Phillips Siobhan M, Lloyd Gillian R, Awick Elizabeth A, McAuley Edward
Department of Preventive Medicine, Northwestern University, Chicago, IL, USA.
Department of Kinesiology and Community Health, University of Illinois Urbana Champaign, Urbana, IL, USA.
Psychooncology. 2017 Sep;26(9):1390-1399. doi: 10.1002/pon.4156. Epub 2016 Jul 8.
Many breast cancer survivors report cancer and cancer treatment-associated cognitive change. However, very little is known about the relationship between physical activity and subjective memory impairment (SMI) in this population. The purpose of this study is to examine the relationship between physical activity and SMI and longitudinally test a model examining the role of self-efficacy, fatigue and distress as potential mediators.
Post-treatment breast cancer survivors (N = 1477) completed measures of physical activity, self-efficacy, distress (depression, concerns about recurrence, perceived stress, anxiety), fatigue and SMI at baseline and 6-month follow-up. A subsample (n = 362) was randomly selected to wear an accelerometer. It was hypothesized that physical activity indirectly influences SMI via exercise self-efficacy, distress and fatigue. Relationships were examined using panel analysis within a covariance modeling framework.
The hypothesized model provided a good fit in the full sample (χ = 1462.5, df = 469, p = <0.001; CFI = 0.96; SRMR = 0.04) and the accelerometer subsample (χ2 = 961.8, df = 535, p = <0.001, CFI = 0.94, SRMR = 0.05) indicating increased physical activity is indirectly associated with reduction in SMI across time, via increased exercise self-efficacy and reduced distress and fatigue.
Higher levels of physical activity, lower levels of fatigue and distress and higher exercise self-efficacy may play an important role in understanding SMI in breast cancer survivors across time. Future research is warranted to replicate and explore these relationships further. Copyright © 2016 John Wiley & Sons, Ltd.
许多乳腺癌幸存者报告存在癌症及与癌症治疗相关的认知变化。然而，对于该人群中身体活动与主观记忆障碍（SMI）之间的关系，人们知之甚少。本研究的目的是检验身体活动与SMI之间的关系，并纵向测试一个模型，该模型考察自我效能感、疲劳和痛苦作为潜在中介因素的作用。
治疗后的乳腺癌幸存者（N = 1477）在基线和6个月随访时完成了身体活动、自我效能感、痛苦（抑郁、对复发的担忧、感知压力、焦虑）、疲劳和SMI的测量。随机选取一个子样本（n = 362）佩戴加速度计。研究假设身体活动通过运动自我效能感、痛苦和疲劳间接影响SMI。在协方差建模框架内使用面板分析来检验这些关系。
假设模型在全样本（χ² = 1462.5，df = 469，p = <0.001；CFI = 0.96；SRMR = 0.04）和加速度计子样本（χ² = 961.8，df = 535，p = <0.001，CFI = 0.94，SRMR = 0.05）中拟合良好，表明随着时间推移，身体活动增加通过提高运动自我效能感、减少痛苦和疲劳，与SMI的降低间接相关。
较高水平的身体活动、较低水平的疲劳和痛苦以及较高的运动自我效能感可能在理解乳腺癌幸存者不同时间的SMI方面发挥重要作用。未来有必要进行研究以进一步复制和探索这些关系。版权所有© 2016约翰威立父子有限公司。
