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头颈癌患者的疾病与治疗观念:莱文索尔的常识模型是否是确定随时间推移结果变化的有用框架?

Illness and treatment beliefs in head and neck cancer: is Leventhal's common sense model a useful framework for determining changes in outcomes over time?

作者信息

Llewellyn Carrie Diane, McGurk Mark, Weinman John

机构信息

Health Psychology Section, Department of Psychology, Institute of Psychiatry (Guy's Campus) King's College London, Guy's Hospital, London, United Kingdom.

出版信息

J Psychosom Res. 2007 Jul;63(1):17-26. doi: 10.1016/j.jpsychores.2007.01.013.

Abstract

OBJECTIVE

The main aim of this prospective study was to examine the utility of Leventhal's common sense model in predicting longitudinal judgement-based outcomes in patients with head and neck cancer (HNC). The study is of potential importance as it focuses on the relations between personality factors, coping styles, informational needs, illness representations, and outcomes using a longitudinal study design. This has particular value as the trend in similar research is to focus on concurrent relations between variables. In addition, the prediction of numerous outcomes from illness perceptions has received relatively scant attention in the field of HNC.

METHODS

Fifty patients completed the following measures prior to treatment, 1 month and 6-8 months after treatment: IPQ-R, BMQ, Brief COPE, LOT-R, SCIP, EORTC QLQ-C30, SF-12, Patient Generated Index (PGI), and HADS.

RESULTS

Baseline illness and treatment beliefs were not predictive of HR-QoL, individualized QoL, or anxiety 6-8 months after treatment; however, beliefs about the chronicity of the disease (timeline beliefs) were predictive of depression after treatment. Coping strategies employed and levels of satisfaction with information before treatment were significant predictors of several outcomes.

CONCLUSIONS

Our findings suggest that a common sense model may be a useful framework for eliciting and understanding patients' beliefs regarding HNC; however, there are concerns regarding the use of a 'dynamic' model to predict longitudinal outcomes from baseline factors that may change over the course of an illness.

摘要

目的

这项前瞻性研究的主要目的是检验莱文索尔常识模型在预测头颈癌(HNC)患者基于判断的纵向结局方面的效用。该研究具有潜在重要性,因为它采用纵向研究设计,关注人格因素、应对方式、信息需求、疾病表征和结局之间的关系。这具有特殊价值,因为类似研究的趋势是关注变量之间的并发关系。此外,在头颈癌领域,从疾病认知预测众多结局的研究相对较少受到关注。

方法

50名患者在治疗前、治疗后1个月以及治疗后6 - 8个月完成了以下测量:IPQ - R、BMQ、简易应对方式问卷(Brief COPE)、生活取向测验修订版(LOT - R)、疾病感知问卷(SCIP)、欧洲癌症研究与治疗组织核心生活质量问卷(EORTC QLQ - C30)、简明健康调查量表(SF - 12)、患者生成指数(PGI)和医院焦虑抑郁量表(HADS)。

结果

基线疾病和治疗信念并不能预测治疗后6 - 8个月的健康相关生活质量(HR - QoL)、个体化生活质量或焦虑;然而,关于疾病慢性程度的信念(时间线信念)可预测治疗后的抑郁。治疗前采用的应对策略和对信息的满意度水平是几个结局的重要预测因素。

结论

我们的研究结果表明,常识模型可能是引出和理解患者关于头颈癌信念的有用框架;然而,对于使用“动态”模型从疾病过程中可能变化的基线因素预测纵向结局存在担忧。

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