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乳腺癌心理弹性的生物心理社会模型:中国大陆的一项初步研究。

A biopsychosocial model of resilience for breast cancer: A preliminary study in mainland China.

作者信息

Ye Zeng Jie, Peng Chao Hua, Zhang Hao Wei, Liang Mu Zi, Zhao Jing Jing, Sun Zhe, Hu Guang Yun, Yu Yuan Liang

机构信息

Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510006, China.

School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510006, China.

出版信息

Eur J Oncol Nurs. 2018 Oct;36:95-102. doi: 10.1016/j.ejon.2018.08.001. Epub 2018 Sep 6.

Abstract

PURPOSE

Patients diagnosed with breast cancer exhibited critical biopsychosocial functions following surgery or adjuvant treatment; therefore, it is important that they exhibit resilience. A Resilience Model for Breast Cancer (RM-BC) was developed using Chinese breast cancer patients to increase our understanding of how resilience outcomes are positively and negatively affected by protective and risk factors, respectively.

METHODS

Chinese women with breast cancer completed the questionnaires within 1 week of beginning treatment. Exploratory Structural Equation Modeling was used to evaluate the RM-BC using a sample size of 342 patients.

RESULTS

RM-BC suggested satisfactory goodness-of-fit indices and 67 percents of variance for resilience was explained. The Fit Indices for the measurement model were as follows: CFI = 0.909, GFI = 0.911, IFI = 0.897, NFI = 0.922, PNFI = 0.896, PCFI = 0.884, and RMSEA = 0.031. Three risk factors - emotional distress, physical distress, and intrusive thoughts - and four protective factors - self-efficacy, social support, courage-related strategy, and hope - were recognized.

CONCLUSION

The resilience model allows for a better understanding of Chinese breast cancer patients' resilience integration while undergoing treatment and provides an effective structure for the development of resilience-focused interventions that are grounded in their experiences. A randomized trial has provided evidences of feasibility in Chinese women with breast cancer and the resilience model could be used as a useful framework for more resilience intervention in the future.

摘要

目的

被诊断患有乳腺癌的患者在手术或辅助治疗后表现出关键的生物心理社会功能;因此,他们展现出恢复力很重要。利用中国乳腺癌患者开发了一种乳腺癌恢复力模型(RM-BC),以增进我们对恢复力结果如何分别受到保护因素和风险因素的正向和负向影响的理解。

方法

中国乳腺癌女性患者在开始治疗的1周内完成问卷。使用探索性结构方程模型,以342名患者为样本评估RM-BC。

结果

RM-BC显示出令人满意的拟合优度指标,并且解释了恢复力67%的方差。测量模型的拟合指标如下:CFI = 0.909,GFI = 0.911,IFI = 0.897,NFI = 0.922,PNFI = 0.896,PCFI = 0.884,RMSEA = 0.031。识别出三个风险因素——情绪困扰、身体困扰和侵入性思维,以及四个保护因素——自我效能感、社会支持、与勇气相关的策略和希望。

结论

该恢复力模型有助于更好地理解中国乳腺癌患者在治疗过程中的恢复力整合情况,并为基于他们的经历开发以恢复力为重点的干预措施提供了有效的结构。一项随机试验为中国乳腺癌女性患者提供了可行性证据,并且该恢复力模型未来可作为更具恢复力干预措施的有用框架。

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