乳腺癌患者的社会支持感知、应对策略、焦虑和抑郁:中介模型评估。
Perceived social support, coping strategies, anxiety and depression among women with breast cancer: Evaluation of a mediation model.
机构信息
Department of Health Education and Promotion, School of Health, Qom University of Medical Sciences, Qom, Iran; Health Psychology and Behavior Medicine Research Group, Students' Scientific Research center, Exceptional Talents Development Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran; Students' Scientific Research center, Exceptional Talents Development Center, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
Eur J Oncol Nurs. 2021 Feb;50:101892. doi: 10.1016/j.ejon.2020.101892. Epub 2020 Dec 30.
PURPOSE
Depression and anxiety are now considered as common adverse reactions to cancer. Prior research has shown that social support and functional coping strategies alleviate depressive and anxious symptoms of cancer patients but the exact relationship between social support and coping strategies in amelioration of the symptoms is yet to be elaborated.
METHODS
The current study examined the relationship between social support, coping strategies and depressive-anxious symptomatology and explored the possible role of coping strategies in mediating the relationship between social support, depression and anxiety in Iranian breast cancer patients (N = 221). Anxiety and depressive symptoms were measured using the Depression-Anxiety-Stress (DASS-21) scale, social support was measured using the Medical Outcome Survey, Social Support Scale (MOSS-SSS), and coping strategies were measured using the brief COPE.
RESULTS
All of the social support subscales were negatively correlated with depression and anxiety. Most of the coping strategies were negatively correlated with depressive-anxious symptoms. When controlling for covariates, mediation analysis revealed that active coping, positive reframing and acceptance partially mediated the association of social support of different types with depression. Positive reframing also partially mediated the relationship of the total social support and positive social interactions with anxiety.
CONCLUSIONS
High levels of social support may relieve depressive and anxious symptoms of breast cancer patients through functional coping. The management of breast cancer patients should also focus on providing patients with social support and educating them on the practice of functional coping strategies.
目的
抑郁和焦虑现在被认为是癌症的常见不良反应。先前的研究表明,社会支持和功能性应对策略可以减轻癌症患者的抑郁和焦虑症状,但社会支持和应对策略在缓解这些症状方面的确切关系仍有待阐述。
方法
本研究考察了社会支持、应对策略与抑郁焦虑症状之间的关系,并探讨了应对策略在调节社会支持、抑郁和焦虑之间关系中的可能作用,研究对象为 221 名伊朗乳腺癌患者。采用抑郁焦虑压力量表(DASS-21)测量焦虑和抑郁症状,采用医疗结局研究社会支持量表(MOSS-SSS)测量社会支持,采用简短应对方式量表(brief COPE)测量应对策略。
结果
所有社会支持分量表与抑郁和焦虑呈负相关。大多数应对策略与抑郁焦虑症状呈负相关。在控制协变量后,中介分析显示,积极应对、重新定向和接受部分中介了不同类型的社会支持与抑郁之间的关系。重新定向也部分中介了总社会支持和积极社会互动与焦虑之间的关系。
结论
高水平的社会支持可能通过功能性应对减轻乳腺癌患者的抑郁和焦虑症状。乳腺癌患者的管理还应侧重于为患者提供社会支持,并教育他们实施功能性应对策略。