Department of Medical Social Sciences, Feinberg School of Medicine at Northwestern University, 625 North Michigan Ave., 27th Floor, Chicago, IL 60611, USA.
Support Care Cancer. 2011 Jun;19(6):757-64. doi: 10.1007/s00520-010-0871-4. Epub 2010 Apr 20.
Individuals diagnosed and treated for cancer often report high levels of distress, continuing even after successful treatment. Spiritual well-being (SpWB) has been identified as an important factor associated with positive health outcomes. This study had two aims: (1) examine the associations between SpWB (faith and meaning/peace) and health-related quality of life (HRQL) outcomes and (2) examine competing hypotheses of whether the relationship among distress, SpWB, and HRQL is better explained by a stress-buffering (i.e., interaction) or a direct (main effects) model.
Study 1 consisted of 258 colorectal cancer survivors (57% men) recruited from comprehensive cancer centers in metropolitan areas (age, M=61; months post-diagnosis, M=17). Study 2 consisted of 568 colorectal cancer survivors (49% men) recruited from a regional cancer registry (age, M=67; months post-diagnosis, M=19). Participants completed measures of SpWB (functional assessment of chronic illness therapy-spiritual well-being (FACIT-Sp)) and HRQL (functional assessment of cancer therapy-colorectal) in both studies. Measures of general distress (profile of mood states-short form) and cancer-specific distress were also completed in study 1 and study 2, respectively.
After controlling for demographic and clinical variables, faith and meaning/peace were positively associated with HRQL. However, meaning/peace emerged as a more robust predictor of HRQL outcomes than faith. Planned analyses supported a direct rather than stress-buffering effect of meaning/peace.
This study provides further evidence of the importance of SpWB, particularly meaning/peace, to HRQL for people with colorectal cancer. Future studies of SpWB and cancer should examine domains of the FACIT-Sp separately and explore the viability of meaning-based interventions for cancer survivors.
被诊断和治疗癌症的个体经常报告高水平的困扰，即使在成功治疗后仍持续存在。精神幸福感（SpWB）已被确定为与积极健康结果相关的重要因素。本研究有两个目的：（1）检查 SpWB（信仰和意义/平静）与健康相关生活质量（HRQL）结果之间的关联；（2）检查困扰、SpWB 和 HRQL 之间的关系是否更好地由应激缓冲（即交互作用）或直接（主要效应）模型来解释的竞争假设。
研究 1 包括 258 名来自大都市综合癌症中心的结直肠癌幸存者（57%为男性）（年龄，M=61；诊断后月数，M=17）。研究 2 包括 568 名来自区域癌症登记处的结直肠癌幸存者（49%为男性）（年龄，M=67；诊断后月数，M=19）。在两项研究中，参与者完成了 SpWB（慢性病治疗的功能评估-精神幸福感（FACIT-Sp））和 HRQL（癌症治疗的功能评估-结直肠癌）的测量。在研究 1 和研究 2 中，还分别完成了一般困扰（心境状态简表）和癌症特异性困扰的测量。
在控制人口统计学和临床变量后，信仰和意义/平静与 HRQL 呈正相关。然而，与信仰相比，意义/平静对 HRQL 结果的预测更为稳健。计划的分析支持了意义/平静的直接而非应激缓冲作用。
本研究进一步证明了 SpWB，特别是意义/平静，对结直肠癌患者 HRQL 的重要性。未来关于 SpWB 和癌症的研究应分别检查 FACIT-Sp 的各个领域，并探索基于意义的干预措施对癌症幸存者的可行性。
