Bowman Karen F, Deimling Gary T, Smerglia Virginia, Sage Paulette, Kahana Boaz
Department of Sociology, Case Western Reserve University, OH 44106-7124, USA.
Psychooncology. 2003 Apr-May;12(3):226-38. doi: 10.1002/pon.630.
Cancer survivorship is best viewed as a process that continues across the life span. Appraisals of cancer change over time and may not be explicit until long after treatment completion. The current study, using the Lazarus and Folkman (1984) stress-appraisal-coping framework, explored factors related to both a stressful and an irrelevant appraisal of the cancer experience by older long-term survivors. Hierarchical regression analysis investigated the individual and cumulative effects of person factors (survivors' demographic characteristics, beliefs about the effect of cancer on family members) and situation factors (characteristics of cancer) on survivors' appraisals that cancer was a stressful life event. The strongest correlates of the stress appraisal were person factors. A more stressful appraisal was associated with: (1). the belief that diagnosis/treatment caused greater family distress, (2). being younger, and (3). being White. The irrelevant appraisal had a marginally significant correlate in bivariate analysis and was not included in regression analysis. Implications for health-care professionals and patient/family interventions are discussed.
癌症生存最好被视为一个贯穿一生的过程。对癌症的评估会随时间而变化,并且可能直到治疗结束很久之后才会明确显现。当前的研究采用拉扎勒斯和福克曼(1984年)的压力评估应对框架,探讨了长期存活的老年癌症幸存者对癌症经历进行压力评估和无关评估的相关因素。分层回归分析研究了个体因素(幸存者的人口统计学特征、对癌症对家庭成员影响的信念)和情境因素(癌症的特征)对幸存者将癌症视为压力性生活事件的评估的个体和累积影响。压力评估的最强相关因素是个体因素。更具压力的评估与以下因素相关:(1)认为诊断/治疗给家庭带来更大困扰,(2)年龄较小,(3)是白人。在双变量分析中,无关评估有一个边缘显著的相关因素,未纳入回归分析。文中讨论了对医疗保健专业人员以及患者/家庭干预的启示。