Yale University School of Nursing, New Haven, CT, USA.
J Psychosoc Oncol. 2011;29(2):121-40. doi: 10.1080/07347332.2010.548445.
In an attempt to understand and cope with their diagnosis, individuals with cancer may develop beliefs about the cause of their illness and these causal attributions may impact psychosocial adjustment. Connecticut participants (N = 775) from the American Cancer Society's Study of Cancer Survivors-I completed a self-administered questionnaire assessing beliefs of the cause of their cancer and if they had contemplated the question "why me?" regarding their diagnosis. Written causal belief responses were coded into thematic categories and defined as either in (modifiable) or out (fixed) of an individual's control. Using logistic regression, the authors examined associations between sociodemographic, clinical, and psychosocial measures and identifying modifiable causal attributions, as well as contemplating "why me." Most cancer survivors (78.2%) identified one or more causes. Lifestyle and biological factors were most common, whereas psychological factors were least common, with some variation by cancer type. After multivariate adjustment, only cancer type was associated with identifying modifiable causes. Participants who contemplated "why me" (47.5%) were more likely to be younger and reported a greater number of cancer-related problems. In conclusion, the majority of cancer survivors reported specific causal attributions, and many had contemplated "why me." Understanding and assessing causal attributions and more general existential questions regarding diagnosis could aid in our understanding of survivors' adjustment and psychosocial well-being. Additional research in large populations is also needed to determine if other characteristics are associated with identifying modifiable causal attributions and asking "why me."
为了理解和应对诊断结果，癌症患者可能会形成对疾病病因的看法，而这些归因可能会影响心理社会适应。美国癌症协会癌症幸存者研究-I 的康涅狄格州参与者（N=775）完成了一份自我管理的问卷，评估他们对癌症病因的看法，以及他们是否考虑过自己的诊断“为什么是我？”。书面因果信念反应被编码为主题类别，并定义为个体控制内（可修改）或控制外（固定）。作者使用逻辑回归分析了社会人口统计学、临床和心理社会测量与确定可修改的因果归因以及思考“为什么是我”之间的关联。大多数癌症幸存者（78.2%）确定了一个或多个原因。生活方式和生物因素最常见，而心理因素最不常见，不同癌症类型有所不同。在多变量调整后，只有癌症类型与确定可修改的原因有关。思考“为什么是我”（47.5%）的参与者更年轻，并且报告了更多与癌症相关的问题。总之，大多数癌症幸存者报告了特定的因果归因，并且许多人思考过“为什么是我”。了解和评估因果归因以及更普遍的关于诊断的存在问题，可以帮助我们理解幸存者的适应和心理社会幸福感。还需要在更大的人群中进行更多的研究，以确定是否还有其他特征与确定可修改的因果归因和提出“为什么是我”有关。
