School of Nursing, College of Medicine, National Taiwan University, Vice Director, Department of Nursing, National Taiwan University Hospital, No.1, Jen-Ai Rd. Sec. 1, Taipei, Taiwan.
Breast Center, National Taiwan University Hospital, Department of Surgery, Collage of Medicine, National Taiwan University, Taiwan.
Breast. 2019 Apr;44:59-65. doi: 10.1016/j.breast.2018.12.011. Epub 2019 Jan 4.
This 14-month study aimed to examine the changes of quality of life following breast cancer surgery and associations of such changes with depression and anxiety levels, and protective factors (attachment styles in close relationship, and meaning in life) based on positive psychology theory.
Women with breast cancer were recruited within one week of completion of breast cancer surgery. They were asked to complete several questionnaires to measure the generic and breast cancer specific quality of life, depression and anxiety levels, attachment styles in close relationship, and meaning in life. Assessments were performed at baseline (T0), T1 (the 2nd month), T2 (the 5th month), T3 (the 8th month), and T4 (the 14th month).
While the generic functions of quality of life improve after surgery, no significant changes of the breast-specific functions were found during the 14-month follow up period. While physical, role, and social functions improved immediately after surgery, the improvements of emotional and cognitive functions began to occur at the 5th and the 8th months after surgery. Depressive symptoms predicted almost all general and breast-specific QOL functions and symptoms. Avoidant and anxious attachment styles were associated with the negative scores for breast-specific functions and symptoms.
Breast-specific functions, in particular body image and sexual function, remain unchanged with the passage of time following surgery. A psychological rehabilitation program aiming to reduce depressive symptoms and enhance secure attachment styles in close relationships needs to be established immediately following surgery and continue through the post-treatment survivorship stages.
本为期 14 个月的研究旨在探讨乳腺癌手术后生活质量的变化,并基于积极心理学理论,探讨这些变化与抑郁和焦虑水平以及保护因素(亲密关系中的依恋类型和生活意义)的关系。
在乳腺癌手术后一周内招募乳腺癌患者。要求她们完成几项问卷,以测量一般和乳腺癌特定的生活质量、抑郁和焦虑水平、亲密关系中的依恋类型以及生活意义。评估在基线(T0)、T1(第 2 个月)、T2(第 5 个月)、T3(第 8 个月)和 T4(第 14 个月)进行。
虽然手术后一般生活质量的功能有所改善,但在 14 个月的随访期间,乳腺癌特异性功能没有明显变化。虽然物理、角色和社会功能在手术后立即得到改善,但情绪和认知功能的改善开始于手术后第 5 个月和第 8 个月。抑郁症状几乎预测了所有一般和乳腺癌特异性 QOL 功能和症状。回避和焦虑的依恋类型与乳腺癌特异性功能和症状的负面评分相关。
手术后,特定于乳房的功能,特别是身体形象和性功能,随着时间的推移保持不变。需要在手术后立即建立旨在减少抑郁症状和增强亲密关系中安全依恋类型的心理康复计划,并在治疗后生存阶段继续进行。