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分享好消息能否缓解对坏消息的恐惧?一项针对诊断后首次乳房 X 光检查前夫妇的癌症复发恐惧的日常日记研究。

Does sharing good news buffer fear of bad news? A daily diary study of fear of cancer recurrence in couples approaching the first mammogram post-diagnosis.

机构信息

University of Delaware, Newark, DE, United States.

Helen F. Graham Cancer Center and Research Institute, Newark, DE, United States.

出版信息

Psychooncology. 2018 Nov;27(11):2581-2586. doi: 10.1002/pon.4813. Epub 2018 Jul 23.

Abstract

OBJECTIVE

The core of fear of cancer recurrence (FCR)-a top concern of couples after successful breast cancer (BC) treatment-is fear of death. Daily relationship processes may be instrumental in regulating FCR as triggers of existential distress are encountered. We tested the hypothesis that daily capitalization, the process of sharing good news (capitalization attempts) to a partner perceived as responsive (responsiveness), buffers patient and spouse FCR as they confront the first mammogram post-diagnosis.

METHODS

Fifty-seven early-stage BC survivors and their spouses reported daily FCR, capitalization, and positivity of the disclosed event during a 3-week diary period beginning 2 weeks before the first annual mammogram post-diagnosis. Dyadic multilevel path models estimated within-person effects of patient and spouse capitalization on same-day FCR, controlling for event positivity.

RESULTS

Before the mammogram, capitalization attempts were unrelated to FCR, but for patients, responsiveness was predictive of greater same-day FCR. After the mammogram, for both partners, attempts were predictive of greater same-day FCR, yet responsiveness was predictive of lower FCR.

CONCLUSIONS

Findings were largely inconsistent with the hypothesis that capitalization buffers existential distress. However, results revealed novel insights about daily dyadic processes that may characterize within-person adaptation to existential threat. Potential explanations for the differential links between capitalization and FCR based on timing (before versus after threat) and capitalization component (attempts versus responsiveness) are discussed.

摘要

目的

对癌症复发恐惧(FCR)的核心——这是成功治疗乳腺癌(BC)后夫妻最关心的问题——是对死亡的恐惧。日常的关系过程可能对调节 FCR 起到重要作用,因为会遇到引发存在性困扰的触发因素。我们检验了这样一个假设,即日常的资本积累,即与被认为有反应的伴侣分享好消息的过程(资本积累尝试),可以缓冲患者和配偶在面对诊断后第一次乳房 X 光检查时的 FCR。

方法

57 名早期 BC 幸存者及其配偶在诊断后第一年的第一次年度乳房 X 光检查前 2 周开始的 3 周日记期间,每天报告 FCR、资本积累和所披露事件的积极性。双变量多层次路径模型在个体内效应中估计了患者和配偶资本积累对当日 FCR 的影响,同时控制了事件积极性。

结果

在乳房 X 光检查之前,资本积累尝试与 FCR 无关,但对患者来说,反应能力预示着当天更高的 FCR。在乳房 X 光检查之后,对于双方来说,尝试都预示着当天更高的 FCR,但反应能力预示着 FCR 更低。

结论

这些发现基本上与资本积累缓冲存在性困扰的假设不一致。然而,结果揭示了关于日常双变量过程的新见解,这些过程可能描述了个体对存在性威胁的适应。基于时间(威胁之前和之后)和资本积累成分(尝试和反应能力),讨论了资本积累与 FCR 之间差异联系的潜在解释。

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