Sleight Alix G, Boyd Patrick, Klein William M P, Jensen Roxanne E
Department of Physical Medicine & Rehabilitation Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.
Psychooncology. 2021 Jan;30(1):52-58. doi: 10.1002/pon.5533. Epub 2020 Oct 21.
To assess the extent to which spiritual well-being moderates the relationship between anxiety and physical well-being in a diverse, community-based cohort of newly diagnosed cancer survivors.
Data originated from the Measuring Your Health (MY-Health) study cohort (n = 5506), comprising people assessed within 6-13 months of cancer diagnosis. Life meaning/peace was assessed using the 8-item subscale of the Spiritual Well-Being Scale (FACIT-Sp-12). Anxiety was measured with an 11-item PROMIS Anxiety short form, and physical well-being was assessed using the 7-item FACT-G subscale. Multiple linear regression models were used to assess relationships among variables.
Life meaning and peace was negatively associated with anxiety, b = -0.56 (P < .001) and positively associated with physical well-being, b = 0.43 (P = <.001) after adjusting for race, education, income, and age. A significant interaction between life meaning/peace and anxiety emerged (P < .001) indicating that spiritual well-being moderates the relationship between anxiety and physical well-being. Specifically, for cancer survivors high in anxiety, physical well-being was dependent on levels of life meaning/peace, b = 0.19, P < .001. For those low in anxiety, physical well-being was not associated with levels of life meaning/peace, b = 0.01, P = .541. Differences in cancer clinical factors (cancer stage at diagnosis, cancer type) did not significantly impact results.
Further research is needed to assess how spiritual well-being may buffer the negative effect of anxiety on physical well-being. A clinical focus on spiritual well-being topics such as peace and life meaning may help cancer survivors of all types as they transition into follow-up care.
在一个多样化的、基于社区的新诊断癌症幸存者队列中,评估精神幸福感在多大程度上调节焦虑与身体健康之间的关系。
数据来源于“衡量你的健康”(MY-Health)研究队列(n = 5506),该队列由在癌症诊断后6 - 13个月内接受评估的人员组成。使用精神幸福感量表(FACIT-Sp-12)的8项子量表评估生活意义/安宁感。使用11项患者报告结果测量信息系统(PROMIS)焦虑简表测量焦虑,并使用7项癌症治疗功能评估量表(FACT-G)子量表评估身体健康状况。采用多元线性回归模型评估变量之间的关系。
在调整种族、教育程度、收入和年龄后,生活意义和安宁感与焦虑呈负相关,b = -0.56(P <.001),与身体健康呈正相关,b = 0.43(P <.001)。生活意义/安宁感与焦虑之间出现了显著的交互作用(P <.001),表明精神幸福感调节了焦虑与身体健康之间的关系。具体而言,对于焦虑程度高的癌症幸存者,身体健康状况取决于生活意义/安宁感水平,b = 0.19,P <.001。对于焦虑程度低的癌症幸存者,身体健康状况与生活意义/安宁感水平无关,b = 0.01,P =.541。癌症临床因素(诊断时的癌症分期、癌症类型)的差异对结果没有显著影响。
需要进一步研究以评估精神幸福感如何缓冲焦虑对身体健康的负面影响。临床关注诸如安宁和生活意义等精神幸福感主题可能有助于各类癌症幸存者过渡到后续护理阶段。