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参加区域癌症服务的患者调整的前瞻性个体和社会预测因素。

Prospective individual and social predictors of changes in adjustment for patients attending a regional cancer service.

机构信息

Behavioural Basis of Health Program, Griffith Health Institute and School of Applied Psychology, Griffith University, Gold Coast, Australia.

出版信息

Qual Life Res. 2013 May;22(4):759-70. doi: 10.1007/s11136-012-0204-9. Epub 2012 Jun 1.

Abstract

PURPOSE

This study applied the social-cognitive processing (SCP) model to examine whether positive (social support) and negative (social constraints) aspects of the social environment influenced emotional distress, quality of life (QoL), well-being, and benefit finding after cancer.

METHODS

Participants were 439 adults at a median of 66 weeks post-diagnosis and 79 % of them had completed cancer treatments. Outcome measures and predictors were assessed twice, 6 months apart, and their relationships were analyzed using hierarchical multiple regressions.

RESULTS

Participants reported improved physical QoL at retest. Correlations showed that better outcomes for depression, anxiety, QoL, and well-being were associated with higher social support and lower social constraints. In addition, benefit finding correlated with social support but not social constraints. After other predictors were taken into account, lower initial social constraints were modestly associated with improved mental QoL at retest. Higher social constraints scores also predicted the development of clinically significant depression and anxiety.

CONCLUSIONS

Results provided some support for the SCP model's prediction that both positive and negative aspects of social environment can contribute to adjustment in people with cancer. Although several findings supported the model, a heterogeneous sample and small effect sizes indicate that replication and further study is needed.

摘要

目的

本研究应用社会认知加工(SCP)模型来检验社会环境中的积极(社会支持)和消极(社会约束)方面是否会影响癌症患者的情绪困扰、生活质量(QoL)、幸福感和获益感知。

方法

参与者为 439 名中位诊断后 66 周的成年人,其中 79%已完成癌症治疗。在 6 个月的时间间隔内,使用分层多重回归分析对两次评估的结局测量和预测因素进行了分析。

结果

参与者在复测时报告了身体 QoL 的改善。相关性表明,抑郁、焦虑、QoL 和幸福感的改善与更高的社会支持和更低的社会约束相关。此外,获益感知与社会支持相关,但与社会约束无关。在考虑了其他预测因素后,较低的初始社会约束与复测时心理 QoL 的改善有一定的相关性。较高的社会约束得分也预示着抑郁和焦虑的发生。

结论

研究结果为 SCP 模型的预测提供了一些支持,即社会环境的积极和消极方面都可能对癌症患者的适应做出贡献。尽管有几个发现支持了该模型,但由于样本的异质性和小的效应量,需要进一步的复制和研究。

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