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乳腺癌手术后女性所感受到的耻辱感。

Stigma Perceived by Women Following Surgery for Breast Cancer.

作者信息

Tripathi Lopamudra, Datta Soumitra Shankar, Agrawal Sanjit Kumar, Chatterjee Sanjoy, Ahmed Rosina

机构信息

Department of Palliative Care and Psycho-oncology, Tata Medical Centre, Kolkata, West Bengal, India.

Institute for Women's Health, University College, London, United Kingdom.

出版信息

Indian J Med Paediatr Oncol. 2017 Apr-Jun;38(2):146-152. doi: 10.4103/ijmpo.ijmpo_74_16.

Abstract

CONTEXT

Women undergoing treatment for breast cancer often have psychological morbidity and body image difficulties. The risk factors for increased levels of stigma in women with breast cancer have not been adequately studied.

AIMS

This study aimed at investigating the associations of high levels of stigma in women with breast cancer.

SETTINGS AND DESIGN

This cross-sectional study was conducted in a comprehensive cancer center in India and recruited women ( = 134) undergoing surgical treatment for breast cancer.

METHODS

Body image difficulties, including stigma and affective symptoms, were quantified, alongside disease- and treatment-related variables using standardized questionnaires.

STATISTICAL ANALYSIS USED

Univariate analysis followed by multivariate logistic regression was performed to find the risk factors of high levels of stigma related to body image.

RESULTS

In the univariate analysis, high levels of stigma were associated with lesser educational attainment (odds ratio [OR] =2.92, confidence interval [CI] 1.25-6.8, = 0.01), breast conservation surgery (BCS) as opposed to mastectomy (OR = 4.78, CI 2.07-11.03, < 0.001), having an anxiety disorder (OR = 2.4, CI 1.09-5.33, = 0.03), and depression (OR = 3.08, CI 1.37-6.89, < 0.01). On multivariate logistic regression, with stigma as the dependent variable, being less educated (adjusted OR [AOR] 3.08, CI 1.18-8.04, = 0.02) and opting for BCS (AOR 6.12, CI 2.41-15.5, < 0.001) were associated with higher stigma.

CONCLUSIONS

Women with breast cancer should be screened for distress and stigma. Women opting for BCS may still have unmet emotional needs on completion of surgery and should have access to psychological interventions to address stigma, affective symptoms, and body image problems.

摘要

背景

接受乳腺癌治疗的女性常常存在心理问题和身体形象困扰。乳腺癌女性耻辱感水平升高的风险因素尚未得到充分研究。

目的

本研究旨在调查乳腺癌女性高水平耻辱感的相关因素。

设置与设计

这项横断面研究在印度一家综合癌症中心进行,招募了134名接受乳腺癌手术治疗的女性。

方法

使用标准化问卷对包括耻辱感和情感症状在内的身体形象困扰以及疾病和治疗相关变量进行量化。

所用统计分析方法

进行单因素分析,随后进行多因素逻辑回归,以找出与身体形象相关的高水平耻辱感的风险因素。

结果

在单因素分析中,高水平耻辱感与较低的教育程度(比值比[OR]=2.92,置信区间[CI]1.25 - 6.8,P = 0.01)、保乳手术(BCS)而非乳房切除术(OR = 4.78,CI 2.07 - 11.03,P < 0.001)、患有焦虑症(OR = 2.4,CI 1.09 - 5.33,P = 0.03)和抑郁症(OR = 3.08,CI 1.37 - 6.89,P < 0.01)相关。在多因素逻辑回归中,以耻辱感为因变量,受教育程度较低(调整后OR[AOR]3.08,CI 1.18 - 8.04,P = 0.02)和选择保乳手术(AOR 6.12,CI 2.41 - 15.5,P < 0.001)与较高的耻辱感相关。

结论

应对乳腺癌女性进行痛苦和耻辱感筛查。选择保乳手术的女性在手术完成后可能仍有未满足的情感需求,应获得心理干预以解决耻辱感、情感症状和身体形象问题。

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