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重度抑郁症、人格障碍和应对策略是影响非转移性乳腺癌患者生活质量较低的独立危险因素。

Major depressive disorder, personality disorders, and coping strategies are independent risk factors for lower quality of life in non-metastatic breast cancer patients.

作者信息

Brunault Paul, Champagne Anne-Laure, Huguet Grégoire, Suzanne Isabelle, Senon Jean-Louis, Body Gilles, Rusch Emmanuel, Magnin Guillaume, Voyer Mélanie, Réveillère Christian, Camus Vincent

机构信息

Clinique Psychiatrique Universitaire, CHRU de Tours, Tours, France.

Équipe de Liaison et de Soins en Addictologie, CHRU de Tours, Tours, France.

出版信息

Psychooncology. 2016 May;25(5):513-20. doi: 10.1002/pon.3947. Epub 2015 Sep 10.

Abstract

OBJECTIVE

Our aim was to identify risk factors for lower quality of life (QOL) in non-metastatic breast cancer patients.

METHODS

Our study included 120 patients from the University Hospital Centers of Tours and Poitiers. This cross-sectional study was conducted 7 months after patients' breast cancer diagnosis and assessed QOL (Quality of Life Questionnaire Core 30 = QLQ-C30), socio-demographic characteristics, coping strategies (Brief-COPE), physiological and biological variables (e.g., initial tumor severity and types of treatment received), the existence of major depressive disorder (Mini International Neuropsychiatric Interview), and pain severity (Questionnaire de Douleur Saint Antoine). We assessed personality disorders 3 months after diagnosis (Vragenlijst voor Kenmerken van de Persoonlijkheid questionnaire). We used multiple linear regression models to determine which factors were associated with physical, emotional, and global QOL.

RESULTS

Lower physical QOL was associated with major depressive disorder, younger age, a more severe initial tumor stage, and the use of the behavioral disengagement coping. Lower emotional QOL was associated with major depressive disorder, the existence of a personality disorder, a more severe pain level, higher use of self-blame, and lower use of acceptance coping strategies. Lower global QOL was associated with major depressive disorder, the existence of a personality disorder, a more severe pain level, higher use of self-blame, lower use of positive reframing coping strategies, and an absence of hormone therapy.

CONCLUSIONS

Lower QOL scores were more strongly associated with variables related to the individual's premorbid psychological characteristics and the manner in which this individual copes with the cancer (e.g., depression, personality, and coping) than to cancer-related variables (e.g., treatment types and cancer severity). Copyright © 2015 John Wiley & Sons, Ltd.

摘要

目的

我们的目的是确定非转移性乳腺癌患者生活质量(QOL)较低的风险因素。

方法

我们的研究纳入了来自图尔和普瓦捷大学医院中心的120名患者。这项横断面研究在患者乳腺癌确诊7个月后进行,评估了生活质量(生活质量问卷核心30项=QLQ-C30)、社会人口学特征、应对策略(简易应对方式问卷)、生理和生物学变量(如初始肿瘤严重程度和接受的治疗类型)、重度抑郁症的存在情况(迷你国际神经精神访谈)以及疼痛严重程度(圣安托万疼痛问卷)。我们在诊断后3个月评估人格障碍(人格特征问卷)。我们使用多元线性回归模型来确定哪些因素与身体、情绪和总体生活质量相关。

结果

较低的身体生活质量与重度抑郁症、较年轻的年龄、更严重的初始肿瘤分期以及行为脱离应对方式的使用有关。较低的情绪生活质量与重度抑郁症、人格障碍的存在、更高的疼痛水平、更多地使用自责以及较少地使用接受应对策略有关。较低的总体生活质量与重度抑郁症、人格障碍的存在、更高的疼痛水平、更多地使用自责、较少地使用积极重新评价应对策略以及未接受激素治疗有关。

结论

较低的生活质量得分与个体病前心理特征以及个体应对癌症的方式(如抑郁、人格和应对)相关的变量的关联,比与癌症相关变量(如治疗类型和癌症严重程度)的关联更为紧密。版权所有© 2015约翰威立父子有限公司。

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