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乳腺癌女性创伤后成长与心理社会因素关系的结构方程模型

Structural equation modeling of the relationship between posttraumatic growth and psychosocial factors in women with breast cancer.

作者信息

Tomita Makiko, Takahashi Miyako, Tagaya Nobumi, Kakuta Miyako, Kai Ichiro, Muto Takashi

机构信息

Division of Cancer Survivorship Research, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan.

Department of Surgery, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan.

出版信息

Psychooncology. 2017 Aug;26(8):1198-1204. doi: 10.1002/pon.4298. Epub 2016 Nov 7.

Abstract

OBJECTIVE

Posttraumatic growth (PTG) is a positive psychological change occurring after struggling with a highly challenging experience. The purposes of this study were to investigate how women's demographic and clinical characteristics as well as psychosocial factors are associated with PTG and to reveal the influence of PTG on depressive symptoms.

METHODS

Participants were 157 women with breast cancer (BC) who attended a breast oncology clinic at a university hospital in Japan. The questionnaire included demographic and clinical characteristics, social support, coping strategies, depressive symptoms, and PTG. Structural equation modeling was conducted.

RESULTS

Coping was directly related to PTG, and social support and having a religion were partially related to PTG. There was a moderate association between social support and coping. PTG mediated the effect of coping on depressive symptoms. PTG as well as a high level of perceived social support and using positive coping decreased depressive symptoms, whereas using self-restraining coping increased depressive symptoms.

CONCLUSION

This study indicated the role of coping strategies and social support in enhancing PTG in Japanese women with BC. Furthermore, perceived social support, a positive approach coping style, and PTG may reduce depressive symptoms. Our results suggest that health care professionals should consider whether patients receive enough support from others, and whether the patients are using the appropriate coping style to adapt to stressors associated with the diagnosis and treatment of BC.

摘要

目的

创伤后成长(PTG)是在经历极具挑战性的事件后出现的一种积极心理变化。本研究旨在调查女性的人口统计学和临床特征以及心理社会因素如何与创伤后成长相关联,并揭示创伤后成长对抑郁症状的影响。

方法

研究对象为157名患有乳腺癌(BC)的女性,她们在日本一家大学医院的乳腺肿瘤诊所就诊。调查问卷包括人口统计学和临床特征、社会支持、应对策略、抑郁症状以及创伤后成长。进行了结构方程模型分析。

结果

应对方式与创伤后成长直接相关,社会支持和有宗教信仰与创伤后成长部分相关。社会支持与应对方式之间存在中度关联。创伤后成长介导了应对方式对抑郁症状的影响。创伤后成长以及高水平的感知社会支持和采用积极应对方式可减轻抑郁症状,而采用自我约束应对方式则会增加抑郁症状。

结论

本研究表明应对策略和社会支持在增强日本乳腺癌女性创伤后成长方面的作用。此外,感知社会支持、积极的应对方式以及创伤后成长可能会减轻抑郁症状。我们的研究结果表明,医疗保健专业人员应考虑患者是否从他人那里获得了足够的支持,以及患者是否正在采用适当的应对方式来适应与乳腺癌诊断和治疗相关的压力源。

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