Yeo W, Kwan W H, Teo P M L, Nip S, Wong E, Hin L Y, Johnson P J
Departments of Clinical Oncology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong.
Psychooncology. 2004 Feb;13(2):132-9. doi: 10.1002/pon.777.
This pilot study assesses the psychosocial impact of different modalities of breast cancer surgery in Chinese patients and their husbands.
Thirty-six patients who underwent conservative breast therapy (BCT) for breast cancer were compared with 36 women who underwent total mastectomy (TM) on four aspects of psychosocial adjustment. They were matched in pairs in terms of stage of disease, age and time since surgery. Where available, their husbands were also consented for similar assessment.
Women who underwent BCT showed a significantly better response to their body and sexual image than those who underwent TM. This difference did not translate into any significant difference in terms of emotional and symptomatic aspects, daily activities, or fear of recurrences. The husbands of patients in the TM group showed significantly more emotional and symptomatic distress and greater change in the perception of their wives' body and sexual images.
This is the first of such study conducted in a Chinese population. The lack of differences in certain psychosocial aspects may indicate a generally good adjustment in the TM patients after their surgery. It may also relate to the fact that volunteers for the study were themselves representative only of the patient population who adapted well to the surgery, and those patients who were emotionally distressed tended to decline to participate. Psychosocial disruption in the patients' families is reflected in our study where patients' husbands in the TM group were significantly more disturbed. However, due to the limited number of patients studied, the findings are not yet conclusive and require further studies for confirmation.
本初步研究评估了不同乳腺癌手术方式对中国患者及其丈夫的心理社会影响。
将36例接受保乳治疗(BCT)的乳腺癌患者与36例接受全乳切除术(TM)的女性在心理社会适应的四个方面进行比较。根据疾病分期、年龄和术后时间对她们进行配对。如有可能,她们的丈夫也同意进行类似评估。
接受BCT的女性对自己身体和性形象的反应明显优于接受TM的女性。但在情绪和症状方面、日常活动或对复发的恐惧方面,这种差异并未转化为任何显著差异。TM组患者的丈夫表现出明显更多的情绪和症状困扰,以及对妻子身体和性形象认知上的更大变化。
这是在中国人群中进行的此类研究中的首例。某些心理社会方面缺乏差异可能表明TM患者术后总体适应良好。这也可能与以下事实有关:该研究的志愿者本身仅代表了那些很好地适应了手术的患者群体,而那些情绪困扰的患者往往拒绝参与。我们的研究反映了患者家庭中的心理社会干扰,其中TM组患者的丈夫受到的干扰明显更大。然而,由于研究的患者数量有限,研究结果尚无定论,需要进一步研究加以证实。