Li Lingyan, Li Shichen, Wang Yuping, Yi Jinyao, Yang Yanjie, He Jincai, Zhu Xiongzhao
1 Medical Psychological Institute, Second Xiangya Hospital, Central South University, Changsha, China.
2 School of Humanities and Social Sciences, Xi'an Jiaotong University, Xi'an, China.
Integr Cancer Ther. 2017 Jun;16(2):196-204. doi: 10.1177/1534735416646854. Epub 2016 May 6.
The study aimed to explore latent profiles of coping in Chinese women newly diagnosed with breast cancer and examine the differences of psychological distress, demographic, and medical characteristics across profiles.
Latent profile analysis was used to identify 3 classes of copers based on data from 618 Chinese women newly diagnosed with breast cancer who completed questionnaires assessing their coping strategies and psychological distress.
"Adaptive coper," reporting most use of adaptive cognitive coping strategies, behaviors of acceptance and shifting attention, and least use of maladaptive cognitive coping strategies, had the best psychological adjustment. "Negative coper," characterized by most use of maladaptive cognitive coping strategies, least use of adaptive cognitive coping strategies except "putting in perspective," and median levels of medical coping behaviors, had the worst psychological adjustment. "Inconsistent coper," with great use of all cognitive coping strategies, and most behaviors of fighting against the disease, and fewest behaviors of attention shift, had relatively high levels of psychological distress. Younger age, less education, shorter time since diagnosis, widowed, living in rural areas, and undergoing chemotherapy are possible markers for patients with less adaptive coping patterns.
Interventions should be developed according to the different coping profiles of patients, and the key group to target is "negative copers," who may benefit from cognitive behavioral approaches that combine emotion, cognition and behavior, which could help them more effectively appraise and cope with stressful events.
本研究旨在探索中国新诊断乳腺癌女性的应对潜在模式,并检验不同模式下心理困扰、人口统计学和医学特征的差异。
基于618名新诊断乳腺癌的中国女性的数据,采用潜在剖面分析来识别3类应对者,这些女性完成了评估其应对策略和心理困扰的问卷。
“适应性应对者”报告称最常使用适应性认知应对策略、接受和转移注意力的行为,且最少使用适应不良的认知应对策略,其心理调适最佳。“消极应对者”的特征是最常使用适应不良的认知应对策略,除“正确看待”外最少使用适应性认知应对策略,且医学应对行为处于中等水平,其心理调适最差。“不一致应对者”大量使用所有认知应对策略,且与疾病抗争的行为最多,注意力转移行为最少,其心理困扰水平相对较高。年龄较小、受教育程度较低、确诊时间较短、丧偶、居住在农村地区以及正在接受化疗可能是应对模式适应性较差患者的标志。
应根据患者不同的应对模式制定干预措施,重点干预对象是“消极应对者”,他们可能从结合情绪、认知和行为的认知行为方法中受益,这有助于他们更有效地评估和应对压力事件。