Department of Psychology, University of California, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA.
Dr. Susan Love Research Foundation, Encino, CA, USA.
Breast Cancer Res Treat. 2018 Aug;171(1):75-84. doi: 10.1007/s10549-018-4823-x. Epub 2018 May 16.
Until recently, people with metastatic breast cancer (MBC) had a very poor prognosis. New treatment approaches have prolonged the time that people with MBC live, but their quality of life has received less attention. Consequently, the needs and concerns across financial, vocational, psychological, social, and physical domains in MBC patients are poorly understood-particularly regarding the collateral damage or longer-term, life-altering impacts of MBC and its treatments. This study's aims were to characterize MBC-related collateral damage, identify groups most likely to experience collateral damage, and examine its associations with psychological health, illness management, and health behaviors.
Participants (N = 515) with MBC were recruited from Dr. Susan Love Research Foundation's Army of Women® and other advocacy organizations. Participants completed questionnaires of MBC-related collateral damage, depressive symptoms, anxiety, self-efficacy for managing oncologic treatments and physical symptoms, sleep, and physical activity.
Eight domains of MBC-related collateral damage, as well as MBC-related benefit finding, were reliably characterized. Concerns about mortality/uncertainty were most prominent. Participants also endorsed high levels of benefit finding. Participants younger than 50 years, with limited financial resources, or with children under 18 at home reported the most collateral damage. Collateral damage was associated significantly with compromised psychological health, lower illness management efficacy, and poorer health behaviors, beyond sociodemographic and medical characteristics.
Subgroups of MBC patients report long-term, life-altering consequences of MBC and its treatments, which relate to important health outcomes. Clinical implications and recommendations are discussed.
直到最近,转移性乳腺癌(MBC)患者的预后仍非常差。新的治疗方法延长了 MBC 患者的生存时间,但他们的生活质量却较少受到关注。因此,人们对 MBC 患者在财务、职业、心理、社会和身体等领域的需求和关注点知之甚少——特别是 MBC 及其治疗的间接损害或长期、改变生活的影响。本研究的目的是描述 MBC 相关的间接损害,确定最有可能发生间接损害的人群,并研究其与心理健康、疾病管理和健康行为的关系。
从 Dr. Susan Love Research Foundation 的“女性军队”和其他宣传组织招募了 515 名患有 MBC 的参与者。参与者完成了与 MBC 相关的间接损害、抑郁症状、焦虑、管理肿瘤治疗和身体症状的自我效能感、睡眠和身体活动的问卷。
可靠地描述了与 MBC 相关的 8 个间接损害领域,以及与 MBC 相关的受益发现。对死亡/不确定性的担忧最为突出。参与者也高度认可受益发现。年龄小于 50 岁、经济资源有限或家中有 18 岁以下孩子的参与者报告了最多的间接损害。间接损害与心理健康受损、疾病管理效能降低以及健康行为较差显著相关,超出了社会人口学和医学特征的影响。
MBC 患者的亚组报告了 MBC 及其治疗的长期、改变生活的后果,这些后果与重要的健康结果有关。讨论了临床意义和建议。