Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA.
Michigan State University, East Lansing, MI, 48824, USA.
Support Care Cancer. 2020 Apr;28(4):1929-1939. doi: 10.1007/s00520-019-04989-6. Epub 2019 Aug 1.
Self-efficacy is an important psychological resource to assist people in managing chronic illness and has been associated with psychological outcomes among patients coping with cancer. Little is known about the course of self-efficacy among gynecological cancer patients coping with cancer and the sociodemographic, medical, and psychological factors that are associated with the course of self-efficacy among these patients.
One hundred twenty-five women recently diagnosed with gynecological cancer completed a measure of communication and affective management self-efficacy at baseline, 5 weeks, 9 weeks, 6 months, 1 year, and 18 months post-baseline. Participants also completed measures of functional impairment, holding back, perceived unsupportive behaviors of family and friends, emotional expressivity, cancer concerns, depressive symptoms, cancer-specific intrusions and avoidance, problem-solving, and positive reappraisal coping.
Growth curve modeling suggested that women varied considerably in their average reports of self-efficacy and varied with regard to their linear trajectories of self-efficacy over time. Average affect management self-efficacy increased significantly over time. Greater functional impairment, more holding back, more unsupportive responses from friends and family, less emotional expressivity, more cancer concerns, depression, intrusions, or avoidance predicted lower average self-efficacy over time. Women who were less emotionally expressive or held back sharing concerns less reported lower self-efficacy which increased over time.
It will be important for providers to identify gynecological cancer patients who report low ability to communicate feelings and needs and manage emotional reactions to cancer and offer them interventions which bolster self-efficacy.
自我效能感是帮助人们管理慢性病的重要心理资源，与癌症患者应对癌症的心理结果有关。对于妇科癌症患者在应对癌症过程中自我效能感的发展轨迹，以及与这些患者自我效能感发展轨迹相关的社会人口学、医学和心理因素，知之甚少。
125 名最近被诊断为妇科癌症的女性在基线、5 周、9 周、6 个月、1 年和 18 个月时完成了沟通和情感管理自我效能感的测量。参与者还完成了功能障碍、抑制、感知到朋友和家人不支持的行为、情绪表达、癌症担忧、抑郁症状、癌症特异性侵入和回避、问题解决和积极重新评估应对的测量。
增长曲线模型表明，女性在自我效能感的平均报告中存在很大差异，并且在自我效能感的线性轨迹方面也存在差异。平均情感管理自我效能感随时间显著增加。功能障碍越大、抑制越多、朋友和家人的不支持反应越多、情绪表达越少、癌症担忧越多、抑郁、侵入或回避越多，预示着平均自我效能感随时间下降。情绪表达较少或抑制较少分享担忧的女性报告的自我效能感较低，但随时间增加而增加。
对于医疗服务提供者来说，重要的是要识别出报告沟通能力和处理癌症引起的情绪反应能力较低的妇科癌症患者，并为他们提供增强自我效能感的干预措施。
