Palmer Steven C, Stricker Carrie T, DeMichele Angela M, Schapira Marilyn, Glanz Karen, Griggs Jennifer J, Jacobs Linda A
Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Support Care Cancer. 2017 Aug;25(8):2405-2412. doi: 10.1007/s00520-017-3646-3. Epub 2017 Feb 23.
Survivor distress is well represented in the literature, but less is known about survivors' concerns and how these relate to adaptation. Using a newly designed Survivorship Concern Scale, we examined concerns and their relationship to psychosocial adaptation among recent breast cancer (BC) survivors.
One hundred forty-three stage 0-III BC survivors completed an online assessment including the Survivorship Concern Scale (0-3 scale; alpha = 0.91), unmet needs, quality of life (QoL), and anxiety and depressive symptoms within 1 year of end of treatment.
Participants were predominately white (76%), middle-aged (51 years), married (70%), and college educated (79%). Eighty-two percent were stage I or II at diagnosis. Mean degree of survivorship concern was moderate (M = 1.75, SD = 0.70) though variable (range = 0.12-3.00). Survivorship concerns were not significantly related to disease, treatment, or demographic variables except income (p = 0.02). Degree of survivorship concern was significantly associated with all indices of psychosocial adaptation: unmet need (r = 0.50), physical and mental QoL (r = -0.32 and r = -0.32, respectively), depressive symptoms (r = 0.21), and anxiety symptoms (r = 0.51; all p < 0.001). Binary logistic regression suggested that each one-point increase in degree of average concern increased the odds for elevated depressive symptoms by 2.83 (p = 0.03) and increased the odds of elevated anxiety symptoms by 3.69 (p < 0.001).
Survivorship concerns in the year following treatment are moderate but variable. Concerns are associated with QoL, unmet need, and psychosocial adaptation. Adequately addressing concerns may be a way to improve psychosocial outcomes early in the survivorship trajectory.
幸存者的痛苦在文献中有充分体现,但对于幸存者的担忧以及这些担忧与适应之间的关系,我们了解得较少。我们使用新设计的幸存者担忧量表,研究了近期乳腺癌(BC)幸存者的担忧及其与心理社会适应的关系。
143名0 - III期乳腺癌幸存者在治疗结束后1年内完成了一项在线评估,包括幸存者担忧量表(0 - 3量表;α = 0.91)、未满足的需求、生活质量(QoL)以及焦虑和抑郁症状。
参与者主要为白人(76%)、中年(51岁)、已婚(70%)且受过大学教育(79%)。82%在诊断时为I期或II期。尽管存在差异(范围 = 0.12 - 3.00),但平均幸存者担忧程度为中等(M = 1.75,SD = 0.70)。除收入外(p = 0.02),幸存者担忧与疾病、治疗或人口统计学变量无显著相关性。幸存者担忧程度与心理社会适应的所有指标均显著相关:未满足的需求(r = 0.50)、身体和心理健康生活质量(分别为r = -0.32和r = -0.32)、抑郁症状(r = 0.21)以及焦虑症状(r = 0.51;所有p < 0.001)。二元逻辑回归表明,平均担忧程度每增加1分,抑郁症状加重的几率增加2.83(p = 0.03),焦虑症状加重的几率增加