Perkins Elizabeth A, Small Brent J, Balducci Lodovico, Extermann Martine, Robb Claire, Haley William E
School of Aging Studies, University of South Florida, 4202 East Fowler Avenue, MHC 1308, Tampa, FL 33612, USA.
Crit Rev Oncol Hematol. 2007 Apr;62(1):74-83. doi: 10.1016/j.critrevonc.2006.11.002. Epub 2007 Jan 19.
Older women who survive breast cancer may differ significantly in their long-term well-being. Using a risk and protective factors model, we studied predictors of well-being in 127 women age 70 and above with a history of at least 1 year's survival of breast cancer. Mean post-cancer survivorship was 5.1 years. Using life satisfaction, depression and general health perceptions as outcome variables, we assessed whether demographic variables, cancer-related variables, health status and psychosocial resources predicted variability in well-being using correlational and hierarchical regression analyses. Higher age predicted increased depression but was not associated with life satisfaction or general health perceptions. Cancer-related variables, including duration of survival, and type of cancer treatment, were not significantly associated with survivors' well-being. Poorer health status was associated with poorer well-being in all three dependent variables. After controlling for demographics, cancer-related variables, and health status, higher levels of psychosocial resources including optimism, mastery, spirituality and social support predicted better outcome in all three dependent variables. While many older women survive breast cancer without severe sequelae, there is considerable variability in their well-being after survivorship. Successful intervention with older breast cancer survivors might include greater attention not only to cancer-specific concerns, but also attention to geriatric syndromes and functional impairment, and enhancement of protective psychosocial resources.
乳腺癌幸存者中的老年女性在长期幸福感方面可能存在显著差异。我们使用风险和保护因素模型,研究了127名70岁及以上且有至少1年乳腺癌生存史的女性幸福感的预测因素。癌症后平均生存期为5.1年。我们以生活满意度、抑郁和总体健康认知作为结果变量,使用相关分析和分层回归分析评估人口统计学变量、癌症相关变量、健康状况和心理社会资源是否能预测幸福感的变化。年龄较大预示着抑郁加剧,但与生活满意度或总体健康认知无关。包括生存期和癌症治疗类型在内的癌症相关变量与幸存者的幸福感无显著关联。较差的健康状况在所有三个因变量中均与较差的幸福感相关。在控制了人口统计学、癌症相关变量和健康状况后,较高水平的心理社会资源,包括乐观、掌控感、精神寄托和社会支持,在所有三个因变量中都预示着更好的结果。虽然许多老年女性在乳腺癌后存活且没有严重后遗症,但她们在存活后的幸福感存在很大差异。对老年乳腺癌幸存者的成功干预可能不仅包括更多关注癌症特定问题,还包括关注老年综合征和功能障碍,以及增强保护性心理社会资源。