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乳腺癌患者癌症复发恐惧轨迹和信念及药物依从性的比率。

Trajectory of fear of cancer recurrence and beliefs and rates of medication adherence in patients with breast cancer.

机构信息

Department of Psychology, Pusan National University, Busan, South Korea.

Department of Surgery, Ulsan University College of Medicine, Seoul, South Korea.

出版信息

Psychooncology. 2020 Nov;29(11):1835-1841. doi: 10.1002/pon.5497. Epub 2020 Oct 2.

Abstract

OBJECTIVE

This study examined the growth trajectory of fear of cancer recurrence (FCR) and its predictors, and the association of that trajectory with the beliefs and rates of medication adherence in patients with breast cancer.

METHODS

Two hundred and ten patients with breast cancer undergoing adjuvant endocrine therapy in a university hospital in Seoul, Korea, were followed up five times over 18 months following surgery, and data from the final 162 patients were analyzed.

RESULTS

Latent class growth analysis identified three classes. Classes 1 (38.31%) and 2 (39.89%) showed low and moderate FCR levels, respectively, with a decreasing trend over time. Class 3 (21.80%) showed a high FCR level with an initially decreasing but increasing trend afterward s. Lower education and unemployed status were associated with the high FCR class. Higher depression was more associated with the moderate FCR class than the low FCR class. Higher emotional representation was more associated with the high FCR class than with low FCR class, and greater illness comprehension was more associated with the moderate FCR class than with the high FCR class. Both necessity and concerns about medication were the highest in the high FCR class. However, self-reported medication adherence rates did not significantly differ between the classes.

CONCLUSIONS

A high level of FCR appears to persist over time, and given its association with greater concerns about medication, monitoring and management of FCR throughout the cancer trajectory.

摘要

目的

本研究旨在探讨乳腺癌患者恐惧癌症复发(FCR)的增长轨迹及其预测因素,以及该轨迹与患者信念和药物依从性之间的关系。

方法

对韩国首尔一家大学附属医院接受辅助内分泌治疗的 210 例乳腺癌患者进行了 18 个月的 5 次随访,分析了最后 162 例患者的数据。

结果

潜在类别增长分析确定了三个类别。第 1 类(38.31%)和第 2 类(39.89%)表现出低和中度 FCR 水平,且随时间呈下降趋势。第 3 类(21.80%)表现出高 FCR 水平,最初呈下降趋势,但随后呈上升趋势。较低的教育程度和失业状态与高 FCR 类别相关。较高的抑郁与中度 FCR 类别更相关,而不是低度 FCR 类别。较高的情绪表达与高 FCR 类别更相关,而不是低 FCR 类别,更大的疾病理解与中度 FCR 类别更相关,而不是高 FCR 类别。高 FCR 类别中对药物的必要性和担忧最高。然而,自我报告的药物依从率在不同类别之间没有显著差异。

结论

高水平的 FCR 似乎会随着时间的推移而持续存在,鉴于其与对药物的担忧程度有关,应在整个癌症病程中监测和管理 FCR。

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