Comprehensive Cancer Center, The Ohio State University College of Medicine, 460 Medical Center Drive, Columbus, OH, 43210, USA.
Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, 460 Medical Center Drive, Columbus, OH, 43210, USA.
J Behav Med. 2021 Apr;44(2):253-259. doi: 10.1007/s10865-020-00192-9. Epub 2020 Nov 1.
A number of studies have shown that self-rated health reliably predicts mortality. This study assessed the impact of perseveration on self-rated health, physical functioning, and physical symptoms (pain, fatigue, breast cancer symptoms) among breast cancer patients. We hypothesized that cancer-related distress would serve as an intervening variable between both worry and rumination and self-rated health, physical functioning, and physical symptoms. Women (N = 124) who were approximately 7 weeks post-surgery but pre adjuvant treatment completed the Impact of Events Scale, the Penn State Worry Questionnaire, and the Rumination Scale. They also rated their pain, fatigue, physical functioning, and self-rated health using the RAND-36 and breast cancer symptoms with the Breast Cancer Prevention Trial Symptom Checklist (BCPT). Covariates included body mass index, age, cancer stage, menopause status, and physical comorbidities. Worry was associated with higher cancer-related distress, which in turn predicted greater pain and breast cancer symptoms, poorer physical functioning, and lower self-rated health. Rumination also predicted greater cancer-related distress, which ultimately contributed to greater pain along with poorer physical functioning and self-rated health. Models with fatigue as an outcome were not significant. These findings suggest that perseveration can heighten cancer-related distress and subsequent perceptions of physical symptoms and health among breast cancer patients prior to adjuvant treatment. Perseveration early in the cancer trajectory can adversely increase the impact of a cancer diagnosis and treatment on functioning and quality of life.
许多研究表明，自我评估的健康状况可以可靠地预测死亡率。本研究评估了坚持对乳腺癌患者的自我评估健康、身体功能和身体症状（疼痛、疲劳、乳腺癌症状）的影响。我们假设癌症相关的困扰将作为担忧和沉思与自我评估健康、身体功能和身体症状之间的中介变量。大约手术后 7 周但在辅助治疗前的女性（N=124）完成了事件影响量表、宾夕法尼亚州担忧问卷和沉思量表。他们还使用 RAND-36 对疼痛、疲劳、身体功能和自我评估健康进行了评分，并使用乳腺癌预防试验症状检查表（BCPT）对乳腺癌症状进行了评分。协变量包括体重指数、年龄、癌症分期、绝经状态和身体合并症。担忧与更高的癌症相关困扰有关，这反过来又预示着更大的疼痛和乳腺癌症状、更差的身体功能和更低的自我评估健康。沉思也预测了更大的癌症相关困扰，这最终导致了更大的疼痛以及更差的身体功能和自我评估健康。作为结果的疲劳模型并不显著。这些发现表明，坚持可以增加乳腺癌患者在辅助治疗前对癌症相关困扰以及随后对身体症状和健康的感知。在癌症轨迹的早期坚持会对癌症诊断和治疗对功能和生活质量的影响产生不利影响。
