Bitsko Matthew J, Stern Marilyn, Dillon Robyn, Russell E Clifton, Laver Joseph
Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA.
Pediatr Blood Cancer. 2008 Mar;50(3):613-9. doi: 10.1002/pbc.21337.
Given the increase in 5- and 10-year survival rates of children and adolescents diagnosed with cancer, current psycho-oncology literature is focusing on finding correlates and predictors to their positive psychosocial adjustment. The purpose of this study was to evaluate two potential mediators to adolescent cancer survivors' quality of life (QOL) and depressive symptomology.
Adolescent cancer survivors (N = 50; 50% males; mean diagnosis age, 13.7; mean age at study, 20.2) were surveyed, testing the mediation effects of their happiness (Subjective Happiness Scale) and past-negative time perspective (Zimbardo Time Perspective Inventory) on QOL (PedsQL 4.0) and depressive symptomology (CES-D). Independent variables included gender and treatment intensity.
Happiness significantly mediated the relationship between treatment intensity in both depressive symptomology (beta = -0.65, P < 0.05, CI = -2.46, -6.41) and QOL (beta = 0.54, P < 0.05, CI = 3.66, 9.01). A past-negative time perspective significantly mediated the relationship between gender and depressive symptomology (beta = 0.60, P < 0.05, CI = 3.34, 9.78). Survivors' gender was not associated with happiness and treatment intensity was not associated with time perspective.
Happiness may be a more direct predictor of QOL and depression than the intensity of treatment for cancer. Also, thinking negatively about one's past may be a more direct predictor of depressive symptomology than being female. Therefore, interventions that cultivate happiness and reframe time perspective may be effective ways to improve survivors' QOL and decrease depressive symptoms-regardless of gender and intensity of treatment protocol.
鉴于被诊断患有癌症的儿童和青少年5年及10年生存率有所提高，当前的心理肿瘤学文献正专注于寻找与其积极心理社会适应相关的因素和预测指标。本研究的目的是评估青少年癌症幸存者生活质量（QOL）和抑郁症状的两个潜在中介因素。
对青少年癌症幸存者（N = 50；50%为男性；平均诊断年龄13.7岁；研究时平均年龄20.2岁）进行了调查，测试他们的幸福感（主观幸福感量表）和过去消极时间观（津巴多时间观问卷）对生活质量（儿童生活质量量表4.0版）和抑郁症状（流调中心用抑郁量表）的中介作用。自变量包括性别和治疗强度。
幸福感在抑郁症状（β = -0.65，P < 0.05，CI = -2.46，-6.41）和生活质量（β = 0.54，P < 0.05，CI = 3.66，9.01）方面均显著中介了治疗强度之间的关系。过去消极时间观显著中介了性别与抑郁症状之间的关系（β = 0.60，P < 0.05，CI = 3.34，9.78）。幸存者的性别与幸福感无关，治疗强度与时间观无关。
与癌症治疗强度相比，幸福感可能是生活质量和抑郁更直接的预测指标。此外，对过去持消极看法可能比女性身份更直接地预测抑郁症状。因此，培养幸福感和重塑时间观的干预措施可能是提高幸存者生活质量和减轻抑郁症状的有效方法，而与性别和治疗方案强度无关。
