Kreitler Shulamith, Peleg Dina, Ehrenfeld Mally
Department of Psychology, Tel-Aviv University, Tel-Aviv Medical Center, 6 Weizman Street, Tel-Aviv 64239, Israel.
Psychooncology. 2007 Apr;16(4):329-41. doi: 10.1002/pon.1063.
The purpose of the study was to examine the effect of different stressors on various domains of quality of life (QOL) in cancer patients. The study focused on testing a model describing interrelations between two kinds of stress antecedents, two mediating variables--perceived stress and self-efficacy--and QOL. The participants were 60 cancer patients of both genders and various diagnoses. They were administered questionnaires of background information, QOL, perceived stress and general self-efficacy. Two stress indices were defined empirically: health stress (based on advanced disease stage, long disease duration, and undergoing treatment) and social stress (based on unemployment, recent immigration, and older age). Confirmatory factor analysis enabled defining five factors of QOL. Hierarchical regression analyses showed that the index of social stress was related to more QOL scales than the index of health stress and very few interactions with the mediating variables. Structural equation modeling provided a more comprehensive and accurate view. It showed that the index of health stress affected QOL mainly through perceived stress, and that self-efficacy affected QOL by reducing perceived stress and increasing QOL. The major conclusions are that QOL is affected negatively by both health stresses and social stresses, but the former are mediated primarily by the experience of perceived stress.
本研究的目的是检验不同应激源对癌症患者生活质量（QOL）各个领域的影响。该研究着重于测试一个描述两种应激源、两个中介变量——感知应激和自我效能感——与生活质量之间相互关系的模型。参与者为60名患有各种癌症的男女患者。他们接受了关于背景信息、生活质量、感知应激和一般自我效能感的问卷调查。通过实证定义了两个应激指标：健康应激（基于疾病晚期、病程长和正在接受治疗）和社会应激（基于失业、近期移民和年龄较大）。验证性因素分析确定了生活质量的五个因素。分层回归分析表明，社会应激指标与更多的生活质量量表相关，而健康应激指标与之相关的量表较少，且与中介变量的相互作用很少。结构方程模型提供了更全面和准确的观点。结果显示，健康应激指标主要通过感知应激影响生活质量，而自我效能感通过降低感知应激和提高生活质量来影响生活质量。主要结论是，健康应激和社会应激均对生活质量产生负面影响，但前者主要通过感知应激的体验起中介作用。
