Adams Rebecca N, Mosher Catherine E, Cohee Andrea A, Stump Timothy E, Monahan Patrick O, Sledge George W, Cella David, Champion Victoria L
Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
Indiana University School of Nursing, Indianapolis, IN, USA.
Psychooncology. 2017 Jul;26(7):982-990. doi: 10.1002/pon.4119. Epub 2016 Mar 10.
Many breast cancer survivors feel constrained in discussing their cancer experience with others. Limited evidence suggests that social constraints (e.g., avoidance and criticism) from loved ones may negatively impact breast cancer survivors' global health, but research has yet to examine relationships between social constraints and common physical symptoms. Informed by social cognitive processing theory, this study examined whether perceived social constraints from partners and healthcare providers (HCPs) were associated with fatigue, sleep disturbance, and attentional functioning among long-term breast cancer survivors (N = 1052). In addition, avoidant coping and self-efficacy for symptom management were examined as potential mediators of these relationships.
Long-term breast cancer survivors (mean years since diagnosis = 6) completed questionnaires assessing social constraints from partners and HCPs, avoidant coping, self-efficacy for symptom management, and symptoms (i.e., fatigue, sleep disturbance, and attentional functioning). Structural equation modeling was used to evaluate the hypothesized relationships among variables in two models: one focused on social constraints from partners and one focused on social constraints from HCPs.
Both models demonstrated good fit. Consistent with theory and prior research, greater social constraints from both partners and HCPs were associated with greater symptom burden (i.e., greater fatigue and sleep disturbance, poorer attentional functioning). In addition, all relationships were mediated by avoidant coping and self-efficacy for symptom management.
Findings are consistent with social cognitive processing theory and suggest that symptom management interventions may be enhanced by addressing the impact of social constraints from survivors' partners and HCPs on their coping and self-efficacy. Copyright © 2016 John Wiley & Sons, Ltd.
许多乳腺癌幸存者在与他人讨论自己的癌症经历时感到受限。有限的证据表明，来自亲人的社会限制（如回避和批评）可能会对乳腺癌幸存者的整体健康产生负面影响，但研究尚未考察社会限制与常见身体症状之间的关系。基于社会认知加工理论，本研究调查了长期乳腺癌幸存者（N = 1052）感知到的来自伴侣和医疗服务提供者（HCPs）的社会限制是否与疲劳、睡眠障碍和注意力功能有关。此外，还考察了回避应对和症状管理的自我效能感作为这些关系的潜在中介因素。
长期乳腺癌幸存者（诊断后平均年数 = 6）完成了问卷调查，评估来自伴侣和HCPs的社会限制、回避应对、症状管理的自我效能感以及症状（即疲劳、睡眠障碍和注意力功能）。采用结构方程模型来评估两个模型中变量之间的假设关系：一个侧重于来自伴侣的社会限制，另一个侧重于来自HCPs的社会限制。
两个模型均显示出良好的拟合度。与理论和先前的研究一致，来自伴侣和HCPs的更大社会限制与更大的症状负担相关（即更严重的疲劳和睡眠障碍、更差的注意力功能）。此外，所有关系均由回避应对和症状管理的自我效能感介导。
研究结果与社会认知加工理论一致，表明通过解决幸存者的伴侣和HCPs的社会限制对其应对和自我效能感的影响，症状管理干预可能会得到加强。版权所有© 2016约翰威立父子有限公司。
