Department of Psychology, University of California, Riverside, Riverside, CA, USA.
Radiology Department, Riverside University Health System-Medical Center, Moreno Valley, CA, USA.
Ann Behav Med. 2019 Jun 4;53(7):630-641. doi: 10.1093/abm/kay072.
Each year, over 1 million women in the USA undergo diagnostic breast biopsies, many of which culminate in a benign outcome. However, for many patients, the experience of awaiting biopsy results is far from benign, instead provoking high levels of distress.
To take a multifaceted approach to understanding the psychological experience of patients undergoing a breast biopsy.
Female patients (N = 214) were interviewed at an appointment for a breast biopsy, just prior to undergoing the biopsy procedure. Pertinent to the current investigation, the interview assessed various patient characteristics, subjective health and cancer history, support availability, outcome expectations, distress, and coping strategies.
The findings revealed a complex set of interrelationships among patient characteristics, markers of distress, and use of coping strategies. Patients who were more distressed engaged in more avoidant coping strategies. Regarding the correlates of distress and coping, subjective health was more strongly associated with distress and coping than was cancer history; perceptions of support availability were also reliably associated with distress.
Taken together, the results suggest that patients focus on their immediate experience (e.g., subjective health, feelings of risk, perceptions of support) in the face of the acute moment of uncertainty prompted by a biopsy procedure, relative to more distal considerations such as cancer history and demographic characteristics. These findings can guide clinicians' interactions with patients at the biopsy appointment and can serve as a foundation for interventions designed to reduce distress in this context.
每年,美国有超过 100 万名女性接受诊断性乳房活检,其中许多活检结果为良性。然而,对许多患者来说,等待活检结果的过程远非良性,反而会引发高度的痛苦。
采用多方面的方法来了解接受乳房活检的患者的心理体验。
在进行乳房活检的预约时,对 214 名女性患者进行了访谈,就在进行活检程序之前进行。与当前研究相关的是,访谈评估了各种患者特征、主观健康和癌症史、支持可用性、结果预期、痛苦和应对策略。
研究结果揭示了患者特征、痛苦标志物和应对策略之间复杂的相互关系。痛苦程度较高的患者采用了更多的回避应对策略。关于痛苦和应对的相关性,主观健康与痛苦和应对的相关性比癌症史更强;对支持可用性的感知也与痛苦有可靠的相关性。
总的来说,研究结果表明,患者在面对活检程序引起的急性不确定时刻时,更关注自己的即时体验(例如主观健康、风险感、对支持的感知),而不是更遥远的考虑因素,如癌症史和人口统计学特征。这些发现可以指导临床医生在活检预约时与患者的互动,并为旨在减轻这种情况下痛苦的干预措施提供基础。