Collie K, Wong P, Tilston J, Butler L D, Turner-Cobb J, Kreshka M A, Parsons R, Graddy K, Cheasty J D, Koopman C
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305-5718, USA.
Psychooncology. 2005 Oct;14(10):901-12; discussion 913-4. doi: 10.1002/pon.944.
This study examined self-efficacy, coping, and social support in relation to difficulties interacting with physicians and nurses among women living with breast cancer. One hundred women living in rural, mountainous communities of northeastern California were recruited, with 89 providing complete data for this study. All women completed a battery of questionnaires that included the CARES--Medical Interaction Subscale and measures of self-efficacy, coping, satisfaction with social support, and demographic and medical characteristics. In a multiple regression analysis, difficulties interacting with medical professionals were found to be greater among women who were not married, who used more behavioral disengagement or less self-distraction to cope with breast cancer, and who reported less self-efficacy for affect regulation and for seeking and understanding medical information. Emotional venting and satisfaction with social support for dealing with cancer-related stress were not, however, significantly related to difficulties in interacting with the medical team. This model accounted for an adjusted value of 42% of the variance. Further research is needed to identify possible causal relationships related to these findings and to determine what interventions might be warranted to improve medical interactions for women with breast cancer living in rural areas.
本研究调查了乳腺癌女性在与医生和护士互动困难方面的自我效能感、应对方式和社会支持情况。招募了居住在加利福尼亚州东北部农村山区社区的100名女性,其中89名为本研究提供了完整数据。所有女性都完成了一系列问卷调查,包括CARES——医疗互动分量表以及自我效能感、应对方式、对社会支持的满意度,以及人口统计学和医学特征的测量。在多元回归分析中,发现未婚女性、更多采用行为脱离或更少采用自我分心来应对乳腺癌的女性,以及在情绪调节、寻求和理解医疗信息方面自我效能感较低的女性,在与医疗专业人员互动时遇到的困难更大。然而,情绪宣泄以及对处理癌症相关压力的社会支持的满意度,与与医疗团队互动的困难并无显著关联。该模型解释了42%的方差调整值。需要进一步研究以确定与这些发现相关的可能因果关系,并确定哪些干预措施可能有助于改善农村地区乳腺癌女性的医疗互动。