Reynolds Lisa M, Bissett Ian P, Porter David, Consedine Nathan S
Department of Psychological Medicine, The University of Auckland, Private bag 92019, Victoria Street West, Auckland, 1142, New Zealand.
Department of Surgery, The University of Auckland, Private bag 92019, Victoria Street West, Auckland, 1142, New Zealand.
Ann Behav Med. 2016 Dec;50(6):935-945. doi: 10.1007/s12160-016-9820-x.
Chemotherapy can be physically and psychologically demanding. Avoidance and withdrawal are common among patients coping with these demands.
This report compares established emotional predictors of avoidance during chemotherapy (embarrassment; distress) with an emotion (disgust) that has been unstudied in this context.
This report outlines secondary analyses of an RCT where 68 cancer patients undergoing chemotherapy were randomized to mindfulness or relaxation interventions. Self-reported baseline disgust (DS-R), embarrassment (SES-SF), and distress (Distress Thermometer) were used to prospectively predict multiple classes of avoidance post-intervention and at 3 months follow-up. Measures assessed social avoidance, cognitive and emotional avoidance (IES Avoidance), as well as information seeking and treatment adherence (General Adherence Scale).
Repeated-measures ANOVAs evaluated possible longitudinal changes in disgust and forward entry regression models contrasted the ability of the affective variables to predict avoidance. Although disgust did not change over time or vary between groups, greater disgust predicted greater social, cognitive, and emotional avoidance, as well as greater information seeking. Social avoidance was predicted by trait embarrassment and distress predicted non-adherence.
This report represents the first investigation of disgust's ability to prospectively predict avoidance in people undergoing chemotherapy. Compared to embarrassment and distress, disgust was a more consistent predictor across avoidance domains and its predictive ability was evident across a longer period of time. Findings highlight disgust's role as an indicator of likely avoidance in this health context. Early identification of cancer patients at risk of deleterious avoidance may enable timely interventions and has important clinical implications (ACTRN12613000238774).
化疗对身体和心理都有很高要求。在应对这些要求时，回避和退缩在患者中很常见。
本报告将化疗期间回避行为的既定情绪预测因素（尴尬；痛苦）与在此背景下尚未研究过的一种情绪（厌恶）进行比较。
本报告概述了一项随机对照试验的二次分析，68名接受化疗的癌症患者被随机分配到正念或放松干预组。使用自我报告的基线厌恶感（DS-R）、尴尬感（SES-SF）和痛苦感（痛苦温度计）来前瞻性预测干预后及3个月随访时的多种回避类别。测量指标包括社交回避、认知和情绪回避（IES回避）以及信息寻求和治疗依从性（总体依从性量表）。
重复测量方差分析评估了厌恶感可能的纵向变化，向前逐步回归模型对比了情感变量预测回避行为的能力。尽管厌恶感不会随时间变化，也不会在组间有所不同，但更高的厌恶感预示着更多的社交、认知和情绪回避，以及更多的信息寻求。特质尴尬可预测社交回避，痛苦感可预测不依从。
本报告首次调查了厌恶感对接受化疗患者回避行为的前瞻性预测能力。与尴尬和痛苦相比，厌恶感在回避领域是更一致的预测因素，其预测能力在更长时间内都很明显。研究结果凸显了厌恶感在这种健康背景下作为可能回避行为指标的作用。早期识别有有害回避风险的癌症患者可能有助于及时进行干预，具有重要的临床意义（澳大利亚新西兰临床试验注册中心编号：ACTRN12613000238774）。
