Li Yu-Chan, Yeh Pei-Chen, Chen Hong-Wen, Chang Yi-Fang, Pi Shih-Hsuan, Fang Chun-Kai
Department of Thanatology and Health Counseling,National Taipei University of Nursing and Health Sciences,Taipei,Taiwan.
MacKay Junior College of Medicine, Nursing, and Management,Taipei,Taiwan.
Palliat Support Care. 2015 Oct;13(5):1449-58. doi: 10.1017/S1478951515000048. Epub 2015 Mar 5.
It is common for patients to experience positive and negative psychological changes (e.g., posttraumatic growth or demoralization) after being diagnosed with cancer. Although demoralization and posttraumatic growth are both related to meaning-making, little attention has been paid to the associations among these concepts. The current study investigated the relationship between demoralization, posttraumatic growth, and meaning-making (focusing on sense-making and benefit-finding during the experience of illness) in cancer patients.
Some 200 cancer patients (with lung cancer, lymphoma, or leukemia) at the MacKay Memorial Hospital in New Taipei completed the Demoralization Scale-Mandarin Version (DS-MV), the Chinese Posttraumatic Growth Inventory (CPTGI), and a self-designed questionnaire for assessing sense-making and benefit-finding.
Demoralization was negatively correlated with posttraumatic growth, sense-making, benefit-finding, and time-since-diagnosis. Multiple regression analysis showed that meaning-making had different effects on demoralization and posttraumatic growth. The interactions of sense-making with either benefit-finding or time-since-diagnosis significantly predicted demoralization. Individuals with relatively higher sense-making and benefit-finding or shorter time-since-diagnosis experienced less demoralization.
The suffering of cancer may turn on the psychological process of demoralization, posttraumatic growth, and meaning-making in patients. Cancer patients who evidenced higher posttraumatic growth experienced less demoralization. Trying to identify positive changes in the experience of cancer may be a powerful way to increase posttraumatic growth. As time goes by, patients experienced less demoralization. Facilitating sense-making can have similar effects. Cancer patients with less benefit-finding experience higher demoralization, but sense-making buffers this effect.
癌症患者在被诊断出患有癌症后，经历积极和消极的心理变化（如创伤后成长或士气低落）是很常见的。尽管士气低落和创伤后成长都与意义建构有关，但这些概念之间的关联很少受到关注。本研究调查了癌症患者中士气低落、创伤后成长和意义建构（关注疾病经历中的意义理解和益处发现）之间的关系。
台北新光医院约200名癌症患者（患有肺癌、淋巴瘤或白血病）完成了中文版士气低落量表（DS-MV）、中文创伤后成长量表（CPTGI）以及一份自行设计的用于评估意义理解和益处发现的问卷。
士气低落与创伤后成长、意义理解、益处发现以及确诊后的时间呈负相关。多元回归分析表明，意义建构对士气低落和创伤后成长有不同影响。意义理解与益处发现或确诊后的时间之间的相互作用显著预测了士气低落。意义理解和益处发现相对较高或确诊后的时间较短的个体经历的士气低落较少。
癌症带来的痛苦可能开启患者士气低落、创伤后成长和意义建构的心理过程。创伤后成长较高的癌症患者经历的士气低落较少。试图识别癌症经历中的积极变化可能是增加创伤后成长的有效方法。随着时间推移，患者经历的士气低落较少。促进意义理解可产生类似效果。益处发现较少的癌症患者士气低落程度较高，但意义理解可缓冲这种影响。
