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乳腺癌后创伤后成长能否促进积极应对?-一项交叉滞后研究。

Can posttraumatic growth after breast cancer promote positive coping?-A cross-lagged study.

机构信息

School of Social Work, Ariel University, Ariel, Israel.

School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel.

出版信息

Psychooncology. 2019 Apr;28(4):767-774. doi: 10.1002/pon.5017. Epub 2019 Feb 14.

Abstract

OBJECTIVES

The diagnosis of breast cancer can be associated with significant emotional distress, yet, over time, cancer survivors also may experience positive psychological changes labeled posttraumatic growth (PTG). Two alternative paths between coping strategies and PTG were tested among breast cancer patients, employing longitudinal design: Would PTG after medical treatment of breast cancer lead to an increase in reporting positive coping strategies; alternatively, would positive coping strategies after medical treatment of breast cancer lead to increased PTG.

METHODS

A longitudinal study was conducted among 198 breast cancer patients who completed validated self-report scales, at five time points: at 3 months after completing active medical treatment (T1); after 6 months (T2); after 1 year (T3); after 2 years (T4); and after 7 years (T5). The current study analyzes three time points: T1, T3, and T5 using structural equation modeling.

RESULTS

Our results support the path that describes the first alternative, that higher report of PTG after medical treatment of breast cancer patients would lead to increased report of positive coping strategies. In addition, positive coping strategies were found to be positively linked to PTG after 6 months, and the link was slightly stronger after 2 years. Nevertheless, 7 years after diagnosis, no association was found between positive coping strategies and PTG measurements.

CONCLUSIONS

Finding positive meaning after coping with breast cancer, as reflected in PTG, may be a significant resource in coping with cancer, and it may lead to increase of positive coping strategies.

摘要

目的

乳腺癌的诊断可能会伴随着明显的情绪困扰,但随着时间的推移,癌症幸存者也可能经历被称为创伤后成长(PTG)的积极心理变化。本研究通过纵向设计检验了乳腺癌患者应对策略与 PTG 之间的两种替代路径:乳腺癌治疗后 PTG 是否会导致积极应对策略的报告增加;或者,乳腺癌治疗后积极的应对策略是否会导致 PTG 的增加。

方法

对 198 名乳腺癌患者进行了纵向研究,这些患者在五个时间点完成了有效的自我报告量表:完成积极的医疗治疗后 3 个月(T1);6 个月后(T2);1 年后(T3);2 年后(T4);和 7 年后(T5)。本研究分析了三个时间点:T1、T3 和 T5,使用结构方程模型。

结果

我们的结果支持描述第一种替代路径的结果,即乳腺癌患者治疗后报告的 PTG 越高,会导致积极应对策略的报告增加。此外,在 6 个月后发现积极的应对策略与 PTG 呈正相关,而在 2 年后这种相关性略强。然而,在诊断后 7 年,积极应对策略与 PTG 测量之间没有关联。

结论

在应对乳腺癌时找到积极的意义,如 PTG 所反映的,可能是应对癌症的重要资源,它可能会导致积极应对策略的增加。

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