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信息自我管理干预对放疗前控制与疾病不确定性之间关联以及放疗后心理困扰的影响。

The impact of an informational self-management intervention on the association between control and illness uncertainty before and psychological distress after radiotherapy.

作者信息

Stiegelis Heidi E, Hagedoorn Mariët, Sanderman Robbert, Bennenbroek Femke T C, Buunk Bram P, van den Bergh Alfons C M, Botke Gerrit, Ranchor Adelita V

机构信息

Northern Centre for Healthcare Research, University of Groningen, Netherlands.

出版信息

Psychooncology. 2004 Apr;13(4):248-59. doi: 10.1002/pon.738.

Abstract

Many studies have reported that cancer patients who show difficulties maintaining perceptions of control report more psychological distress than patients who are higher in control. Besides perceptions of control, feelings of illness uncertainty have also been regarded as a predictor of psychological distress. Given these strong relationships between perceptions of low control and high illness uncertainty and psychological distress, the present study examined whether an informational self-management intervention (booklet) could moderate this relationship. The booklet contained general and specific information about cancer and cancer treatment, information about possible coping strategies, and social comparison information, which consisted of short stories of other patients. Prior to radiotherapy, 209 patients with cancer completed baseline measures, including control and illness uncertainty. After completing radiotherapy, patients were randomly allocated to receive either a booklet (experimental group; N=103) or no booklet (control group; N=106). Three months after the intervention, aspects of psychological distress were assessed, including tension, anger, depression, fatigue and vigour. The results supported our hypotheses and suggested that a self-management intervention is relevant in reducing the relationship between control and illness uncertainty before radiotherapy and psychological distress after radiotherapy. This seems important, especially for high-risk patients who perceive little control and much illness uncertainty.

摘要

许多研究报告称,与能够更好地保持控制感的癌症患者相比,那些在维持控制感方面存在困难的癌症患者会表现出更多的心理困扰。除了控制感之外,疾病不确定性的感受也被视为心理困扰的一个预测因素。鉴于低控制感、高疾病不确定性与心理困扰之间存在着这些紧密的关系,本研究考察了一种信息自我管理干预措施(手册)是否能够缓和这种关系。该手册包含了有关癌症及癌症治疗的一般和具体信息、有关可能的应对策略的信息以及社会比较信息,后者由其他患者的简短故事组成。在放疗前,209名癌症患者完成了包括控制感和疾病不确定性在内的基线测量。放疗结束后,患者被随机分配接受手册(实验组;N = 103)或不接受手册(对照组;N = 106)。干预三个月后,对心理困扰的各个方面进行了评估,包括紧张、愤怒、抑郁、疲劳和活力。结果支持了我们的假设,并表明自我管理干预措施对于减轻放疗前的控制感与疾病不确定性之间以及放疗后的心理困扰之间的关系是有意义的。这似乎很重要,尤其是对于那些控制感低且疾病不确定性高的高危患者。

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