Vinokur A D, Threatt B A, Caplan R D, Zimmerman B L
Institute for Social Research, University of Michigan, Ann Arbor 48106-1248.
Cancer. 1989 Jan 15;63(2):394-405. doi: 10.1002/1097-0142(19890115)63:2<394::aid-cncr2820630233>3.0.co;2-5.
The effects of age, recency of breast cancer (BC) diagnosis, and severity of the disease on adjustment outcomes were investigated in a sample of 349 women from the 10,056 women screened for BC by the University of Michigan Breast Cancer Detection Demonstration Project between 1974 and 1981. In the 1985 follow-up, data were collected from the 173 surviving BC patients who had invasive BC, and from a matched control group of 176 women who were asymptomatic of BC. Fifty-five percent of the BC patients were 5 years past diagnosis and treatment at the time of data collection. The BC patients group as a whole did not differ from the asymptomatic control group on indicators of mental health, social and psychological well-being, or physical functioning. However, the BC group reported a greater number of diagnosed medical conditions that limited their activities, and taking more medications, than the asymptomatic group. Within the BC group, severity and recency of the cancer had strong independent adverse effects on several of the indicators of mental health and physical functioning. Advanced age had the same main effects in both groups: greater number of medications and diagnosed medical conditions that cause limitations in activities, but, in contrast, better mental health and well-being. Age had interactive effects with the recency and with severity of BC: more recent and severe cases of BC appeared to produce particularly serious difficulties in psychological adjustment for younger patients, and particularly serious medical problems and physical difficulties in adjustment for older patients.
在1974年至1981年间，密歇根大学乳腺癌检测示范项目对10,056名女性进行了乳腺癌（BC）筛查，从其中抽取了349名女性样本，研究年龄、乳腺癌诊断时间的远近以及疾病严重程度对适应结果的影响。在1985年的随访中，收集了173名存活的浸润性乳腺癌患者以及176名无症状乳腺癌女性匹配对照组的数据。在收集数据时，55%的乳腺癌患者已确诊并接受治疗5年。乳腺癌患者组在心理健康、社会和心理幸福感或身体功能指标上与无症状对照组总体上没有差异。然而，乳腺癌组报告称，与无症状组相比，被诊断出的限制其活动的医疗状况更多，服用的药物也更多。在乳腺癌组中，癌症的严重程度和诊断时间的远近对心理健康和身体功能的几个指标有强烈的独立负面影响。高龄在两组中都有相同的主要影响：服用的药物更多，被诊断出的限制活动的医疗状况更多，但相比之下，心理健康和幸福感更好。年龄与乳腺癌的诊断时间远近和严重程度存在交互作用：对于年轻患者，更近发生且更严重的乳腺癌病例似乎在心理适应方面产生特别严重的困难，而对于老年患者，在适应方面则产生特别严重的医疗问题和身体困难。
