Schnur Julie B, Hallquist Michael N, Bovbjerg Dana H, Silverstein Jeffrey H, Stojceska Angelina, Montgomery Guy H
Department of Oncological Sciences, Box 1130, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, New York, NY 10029-6574, United States.
Pers Individ Dif. 2007;42(3):419-429. doi: 10.1016/j.paid.2006.07.009.
Expectancies for post-surgical pain and fatigue have previously been found to predict pain and fatigue among breast cancer surgery patients. However, the study of predictors of these expectancies has been neglected. The present study was designed to investigate predictors of expectancies for post-surgical pain and fatigue among breast cancer surgery patients.Four hundred and eighteen women (M = 48.3 years, SD = 13.66 years) scheduled to undergo excisional breast biopsy or lumpectomy completed questionnaires assessing demographics/medical history, pre-surgical distress, stable personality characteristics, pre-surgical pain and fatigue, and expectancies for post-surgical pain and fatigue.Path analysis revealed: expectancies for post-surgical pain were significantly predicted by trait anxiety, acute pre-surgical distress, and age; and expectancies for post-surgical fatigue were significantly predicted by acute pre-surgical distress, acute pre-surgical fatigue, previous experience with the same surgical procedure, and education (all ps < .05). Examination of an alternative model revealed that the effects of the aforementioned predictors on expectancies were not mediated by acute pre-surgical distress, clarifying the directionality of the distress-expectancy relationship.Expectancies for post-surgical pain and fatigue are influenced by distress, treatment history, stable personality characteristics, extant symptoms, and demographic factors. These variables should be considered in designing clinical interventions to manipulate expectancies for patient benefit.
先前已发现，对术后疼痛和疲劳的预期能够预测乳腺癌手术患者的疼痛和疲劳情况。然而，对这些预期的预测因素的研究却被忽视了。本研究旨在调查乳腺癌手术患者对术后疼痛和疲劳的预期的预测因素。418名计划接受乳房切除活检或肿块切除术的女性（平均年龄M = 48.3岁，标准差SD = 13.66岁）完成了问卷调查，内容涉及人口统计学/病史、术前痛苦、稳定的人格特征、术前疼痛和疲劳，以及对术后疼痛和疲劳的预期。路径分析显示：术后疼痛预期由特质焦虑、术前急性痛苦和年龄显著预测；术后疲劳预期由术前急性痛苦、术前急性疲劳、相同手术的既往经历和教育程度显著预测（所有p值均<0.05）。对替代模型的检验表明，上述预测因素对预期的影响并非由术前急性痛苦介导，从而明确了痛苦与预期关系的方向性。术后疼痛和疲劳的预期受痛苦、治疗史、稳定的人格特征、现有症状和人口统计学因素的影响。在设计临床干预措施以操纵预期从而使患者受益时，应考虑这些变量。
