Vinokur A D, Threatt B A, Vinokur-Kaplan D, Satariano W A
Institute for Social Research, University of Michigan, Ann Arbor 48106-1248.
Cancer. 1990 Mar 1;65(5):1242-54. doi: 10.1002/1097-0142(19900301)65:5<1242::aid-cncr2820650535>3.0.co;2-1.
A representative community sample of 274 breast cancer (BC) patients from the Metropolitan Detroit Cancer-Surveillance System was studied longitudinally during the year after their BC diagnosis. The adjustment of these patients to their disease was examined in terms of (1) the changes in their physical and mental health functioning; and (2) the factors that predict or facilitate the recovery process, including the independent and interactive effects of age. Comparison of the outcomes at 4 and 10 months after diagnosis manifested a significant and consistent improvement in physical functioning. In contrast, there was an absence of any improvement in indicators of mental health and well-being. Whereas the cross-sectional analyses demonstrated that stage of disease had an impact on physical impairment, the longitudinal analyses revealed that physical impairment at time 1 was the significant predictor of deteriorating mental health at time 2. Furthermore, younger age was shown to exacerbate the impact of impairment on mental health. The more seriously impaired younger patients experienced significantly greater deterioration in their mental health and well-being than similarly impaired older patients. However, older age was found to exacerbate the impact of more extensive surgery on symptoms that produce limitations in activity.
对来自底特律大都会癌症监测系统的274名乳腺癌（BC）患者的代表性社区样本，在其乳腺癌诊断后的一年中进行了纵向研究。从以下方面考察了这些患者对疾病的适应情况：（1）他们身心健康功能的变化；（2）预测或促进康复过程的因素，包括年龄的独立和交互作用。诊断后4个月和10个月的结果比较显示，身体功能有显著且持续的改善。相比之下，心理健康和幸福感指标没有任何改善。横断面分析表明疾病分期对身体损伤有影响，而纵向分析显示，第1阶段的身体损伤是第2阶段心理健康恶化的显著预测因素。此外，年龄较小被证明会加剧损伤对心理健康的影响。与同样受损的老年患者相比，受损更严重的年轻患者在心理健康和幸福感方面的恶化程度明显更大。然而，发现年龄较大加剧了更广泛手术对导致活动受限症状的影响。
