Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, MO, USA.
Psychooncology. 2018 Feb;27(2):477-483. doi: 10.1002/pon.4485. Epub 2017 Aug 4.
Because of the poor prognosis of ovarian cancer and concomitant distress, understanding contributors to positive well-being is critical. This study examines spiritual growth as a domain of posttraumatic growth and its contribution to longitudinal emotional outcomes in ovarian cancer.
Ovarian cancer patients (N = 241) completed measures assessing spirituality (Functional Assessment of Chronic Illness Therapy-Spiritual Well-being-12; subscales: faith, meaning, and peace), depression (Center for Epidemiologic Studies Depression Scale), cancer-specific anxiety (Impact of Event Scale), and total mood disturbance (TMD; Profile of Mood States) prior to surgery and 1-year postsurgery. Stressful life events in the year after diagnosis were measured at 1-year postsurgery. Regressions examined the association between changes in spirituality and depression, anxiety, and TMD at 1-year postsurgery. Additionally, spiritual change was examined as a moderator of the effect of recent life events on mood.
Increases in peace were related to lower depression (β = -.40, P < .001), anxiety (β = -.20, P = .004), and TMD (β = -.41, P < .001) at 1 year. Changes in meaning and faith were unrelated to all outcomes. Additionally, changes in peace moderated the effect of stressful life events on depression (β = -.14, P = .027), anxiety (β = -.16, P = .05), and TMD (β = -.17, P = .01), such that those with a high number of life events paired with a decrease in peace experienced the worst psychological outcomes at 1 year.
These findings suggest that the quality of peace may be the most adaptive facet of spiritual growth in cancer patients. Furthermore, changes in peace appear to moderate the effect of life events on psychological well-being.
由于卵巢癌预后不良和随之而来的痛苦，了解积极幸福感的促成因素至关重要。本研究探讨了精神成长作为创伤后成长的一个领域，以及它对卵巢癌患者纵向情绪结果的贡献。
卵巢癌患者（N=241）在手术前和手术后 1 年完成了评估精神状态（慢性疾病治疗的功能性评估-精神幸福感-12；子量表：信仰、意义和和平）、抑郁（流行病学研究中心抑郁量表）、癌症特异性焦虑（事件影响量表）和总情绪障碍（心境状态问卷）的测量。在手术后 1 年测量了诊断后 1 年内的应激性生活事件。回归分析考察了手术后 1 年精神状态变化与抑郁、焦虑和 TMD 的关系。此外，还考察了精神状态变化作为近期生活事件对情绪影响的调节因素。
和平感的增加与术后 1 年时的抑郁（β=-.40，P<.001）、焦虑（β=-.20，P=.004）和 TMD（β=-.41，P<.001）降低有关。意义和信仰的变化与所有结果均无关。此外，和平感的变化调节了应激性生活事件对抑郁（β=-.14，P=.027）、焦虑（β=-.16，P=.05）和 TMD（β=-.17，P=.01）的影响，即生活事件数量多且和平感下降的患者在术后 1 年时经历了最严重的心理后果。
这些发现表明，在癌症患者中，和平感的质量可能是精神成长最适应的方面。此外，和平感的变化似乎调节了生活事件对心理健康的影响。
