De Boer M F, Ryckman R M, Pruyn J F, Van den Borne H W
Department of Head and Neck Surgery, University Hospital Rotterdam Daniel den Hoed Cancer Center, Rotterdam, The Netherlands.
Patient Educ Couns. 1999 Jul;37(3):215-30. doi: 10.1016/s0738-3991(99)00029-4.
This article reviews literature on the psychosocial correlates of cancer relapse and survival from 1979 through 1995. The factors studied were structured according to a theoretical model of coping with cancer. Reviewed studies have shown that factors most frequently evaluated were depression, anxiety, hopelessness/helplessness, hostility, marital status and social involvement. Mainly inconsistent results were found. The strongest evidence for a relationship between psychosocial variables and prognosis was found for social involvement/social support; in 7 of 15 studies a positive relationship was demonstrated, while no negative associations were found. Coping styles e.g., fighting spirit and stoic acceptance, and severe/stressful life events were found to have no conclusive influence on the length of survival. Important determinants of the coping model, such as uncertainty and information given by the specialist were not studied as possible predictors of survival and/or relapse free period. Among the factors that showed no correlation at all was multidimensional health locus of control. For the inconsistent findings, a considerable number of methodologic shortcomings with respect to study design, sample size, measure and statistical analysis are enumerated.
本文回顾了1979年至1995年间有关癌症复发和生存的社会心理相关因素的文献。所研究的因素是根据应对癌症的理论模型进行组织的。综述研究表明，最常评估的因素是抑郁、焦虑、绝望/无助、敌意、婚姻状况和社会参与度。主要发现的结果并不一致。社会心理变量与预后之间关系的最有力证据是社会参与/社会支持；在15项研究中的7项中显示出正相关，而未发现负相关。应对方式，如斗志和坚忍接受，以及严重/应激性生活事件被发现对生存时长没有决定性影响。应对模型的重要决定因素，如不确定性和专家提供的信息，未被作为生存和/或无复发期的可能预测因素进行研究。完全没有相关性的因素之一是多维健康控制点。对于这些不一致的发现，列举了在研究设计、样本量、测量和统计分析方面的大量方法学缺陷。
