Carver Charles S, Smith Roselyn G, Petronis Vida M, Antoni Michael H
Department of Psychology, University of Miami, Coral Gables, FL 33124-0751, USA.
Psychooncology. 2006 Sep;15(9):749-58. doi: 10.1002/pon.1006.
Quality of life (QOL) has many aspects, both in the short-term and in the long-term. Different aspects of QOL may have different types of precursors: demographic, medical, and psychosocial. We examined this possibility in a group of long-term breast cancer survivors. Early-stage breast cancer patients (N = 163) who had provided information about medical, demographic, and psychosocial variables during the year after surgery completed a multidimensional measure of QOL 5-13 years later. Initial chemotherapy and higher stage predicted greater financial problems and greater worry about appearance at follow-up. Being partnered at diagnosis predicted many psychosocial benefits at follow-up. Hispanic women reported greater distress and social avoidance at follow-up. Initial trait optimism predicted diverse aspects of better psychosocial QOL at follow-up, but not other aspects of QOL. Thus, different aspects of QOL at long-term follow-up had different antecedents. Overall, psychological outcomes were predicted by psychosocial variables, presence of a partner at diagnosis, and ethnicity. Financial outcomes, in contrast, were predicted by medical variables, which otherwise predicted little about long-term QOL. This divergence among aspects of QOL should receive closer attention in future work.
生活质量（QOL）在短期和长期都有多个方面。生活质量的不同方面可能有不同类型的先兆因素：人口统计学因素、医学因素和心理社会因素。我们在一组长期乳腺癌幸存者中研究了这种可能性。早期乳腺癌患者（N = 163）在手术后一年内提供了有关医学、人口统计学和心理社会变量的信息，并在5至13年后完成了一项多维生活质量测量。初始化疗和更高的分期预示着随访时更大的经济问题和对外观的更多担忧。诊断时处于伴侣关系预示着随访时有许多心理社会益处。西班牙裔女性在随访时报告有更大的痛苦和社交回避。初始特质乐观预示着随访时心理社会生活质量的多个方面更好，但对生活质量的其他方面没有预示作用。因此，长期随访时生活质量的不同方面有不同的前因。总体而言，心理结果由心理社会变量、诊断时是否有伴侣以及种族预测。相比之下，经济结果由医学变量预测，而医学变量对长期生活质量的预测作用很小。生活质量各方面之间的这种差异在未来的研究中应得到更密切的关注。
