Royal Marsden NHS Foundation Trust, Sutton, UK.
Stress Health. 2012 Dec;28(5):376-80. doi: 10.1002/smi.2459.
The purpose of this study was to analyse the impact of coping response on survival of breast cancer by using a new method of assessing coping.
Adjustment to cancer was assessed using a revised measure in a large cohort of breast cancer patients (N = 578) followed up over a period of 10 years. Impact of coping response measured early in the disease process (<4 months from primary diagnosis of early-stage breast cancer) was assessed, and survival analyses were undertaken including known clinical staging data and cancer treatment details.
After 5 years of follow-up from primary diagnosis, the effect of prior 'negative adjustment' was statistically significantly linked to increased risk of death and relapse of breast cancer, and for the 10-year analysis, this result remained for both risk of death and relapse. There was no statistically significant effect on survival of the novel 'positive adjustment' response.
Coping with cancer was assessed using a new methodology and is linked to an adverse impact of negative adjustment on overall survival. Positive adjustment was unrelated to survival. The current study strengthens previous evidence that there is a link between survival and coping response. The question remains of how coping response might affect physical outcome. It is considered that coping response likely impacts survival through the mediating effects on lifestyle and health behaviour that may contribute to an adverse prognosis.
本研究旨在通过使用一种新的应对评估方法，分析应对方式对乳腺癌生存的影响。
在一项对 578 例乳腺癌患者进行了 10 年随访的大型队列研究中，使用修订后的方法评估癌症适应情况。评估疾病早期（距早期乳腺癌确诊<4 个月）的应对反应的影响，并进行生存分析，包括已知的临床分期数据和癌症治疗细节。
在原发性诊断后 5 年的随访中，先前的“消极调整”效应与乳腺癌死亡和复发风险的增加具有统计学显著关联，而在 10 年的分析中，这一结果在死亡和复发风险方面均成立。新型“积极调整”反应对生存没有统计学显著影响。
本研究采用新的方法学评估了癌症应对方式，发现消极应对与总生存的不良影响有关。积极应对与生存无关。本研究进一步证实了生存与应对反应之间存在关联。目前仍存在一个问题，即应对反应如何影响身体结局。人们认为，应对反应可能通过对生活方式和健康行为的中介作用影响生存，从而导致预后不良。
