School of Psychology, National University of Ireland Galway, Galway, Ireland.
Centre for Improving Health-Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, United Kingdom.
PLoS One. 2020 Sep 17;15(9):e0239469. doi: 10.1371/journal.pone.0239469. eCollection 2020.
Diagnosis and treatment of prostate cancer can generate many challenges which impact on adjustment, so understanding the psychosocial factors which contribute to individual vulnerability to poor adaptation warrants further investigation. This study investigates stress and masculine identity threat as predictors of quality of life and emotional adjustment in men with localized prostate cancer and the role of resilience as a potential protective psychological factor.
Participants were invited to complete a survey study via online prostate cancer forums. Participants were 204 men ranging in age from 44-88 years (M = 65.24±7.51) and who were diagnosed with early localized prostate cancer within the previous five years. Measures used included the Perceived Stress Scale, Cancer-Related Masculine Threat Scale and the Conor-Davidson Resilience Scale. Using a cross-sectional online survey design, the extent to which perceived stress, masculine threat and psychological resilience are associated with quality of life, positive and negative affect and distress was assessed.
Hierarchical regression analysis demonstrated that perceived stress accounted for 26%-44% of variance on quality of life and adjustment indices, with high stress associated with low mood and poor quality of life. Low masculine threat and high resilience predicted better quality of life and emotional adjustment accounting for between 1-7% of the variance. Resilience moderated the relationship between stress and distress and mediated the association between masculine threat and distress and negative affect.
Perceived stress was the most powerful predictor in the model and findings suggest it contributes significantly to functional and affective status in survivors of prostate cancer. Psychological resilience is a protective factor which buffers the negative effect of stress and masculine identity threat on emotional adjustment. Findings indicate that men should be screened as part of the diagnostic and treatment process for high perceived stress and low resilience to identify those at risk for poor adjustment during survivorship.
前列腺癌的诊断和治疗会带来诸多挑战，从而影响患者的适应能力。因此，深入研究导致个体适应不良的心理社会因素非常必要。本研究旨在探讨压力和男性身份威胁对局限性前列腺癌患者生活质量和情绪适应的预测作用，以及韧性作为潜在的保护性心理因素的作用。
通过在线前列腺癌论坛邀请参与者完成一项调查研究。参与者为 204 名年龄在 44-88 岁之间（M=65.24±7.51）的男性，他们在过去五年内被诊断为早期局限性前列腺癌。研究采用的测量工具包括感知压力量表、癌症相关男性威胁量表和科恩-戴维森韧性量表。采用横断面在线调查设计，评估感知压力、男性威胁和心理韧性与生活质量、正性和负性情绪以及困扰的相关性。
分层回归分析表明，感知压力可解释生活质量和调整指数 26%-44%的方差，高压力与情绪低落和生活质量差有关。低男性威胁和高韧性可预测更好的生活质量和情绪调整，解释 1-7%的方差。韧性调节了压力和困扰之间的关系，中介了男性威胁和困扰与负性情绪之间的关系。
感知压力是模型中最有力的预测因子，研究结果表明其对前列腺癌幸存者的功能和情感状态有重要影响。心理韧性是一种保护因素，可以缓冲压力和男性身份威胁对情绪调整的负面影响。研究结果表明，在诊断和治疗过程中，应筛查男性的感知压力和韧性，以识别出生存者中存在不良适应风险的患者。
