Bai Mei, Lazenby Mark, Jeon Sangchoon, Dixon Jane, McCorkle Ruth
Yale University,School of Nursing,New Haven,Connecticut.
Palliat Support Care. 2015 Aug;13(4):927-35. doi: 10.1017/S1478951514000820. Epub 2014 Jul 3.
In our context, existential plight refers to heightened concerns about life and death when people are diagnosed with cancer. Although the duration of existential plight has been proposed to be approximately 100 days, evidence from longitudinal studies raises questions about whether the impact of a diagnosis of advanced cancer may require a longer period of adjustment. The purpose of our study was to examine spiritual well-being (SpWB) and quality of life (QoL) as well as their interrelationship in 52 patients with advanced cancer after 100 days since the diagnosis at one and three months post-baseline.
The study was designed as a secondary data analysis of a cluster randomized clinical trial involving patients with stage 3 or 4 cancer undergoing treatment. SpWB was measured using the 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp-12); common factor analyses revealed a three-factor pattern on the FACIT-Sp-12. Quality of life was measured with the Functional Assessment of Cancer Therapy-General (FACT-G). We limited our sample to participants assigned to the control condition (n = 52).
SpWB and QoL remained stable between one and three months post-baseline, which were a median of 112 and 183 days after diagnosis, respectively. SpWB was found to be associated with QoL more strongly than physical and emotional well-being. Peace and Meaning each contributed unique variance to QoL, and their relative importance shifted over time. Faith was positively related to QoL initially. This association became insignificant at three months post-baseline.
This study underscores the significance of SpWB for people newly diagnosed with advanced cancer, and it highlights the dynamic pattern of Peace, Meaning, and Faith in association with QoL. Our results confirm that patients newly diagnosed with advanced cancer experience an existential crisis, improve and stabilize over time. Future studies with larger samples over a longer period of time are needed to verify these results.
在我们的研究背景下，生存困境是指人们被诊断出患有癌症时对生死的高度关注。尽管生存困境的持续时间被认为约为100天，但纵向研究的证据引发了关于晚期癌症诊断的影响是否可能需要更长调整期的疑问。我们研究的目的是在基线后1个月和3个月，对52例晚期癌症患者诊断100天后的精神幸福感（SpWB）和生活质量（QoL）及其相互关系进行研究。
本研究设计为对一项涉及接受治疗的3期或4期癌症患者的整群随机临床试验的二次数据分析。使用12项慢性病治疗功能评估-精神幸福感量表（FACIT-Sp-12）测量SpWB；共同因素分析揭示了FACIT-Sp-12上的三因素模式。使用癌症治疗功能评估-通用量表（FACT-G）测量生活质量。我们将样本限制为分配到对照组的参与者（n = 52）。
基线后1个月至3个月期间，SpWB和QoL保持稳定，诊断后中位数分别为112天和183天。发现SpWB与QoL的关联比身体和情感幸福感更强。安宁和意义各自对QoL有独特的方差贡献，且它们的相对重要性随时间变化。信仰最初与QoL呈正相关。这种关联在基线后3个月变得不显著。
本研究强调了SpWB对新诊断为晚期癌症患者的重要性，并突出了安宁、意义和信仰与QoL相关的动态模式。我们的结果证实，新诊断为晚期癌症的患者经历了生存危机，随着时间推移会改善并稳定下来。需要未来进行更大样本、更长时间的研究来验证这些结果。
