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肺癌患者污名、自我同情与健康相关调整的多维度研究:一项纵向研究。

Facets of stigma, self-compassion, and health-related adjustment to lung cancer: A longitudinal study.

机构信息

Department of Psychiatry and Behavioral Sciences.

Department of Medicine, David Geffen School of Medicine.

出版信息

Health Psychol. 2022 Apr;41(4):301-310. doi: 10.1037/hea0001156.

Abstract

OBJECTIVE

The aim of this study was to investigate whether three facets of lung cancer stigma (internalized stigma, constrained disclosure, and perceived subtle discrimination) uniquely predicted psychological and physical health-related adjustment to lung cancer across 12 weeks. Additionally, self-compassion was tested as a moderator of the stigma-health relationship.

METHOD

Adults receiving oncologic treatment for lung cancer (N = 108) completed measures of lung cancer stigma, self-compassion, depressive symptoms, cancer-related stress, and physical symptom bother. Multivariable linear regression models were used to investigate cross-sectional and longitudinal relationships (at 6- and 12-week follow-up) between indicators of stigma and health-related outcomes, controlling for covariates. Self-compassion was tested as a moderator of these relationships.

RESULTS

At study entry, higher internalized stigma, constrained disclosure, and perceived subtle discrimination were associated significantly and uniquely with higher depressive symptoms (all p < .05). Constrained disclosure and perceived subtle discrimination were also associated significantly with higher cancer-related stress and higher physical symptom bother at study entry (all p < .05). Furthermore, higher internalized stigma predicted significant increases in depressive symptoms across 12 weeks and in cancer-related stress across 6 and 12 weeks (all p < .05). Higher self-compassion significantly moderated relationships between perceived discrimination and psychological health outcomes at study entry as well as between internalized stigma and increasing depressive symptoms across 12 weeks (all p < .05).

CONCLUSIONS

Results indicated robust relationships between distinct facets of stigma and health-related adjustment to lung cancer. Supportive care programs that bolster self-compassion may be useful for reducing lung cancer stigma. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

摘要

目的

本研究旨在探讨肺癌污名的三个方面(内化污名、受限披露和感知微妙歧视)是否能独特地预测肺癌患者在 12 周内心理和身体健康相关调整。此外,还测试了自我同情作为污名与健康关系的调节因素。

方法

接受肺癌肿瘤治疗的成年人(N=108)完成了肺癌污名、自我同情、抑郁症状、癌症相关压力和身体症状困扰的测量。多变量线性回归模型用于调查在 6 周和 12 周随访时,污名和健康相关结果之间的横断面和纵向关系,同时控制了协变量。测试了自我同情对这些关系的调节作用。

结果

在研究开始时,较高的内化污名、受限披露和感知微妙歧视与较高的抑郁症状显著相关(均 p<.05)。受限披露和感知微妙歧视也与较高的癌症相关压力和较高的身体症状困扰显著相关(均 p<.05)。此外,较高的内化污名预测了 12 周内抑郁症状的显著增加,以及 6 周和 12 周内癌症相关压力的显著增加(均 p<.05)。较高的自我同情显著调节了在研究开始时感知歧视与心理健康结果之间的关系,以及内化污名与 12 周内抑郁症状增加之间的关系(均 p<.05)。

结论

研究结果表明,污名的不同方面与肺癌患者的健康相关调整之间存在着强有力的关系。支持性护理计划,增强自我同情,可能对减少肺癌污名有用。

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