Wang Feng, Liu Jiajia, Liu Liyuan, Wang Fei, Ma Zhongbing, Gao Dezong, Zhang Qiang, Yu Zhigang
Breast Disease Department, the Second Hospital of Shandong University, 247#, Beiyuan St, Tianqiao District, Jinan, Shandong 250033, P, R, China.
BMC Public Health. 2014 Apr 8;14:326. doi: 10.1186/1471-2458-14-326.
Breast cancer presents specific challenges both physiologically and psychologically to women, and consequently affect the patients' mental health. Psychosocial factors may play important roles in the symptoms and development of mental disorders among breast-cancer survivors. This study assesses the depression and anxiety status of breast-cancer survivors and further identifies the risk factors.
A 1:1 matched, case-control study was conducted with a total sample of 222 individuals. Participants were selected from a national epidemiological survey. The Center for Epidemiological Studies-Depression Scale and State-Trait Anxiety Inventory were used to assess depression and anxiety. The Social Support Rating Scale and Perceived Social Support Scale were used as measures of social support and perceived social support, and the Rosenberg Self-Esteem Scale as a measure of self-esteem. Coping style was assessed using the Simplified Coping Style Questionnaire. The predictive effect of these psychosocial factors for depression and anxiety was investigated with hierarchical linear regressions.
Breast-cancer survivors experienced a high level of depressive and anxious symptoms. Multivariate analysis revealed that breast cancer functions as an independent but not a main risk factor of both depression and anxiety. Higher levels of depression and anxiety were positively associated with a higher level of passive coping style, and negatively with perceived social support, objective social support and an active coping style.
The mental health of breast-cancer survivors should be promoted through the transformation of coping styles and improvement of social support.
乳腺癌在生理和心理方面给女性带来了特殊挑战，进而影响患者的心理健康。社会心理因素可能在乳腺癌幸存者精神障碍的症状及发展过程中发挥重要作用。本研究评估乳腺癌幸存者的抑郁和焦虑状况，并进一步确定危险因素。
进行了一项1:1匹配的病例对照研究，总样本量为222人。参与者选自一项全国性流行病学调查。采用流行病学研究中心抑郁量表和状态-特质焦虑问卷评估抑郁和焦虑。社会支持评定量表和领悟社会支持量表用于衡量社会支持和领悟社会支持，罗森伯格自尊量表用于衡量自尊。使用简易应对方式问卷评估应对方式。通过分层线性回归研究这些社会心理因素对抑郁和焦虑的预测作用。
乳腺癌幸存者存在高水平的抑郁和焦虑症状。多因素分析显示，乳腺癌是抑郁和焦虑的独立危险因素，但并非主要危险因素。抑郁和焦虑水平较高与消极应对方式水平较高呈正相关，与领悟社会支持、客观社会支持及积极应对方式呈负相关。
应通过转变应对方式和改善社会支持来促进乳腺癌幸存者的心理健康。
