School of Psychology, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
Complement Ther Med. 2012 Feb-Apr;20(1-2):61-9. doi: 10.1016/j.ctim.2011.09.008. Epub 2011 Oct 22.
While several cross-sectional studies have examined psychological correlates of complementary and alternative medicine (CAM) use and cancer, few prospective longitudinal investigations have been reported. This study examined whether CAM use moderated distress and quality of life (HRQoL) from pre- to post-cancer.
A prospective longitudinal national cohort design.
Participants were 718 mid-aged women from the Australian longitudinal study on women's health who did not have cancer at survey 1, but who subsequently developed cancer. For each participant, three waves of data were extracted: the wave prior to diagnosis ('pre'), at diagnosis ('cancer'), and after cancer ('post').
CAM use was measured by the question 'in the past 12 months have you consulted an alternative health practitioner'. Distress was measured by perceived stress (PSS) and depression (CES-D 10), HRQoL was measured by physical and mental health functioning (SF-36).
CAM use significantly moderated the change over time in stress [F(561)=3.09, p=0.04], depression [F(494)=3.14, p=0.04], but not HRQoL. CAM-users were significantly more stressed than non-users pre-cancer (p<0.05), but there were no significant differences at subsequent surveys. CAM-users were significantly less depressed post-cancer compared to non-users (p<0.05).
Findings indicated that CAM users may be more psychologically vulnerable than non-users with respect to stress, with CAM acting as an effective psychological, but not HRQoL, intervention.
虽然有几项横断面研究探讨了补充和替代医学(CAM)使用与癌症之间的心理关联,但很少有前瞻性纵向研究报告。本研究考察了 CAM 使用是否能调节癌症前至后期间的痛苦和生活质量(HRQoL)。
前瞻性纵向全国队列设计。
参与者为澳大利亚女性健康纵向研究中的 718 名中年女性,她们在第一次调查时没有癌症,但随后患上了癌症。对于每个参与者,提取了三波数据:诊断前的波(“前”)、诊断时的波(“癌症”)和癌症后的波(“后”)。
CAM 使用通过问题“在过去 12 个月中,您是否咨询过替代健康从业者”来衡量。痛苦通过感知压力(PSS)和抑郁(CES-D 10)来衡量,HRQoL 通过身体和心理健康功能(SF-36)来衡量。
CAM 使用显著调节了压力(F(561)=3.09,p=0.04)、抑郁(F(494)=3.14,p=0.04)的随时间变化,但对 HRQoL 没有影响。CAM 使用者在癌症前比非使用者更紧张(p<0.05),但在随后的调查中没有显著差异。CAM 使用者在癌症后比非使用者抑郁程度显著降低(p<0.05)。
研究结果表明,CAM 用户在压力方面可能比非用户更脆弱,CAM 作为一种有效的心理干预措施,但不是 HRQoL 干预措施。