Division of Population Health Sciences, Royal College of Surgeons in Ireland, Beaux Lane House, Mercer Street, Dublin, 2, Ireland.
Mater Misericordiae University Hospital, Dublin, 1, Ireland.
BMC Cancer. 2020 Oct 2;20(1):948. doi: 10.1186/s12885-020-07389-w.
Breast cancer care today involves state-of-the-art biomedical treatment but can fail to address the broader psychosocial and quality-of-life (QoL) issues associated with the transition to breast cancer survivorship. This scoping review examines the evidence on the influence of psychosocial determinants on QoL in breast cancer survivors.
Scoping review methodology was used to: (1) identify the research question(s); (2) identify relevant studies; (3) undertake study selection; (4) extract data; (5) collate, summarise and report the results.
A total of 33 studies met the inclusion criteria. The majority of studies were conducted in the US (n = 22, 67%) and were mainly cross-sectional (n = 26, 79%). Sixteen psychosocial determinants of QoL were identified. Social support (n = 14, 42%), depression (n = 7, 21%) and future appraisal and perspective (n = 7, 21%) were the most frequently investigated determinants. Twelve different QoL measures were used. A range of different measurement tools were also used per psychosocial determinant (weighted average = 6). The 14 studies that measured the influence of social support on QoL employed 10 different measures of social support and 7 different measures of QoL. In general, across all 33 studies, a higher level of a positive influence and a lower level of a negative influence of a psychosocial determinant was associated with a better QoL e.g. higher social support and lower levels of depression were associated with a higher/better QoL. For some determinants such as spirituality and coping skills the influence on QoL varied, but these determinants were less commonly investigated.
Consensus around measures of QoL and psychological determinants would be valuable and would enable research to determine the influence of psychosocial determinants on QoL adequately. Research in other healthcare settings beyond the US is required, in order to understand the influence of organisation and follow-up clinical and supportive care on psychosocial determinants and QoL and to improve the quality of care in breast cancer survivors.
当今的乳腺癌护理涉及最先进的生物医学治疗，但可能无法解决与乳腺癌生存者过渡相关的更广泛的心理社会和生活质量（QoL）问题。本范围综述检查了心理社会决定因素对乳腺癌幸存者生活质量的影响的证据。
使用范围综述方法：（1）确定研究问题；（2）确定相关研究；（3）进行研究选择；（4）提取数据；（5）整理、总结和报告结果。
共有 33 项研究符合纳入标准。大多数研究在美国进行（n=22，67%），主要是横断面研究（n=26，79%）。确定了 16 个生活质量的心理社会决定因素。社会支持（n=14，42%）、抑郁（n=7，21%）和未来评估和观点（n=7，21%）是研究最多的决定因素。使用了 12 种不同的生活质量测量方法。每种心理社会决定因素也使用了多种不同的测量工具（加权平均值=6）。测量社会支持对生活质量影响的 14 项研究使用了 10 种不同的社会支持测量方法和 7 种不同的生活质量测量方法。一般来说，在所有 33 项研究中，心理社会决定因素的积极影响程度较高，消极影响程度较低，与生活质量较好相关，例如较高的社会支持和较低的抑郁水平与较高/较好的生活质量相关。对于一些决定因素，如灵性和应对技巧，其对生活质量的影响不同，但这些决定因素的研究较少。
在生活质量和心理决定因素的测量方面达成共识将是有价值的，并使研究能够充分确定心理社会决定因素对生活质量的影响。需要在美国以外的其他医疗保健环境中进行研究，以了解组织和后续临床及支持性护理对心理社会决定因素和生活质量的影响，并提高乳腺癌生存者的护理质量。
