Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Support Care Cancer. 2020 Nov;28(11):5371-5379. doi: 10.1007/s00520-020-05378-0. Epub 2020 Mar 5.
This study examined the Sense of Coherence (SOC) of patients participating in the randomized controlled 'Optimal Training for Women with Breast Cancer' (OptiTrain) study and assessed how patient characteristics were associated with SOC. Secondary aims were to assess the association between SOC and patients' participation in this study and to determine whether SOC moderates the effect of the 16-week exercise intervention on fatigue, quality of life (QoL), and symptom burden in women with breast cancer undergoing chemotherapy.
Modified Poisson regression analyses were conducted to determine the relative risk of weak-normal SOC versus strong SOC in terms of exercise session attendance, study and intervention dropout, and long absence rates. Analyses of covariance were performed to assess whether SOC moderated the effect of the exercise intervention (p ≤ 0.10).
Two hundred and forty women with early breast cancer (mean age 53 ± 10) participated in the OptiTrain study. Women with strong SOC reported less fatigue, lower symptom burden, and higher QoL. Women with weak-normal SOC were significantly more likely to drop out from the OptiTrain study and tended to have slightly poorer exercise session attendance. Women with breast cancer and weaker SOC benefitted as much from the exercise intervention, in terms of fatigue and QoL, as those with stronger SOC (p > 0.10).
Strong SOC appears to be associated with a more positive subjective state of health. Women with weak-normal SOC may need additional support to encourage participation and adherence in exercise trials. Assessing SOC may assist clinicians to identify and provide extra support for participants with weak SOC, who may be less inclined to participate in exercise programs.
本研究调查了参与随机对照“乳腺癌女性最佳训练”（OptiTrain）研究的患者的心理韧性（SOC），并评估了患者特征与 SOC 的相关性。次要目的是评估 SOC 与患者参与该研究的相关性，并确定 SOC 是否调节了 16 周运动干预对接受化疗的乳腺癌女性的疲劳、生活质量（QoL）和症状负担的影响。
采用修正泊松回归分析确定弱-正常 SOC 与强 SOC 在运动次数出席、研究和干预脱落以及长期缺勤率方面的相对风险。协方差分析用于评估 SOC 是否调节了运动干预的效果（p≤0.10）。
240 名早期乳腺癌女性（平均年龄 53±10 岁）参与了 OptiTrain 研究。具有强 SOC 的女性报告疲劳感更低、症状负担更低和 QoL 更高。具有弱-正常 SOC 的女性更有可能从 OptiTrain 研究中脱落，并且运动次数出席率略低。具有较弱 SOC 的乳腺癌女性在疲劳和 QoL 方面同样从运动干预中获益，与具有较强 SOC 的女性一样（p＞0.10）。
强 SOC 似乎与更积极的主观健康状况相关。具有弱-正常 SOC 的女性可能需要额外的支持来鼓励她们参与和坚持运动试验。评估 SOC 可能有助于临床医生识别和为具有较弱 SOC 的参与者提供额外支持，这些参与者可能不太愿意参加运动项目。
