Department of Psychology, University of Hong Kong, Hong Kong SAR, China.
Psychol Health. 2010 Apr;25(4):417-31. doi: 10.1080/08870440802559375.
Physical symptom distress is one of the commonest correlates of psychological adjustment in cancer patients. Positive affect (PA) can be a dynamic resource for patients to cope with the cancer-related physical demands. The present study examined whether differential patterns of change in PA were associated with anxiety and depressed mood, and whether PA modified the association between change in symptom distress and psychological distress in 215 Chinese people newly diagnosed with colorectal cancer (CRC). Participants completed measures of physical symptoms, PA, and anxiety and depression at diagnosis and again at 3-month follow-up. Multivariate analyses of covariance revealed that at follow-up, people reporting higher anxiety and depressed mood demonstrated loss in PA, whereas those reporting lower depressed mood demonstrated a gain in PA. Structural equation modelling revealed that change in PA significantly mediated and moderated the associations between increased symptom distress and anxiety and depressed mood. We conclude that in line with Hobfoll's conservation of resources theory, continuous physical symptom distress depletes PA of newly diagnosed cancer patients, resulting in higher levels of anxiety and depressed mood. Effectiveness of symptom management intervention could be enhanced by preserving or enhancing PA in patients.
身体症状困扰是癌症患者心理适应的最常见相关因素之一。积极情绪 (PA) 可以成为患者应对与癌症相关的身体需求的动态资源。本研究考察了 PA 的变化模式是否与焦虑和抑郁情绪有关，以及 PA 是否改变了 215 名新诊断为结直肠癌 (CRC) 的中国人中症状困扰变化与心理困扰之间的关联。参与者在诊断时和 3 个月随访时完成了身体症状、PA、焦虑和抑郁的测量。协方差的多变量分析显示，在随访时，报告有较高焦虑和抑郁情绪的人表现出 PA 的丧失，而报告有较低抑郁情绪的人表现出 PA 的增加。结构方程模型显示，PA 的变化显著中介和调节了症状困扰增加与焦虑和抑郁情绪之间的关联。我们的结论是，符合霍布福勒的资源保护理论，持续的身体症状困扰会消耗新诊断癌症患者的 PA，导致更高水平的焦虑和抑郁情绪。通过在患者中保留或增强 PA，可以提高症状管理干预的效果。
