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癌症积极心理副产物的相关因素:家庭照顾者和信息支持的作用。

Correlates of the positive psychological byproducts of cancer: Role of family caregivers and informational support.

机构信息

School of Human Ecology,University of Wisconsin-Madison,Madison,Wisconsin.

Department of Natural and Applied Sciences,Bentley University,Waltham,Massachusetts.

出版信息

Palliat Support Care. 2017 Dec;15(6):693-703. doi: 10.1017/S1478951517000050. Epub 2017 Feb 21.

Abstract

OBJECTIVE

Experiencing a life-threatening illness such as cancer can elicit both negative (e.g., distress) and positive (e.g., growth) psychological responses. The present study sought to determine the correlates of four positive psychological byproducts in cancer survivors: becoming a stronger person, coping better with life's challenges, making positive changes in life, and adopting healthier habits.

METHOD

Data for this cross-sectional study were taken from the Medical Expenditures Panel Survey (MEPS) Experiences with Cancer Survivorship Supplement (Yabroff et al., 2012). Cancer survivors (N = 785) reported their sociodemographic and cancer-related characteristics. Descriptive statistics were utilized to summarize cancer survivor characteristics, including demographic factors, cancer factors, and stressors and resources related to cancer. Multivariable logistic regressions were employed to assess the independent association of the stressors and resources with each psychological response, controlling for covariates. All analyses were weighted to account for the complex sampling design of the MEPS.

RESULTS

In multivariable analyses, those with a family caregiver were 50% more likely to report better coping with challenges, and around 70% were more likely to report making positive changes in life or adopting healthier habits because of their cancer. Receiving informational support from healthcare providers was also consistently associated with positive byproducts (odds ratios ranging from 1.6 to 2.0). Few of the stressors were associated with positive byproducts: having insurance problems due to cancer was positively associated with becoming a stronger person, and work limitations were associated with making positive changes in life; those who reported high perceived chances of recurrence were less likely to report becoming a stronger person.

SIGNIFICANCE OF RESULTS

Having a family caregiver and receiving detailed informational support from healthcare providers were associated with reporting positive experiences with cancer. The hypotheses and future research stimulated by these findings may improve our understanding of the process by which positive byproducts develop and may ultimately help improve psychological well-being among cancer survivors.

摘要

目的

罹患危及生命的疾病(如癌症)会引发负面(例如,痛苦)和正面(例如,成长)的心理反应。本研究旨在确定癌症幸存者的四种积极心理副产物的相关因素:变得更强大、更好地应对生活挑战、积极改变生活和养成更健康的习惯。

方法

本横断面研究的数据来自医疗支出面板调查(MEPS)癌症生存者体验补充调查(Yabroff 等人,2012 年)。癌症幸存者(N=785)报告了他们的社会人口统计学和癌症相关特征。描述性统计用于总结癌症幸存者的特征,包括人口统计学因素、癌症因素以及与癌症相关的压力源和资源。多变量逻辑回归用于评估压力源和资源与每种心理反应的独立关联,同时控制了协变量。所有分析均进行了加权,以考虑 MEPS 的复杂抽样设计。

结果

在多变量分析中,有家庭照顾者的人报告更好地应对挑战的可能性增加 50%,约 70%的人更有可能报告因癌症而积极改变生活或养成更健康的习惯。从医疗保健提供者那里获得信息支持也与积极的副产物始终相关(比值比范围从 1.6 到 2.0)。很少有压力源与积极的副产物相关:因癌症而出现保险问题与变得更强大呈正相关,工作限制与积极改变生活相关;那些报告高复发可能性的人不太可能报告变得更强大。

意义

有家庭照顾者并从医疗保健提供者那里获得详细的信息支持与报告癌症的积极体验相关。这些发现激发的假设和未来研究可能会增进我们对积极副产物发展过程的理解,并最终有助于改善癌症幸存者的心理健康。

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