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乳腺癌化疗患者的生活质量与皮质醇的调节作用

Quality of Life in Women With Breast Cancer Receiving Chemotherapy and the Moderating Role of Cortisol.

机构信息

Author Affiliations: School of Psychology (Mss I. Pereira and M. Pereira and Dr Pereira) and Psychology Research Center (CIPsi) (Dr Leite), University of Minho Braga, Portugal.

出版信息

Cancer Nurs. 2022;45(6):E856-E864. doi: 10.1097/NCC.0000000000001081. Epub 2022 Aug 28.

Abstract

BACKGROUND

Quality of life (QoL) is severely affected by breast cancer (BC) and its treatment, particularly chemotherapy treatment. Psychological morbidity, illness perceptions, and self-efficacy for coping are important variables that impact QoL during the treatment of BC. The impact of cortisol on QoL has been poorly studied.

OBJECTIVE

The aim of this study was to identify the contributing variables to QoL in women with BC receiving adjuvant chemotherapy, as well as the moderating role of cortisol in the relationship between treatment adverse effects and QoL.

METHODS

This cross-sectional study included 112 women with BC undergoing chemotherapy who answered the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire, the Supplementary Questionnaire Breast Cancer Module, the Illness Perception Questionnaire, the Cancer Behavior Inventory-Brief Version, and the Hospital Anxiety and Depression Scale. In addition, salivary cortisol concentrations were also assessed.

RESULTS

The strongest contributor to lower QoL was treatment adverse effects. The illness perception and the cancer stage also contributed to a lower QoL. Nadir cortisol moderated the relationship between adverse effects and QoL.

CONCLUSION

Breast cancer chemotherapy and illness perceptions, even at the beginning of treatment, showed a great impact on QoL.

IMPLICATIONS FOR PRACTICE

It is important during chemotherapy to assess women's illness perceptions, as well as their stress levels to help women cope with the stress associated with treatment adverse effects. Monitoring cortisol is important as cortisol moderated the relationship between adverse effects and QoL. For those women struggling with stress, a reference to a mental health provider is warranted.

摘要

背景

生活质量(QoL)受到乳腺癌(BC)及其治疗的严重影响,尤其是化疗治疗。心理发病率、疾病认知和应对自我效能是影响 BC 治疗期间 QoL 的重要变量。皮质醇对 QoL 的影响研究甚少。

目的

本研究旨在确定接受辅助化疗的 BC 女性 QoL 的影响因素,以及皮质醇在治疗不良反应与 QoL 之间关系中的调节作用。

方法

这是一项横断面研究,纳入了 112 名正在接受化疗的 BC 女性,她们回答了欧洲癌症研究与治疗组织核心生活质量问卷、补充问卷乳腺癌模块、疾病认知问卷、癌症行为量表-简短版和医院焦虑抑郁量表。此外,还评估了唾液皮质醇浓度。

结果

治疗不良反应是导致 QoL 下降的最强因素。疾病认知和癌症分期也与较低的 QoL 相关。皮质醇最低点调节了不良反应与 QoL 之间的关系。

结论

乳腺癌化疗和疾病认知,即使在治疗开始时,也对 QoL 产生了重大影响。

实践意义

在化疗期间,评估女性的疾病认知以及压力水平非常重要,这有助于女性应对与治疗不良反应相关的压力。监测皮质醇很重要,因为皮质醇调节了不良反应与 QoL 之间的关系。对于那些面临压力的女性,建议她们咨询心理健康专家。

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