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理解结直肠癌患者的获益发现:一项纵向研究。

Understanding benefit finding among patients with colorectal cancer: a longitudinal study.

机构信息

Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA.

Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA.

出版信息

Support Care Cancer. 2021 May;29(5):2355-2362. doi: 10.1007/s00520-020-05758-6. Epub 2020 Sep 11.

Abstract

PURPOSE

Perceiving positive life changes ("benefit finding") is thought to promote better adjustment after cancer, yet is poorly understood among colorectal cancer (CRC) patients. We characterized benefit finding and examined its relationship to demographic/medical factors, change over time, and association with distress.

METHODS

CRC outpatients (N = 133, 50% metastatic) completed self-report measures (demographic/medical factors, benefit finding, distress) at baseline and 6 months later. Wilcoxon rank-sum (Kruskal-Wallis) tests or Spearman correlations tested associations between benefit finding and demographic/medical factors. Linear regressions assessed (1) change in benefit finding over time and whether this differed by demographic/medical factors, and (2) association between benefit finding and distress and whether this changed over time.

RESULTS

Benefit finding was common among patients with CRC, with highest rated items reflecting gratitude, acceptance, and stronger family relationships. Women and racial minorities reported greater benefit finding than men (p < 0.001) and White patients (p = 0.015), respectively. Medical factors (e.g., metastatic disease) were not associated with benefit finding. Benefit finding significantly increased over time (p = 0.03). While greater benefit finding trended towards an association with lower distress, results were not statistically significant and the relationship did not change over time.

CONCLUSION

Benefit finding was characterized largely by perceived psychological and social benefits, as opposed to pragmatic benefits. Individual differences and social determinants may be more informative than medical characteristics when it comes to benefit finding; although, cultural factors and mediators should be examined further. Benefit finding seems to evolve over time perhaps as a coping process; however, its association with psychological distress appears tenuous.

摘要

目的

人们认为感知积极的生活变化(“获益发现”)有助于癌症患者更好地适应,但结直肠癌(CRC)患者对此知之甚少。我们对获益发现进行了特征描述,并研究了其与人口统计学/医学因素、随时间的变化以及与痛苦的关联。

方法

CRC 门诊患者(N=133,50%转移性)在基线和 6 个月后完成了自我报告的测量(人口统计学/医学因素、获益发现、痛苦)。Wilcoxon 秩和(Kruskal-Wallis)检验或 Spearman 相关检验用于检验获益发现与人口统计学/医学因素之间的关联。线性回归用于评估(1)随时间的获益发现变化,以及这种变化是否因人口统计学/医学因素而异,以及(2)获益发现与痛苦之间的关联,以及这种关联是否随时间变化。

结果

CRC 患者中获益发现较为常见,评分最高的项目反映了感激、接受和更强的家庭关系。女性和少数族裔患者比男性(p<0.001)和白人患者(p=0.015)报告的获益发现更多。医学因素(如转移性疾病)与获益发现无关。获益发现随时间显著增加(p=0.03)。虽然更大的获益发现与较低的痛苦呈趋势相关,但结果没有统计学意义,并且这种关系随时间没有变化。

结论

获益发现主要由感知的心理和社会益处构成,而不是实际的益处。在获益发现方面,个体差异和社会决定因素可能比医学特征更具信息性;然而,文化因素和中介因素应该进一步研究。获益发现似乎随着时间的推移而演变,也许是作为一种应对过程;然而,它与心理痛苦的关联似乎很脆弱。

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