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疾病表征在乳腺癌患者应对方式及健康状况中的作用

The role of illness representations in coping and health of patients treated for breast cancer.

作者信息

Rozema Hetje, Völlink Trijntje, Lechner Lilian

机构信息

Faculty of Psychology, Open University of The Netherlands, 6401 DL Heerlen, The Netherlands.

出版信息

Psychooncology. 2009 Aug;18(8):849-57. doi: 10.1002/pon.1488.

Abstract

OBJECTIVE

The present study examined the relation of cognitive and emotional representations of illness specified by the Common Sense Model of Illness Cognition (Handbook of Psychology and Health: Social Psychological Aspects of Health. Earlbaum, Hillsdale: New York, 1984; 219-252) with the coping strategies and perceived health of patients who were treated for breast cancer.

METHODS

Participants were 119 women within 2 years after their diagnosis of breast cancer, who completed a questionnaire containing measures of illness representations, coping strategies and perceived physical and mental health.

RESULTS

Breast cancer patients differ in the subjective perception of their disease. Patients who view their illness as a condition with serious symptoms and consequences, patients who believe their illness is chronic and patients who consider their illness uncontrollable were found to report worse physical and mental health than those who believed the opposite. Regression analysis showed that, after controlling for external variables, the cognitive illness representations identity and consequences explained 57% of variance in physical health, whereas emotional illness representation and treatment control explained 47% of variance in mental health.

CONCLUSION

Results provide some support for the hypotheses of the Common Sense Model of Illness Cognition. Illness representations seem to play an important role in perceived health in breast cancer. The implications of these findings for the design of health-care-related interventions for breast cancer patients are discussed.

摘要

目的

本研究考察了疾病认知常识模型(《心理学与健康手册:健康的社会心理方面》。埃尔鲍姆出版社,希尔斯代尔:纽约,1984年;第219 - 252页)所明确的疾病认知和情感表征与接受乳腺癌治疗的患者的应对策略及感知健康之间的关系。

方法

参与者为119名在确诊乳腺癌后2年内的女性,她们完成了一份包含疾病表征、应对策略以及感知身心健康测量项目的问卷。

结果

乳腺癌患者对其疾病的主观认知存在差异。那些将自己的疾病视为具有严重症状和后果的患者、认为自己的疾病是慢性的患者以及认为自己的疾病无法控制的患者,相比那些持相反看法的患者,报告的身心健康状况更差。回归分析表明,在控制外部变量后,疾病认知表征的特征和后果解释了身体健康方面57%的方差变异,而疾病情感表征和治疗控制解释了心理健康方面47%的方差变异。

结论

研究结果为疾病认知常识模型的假设提供了一定支持。疾病表征似乎在乳腺癌患者的感知健康中起着重要作用。本文还讨论了这些发现对乳腺癌患者相关医疗保健干预措施设计的启示。

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