Sumpio Catherine, Jeon Sangchoon, Northouse Laurel L, Knobf M Tish
Yale New Haven.
Yale University.
Oncol Nurs Forum. 2017 May 1;44(3):384-392. doi: 10.1188/17.ONF.384-392.
PURPOSE/OBJECTIVES: To explore the relationships between optimism, self-efficacy, symptom distress, treatment complexity, illness appraisal, coping, and mood disturbance in patients with advanced-stage cancer. .
DESIGN: Cross-sectional study. .
SETTING: Smilow Cancer Hospital at Yale New Haven in Connecticut, an outpatient comprehensive cancer center. .
SAMPLE: A convenience sample of 121 adult patients with stages III-IV cancer undergoing active chemotherapy. .
METHODS: Participants completed common self-report questionnaires to measure variables. Treatment hours and visits were calculated from data retrieved from medical record review. Mediation and path analysis were conducted to identify direct and indirect pathways from the significant antecedent variables to mood disturbance. .
MAIN RESEARCH VARIABLES: Dispositional optimism, self-efficacy, social support, treatment complexity, symptom distress, illness appraisal, coping, and mood disturbance. .
FINDINGS: Greater optimism and self-efficacy were associated with less negative illness appraisal, less avoidant coping, and decreased mood disturbance. Conversely, greater symptom distress was associated with greater negative illness appraisal, greater avoidant coping, and greater mood disturbance. In the final model, optimism and symptom distress had direct and indirect effects on mood disturbance. Indirect effects were partially mediated by illness appraisal. .
CONCLUSIONS: Mood disturbance resulted from an interaction of disease stressors, personal resources, and cognitive appraisal of illness. Avoidant coping was associated with greater disturbed mood, but neither avoidant nor active coping had a significant effect on mood in the multivariate model. .
Illness appraisal, coping style, and symptom distress are important targets for intervention. Optimism is a beneficial trait and should be included, along with coping style, in comprehensive nursing assessments of patients with cancer.
目的/目标：探讨晚期癌症患者的乐观主义、自我效能感、症状困扰、治疗复杂性、疾病评估、应对方式和情绪障碍之间的关系。
横断面研究。
康涅狄格州耶鲁纽黑文的斯米洛癌症医院，一家门诊综合癌症中心。
121名正在接受积极化疗的III - IV期成年癌症患者的便利样本。
参与者完成常见的自我报告问卷以测量变量。治疗时间和就诊次数根据病历审查中获取的数据计算得出。进行中介和路径分析以确定从显著的先行变量到情绪障碍的直接和间接途径。
特质乐观主义、自我效能感、社会支持、治疗复杂性、症状困扰、疾病评估、应对方式和情绪障碍。
更高的乐观主义和自我效能感与更少的负面疾病评估、更少的回避应对方式以及更低的情绪障碍相关。相反，更高的症状困扰与更负面的疾病评估、更多的回避应对方式以及更严重的情绪障碍相关。在最终模型中，乐观主义和症状困扰对情绪障碍有直接和间接影响。间接影响部分由疾病评估介导。
情绪障碍是由疾病应激源、个人资源和疾病认知评估相互作用导致的。回避应对方式与更严重的情绪困扰相关，但在多变量模型中，回避应对和积极应对方式对情绪均无显著影响。
疾病评估、应对方式和症状困扰是重要的干预目标。乐观主义是一种有益的特质，应与应对方式一起纳入癌症患者的综合护理评估中。
