量表(MBSS)在多大程度上可用于区分可能从包含大量信息成分的康复治疗中获益的癌症患者与无法获益的患者。

方法

新诊断的乳腺癌、胃肠道癌或前列腺癌患者(N = 442)被纳入一项随机前瞻性研究,该研究比较了诊断后约4个月康复治疗(与对照患者相比)对焦虑、抑郁、侵入性思维、回避行为的影响。根据MBSS将患者分为“监测者”或“钝化者”(368名患者,83%,完成了MBSS)。

结果

仅在乳腺癌和前列腺癌患者的回避行为方面发现了干预后应对方式与实验条件(即康复或对照)之间预期的相互作用。对于钝化者,分配到康复或对照条件对结果没有影响。在监测者中,乳腺癌和前列腺癌患者的反应模式不同。前列腺癌监测者似乎在所有结果指标上都从康复治疗中获益,而在对照条件下,乳腺癌患者的侵入性思维和回避行为有所减少。监测者中诊断与条件(康复或对照)的这种相互作用被认为是由于在诊断工作期间、诊断后不久以及治疗决策前对特定诊断信息的需求。

结论

只有监测者概念似乎有助于预测对包含大量信息成分的癌症康复治疗的反应。然而,康复治疗是否有益还取决于其他因素。

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