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乳腺癌辅助内分泌治疗患者的社会心理适应、药物依从性与生活质量的关系。

The relationship among psychosocial adaptation, medication adherence and quality of life in breast cancer women with adjuvant endocrine therapy.

机构信息

Department of Breast Oncology, The First Affiliated Hospital of China Medical University, Shenyang, China.

Nursing Department, The First Affiliated Hospital of Dalian Medical University, Dalian, China.

出版信息

BMC Womens Health. 2022 Apr 27;22(1):135. doi: 10.1186/s12905-022-01722-0.

Abstract

BACKGROUND

Patients undergoing endocrine therapy for breast cancer often suffer from poor psychosocial adaptation, low compliance with endocrine therapy and poor quality of life. However, the relationship among the three is not completely clear. The aims of this study were to investigate the status of psychosocial adaptation (PSA), medication adherence and quality of life (QOL) in breast cancer women with adjuvant endocrine therapy (AET), and to analyze the influencing factors of QOL and explore the relationship among them.

METHODS

346 breast cancer women were selected who underwent endocrine therapy after surgery, and data collected by the general information questionnaire, the PSA questionnaire among breast cancer women with AET, Morisky Medication Adherence Scale and The Functional Assessment of Cancer Therapy-Breast (FACT-B). The relationship among the variables was investigated by univariate analysis, multiple stepwise regression analysis and mediating effect analysis.

RESULTS

The scores of PSA, medication adherence and QOL were slightly above the medium level. Univariate analysis showed that there were significant differences in QOL among breast cancer women of AET with different types of exercise, medical payment methods, discomfort symptoms (headache, hypomnesis, arthralgia, perturbation), type of discomfort symptoms, medication adherence and PSA; Multi-factor analysis showed that PSA and medication adherence were the influential factors of QOL; mediating effect showed that medication adherence played a partial mediating role in PSA and QOL.

CONCLUSION

The QOL of breast cancer women with AET will be directly affected by PSA. Medication compliance has a weak mediating effect in the indirect impact of PSA on the QOL. In the future, clinical nursing work should take targeted measures to improve the PSA level of patients, and effectively improve the compliance of patients with medication, so as to better improve the QOL of breast cancer women.

摘要

背景

接受乳腺癌内分泌治疗的患者常伴有较差的社会心理适应、内分泌治疗依从性低和生活质量差。但三者之间的关系尚不完全清楚。本研究旨在调查辅助内分泌治疗(AET)的乳腺癌女性的社会心理适应(PSA)、用药依从性和生活质量(QOL)状况,并分析 QOL 的影响因素,探讨三者之间的关系。

方法

选择 346 例术后接受内分泌治疗的乳腺癌女性,采用一般资料问卷、乳腺癌 AET 女性 PSA 问卷、Morisky 用药依从性量表和癌症治疗功能评估-乳房(FACT-B)进行调查。采用单因素分析、多元逐步回归分析和中介效应分析探讨变量之间的关系。

结果

PSA、用药依从性和 QOL 得分略高于中等水平。单因素分析显示,不同运动类型、医疗付费方式、不适症状(头痛、记忆力减退、关节痛、烦躁)、不适症状类型、用药依从性和 PSA 的乳腺癌 AET 女性 QOL 存在显著差异;多因素分析显示,PSA 和用药依从性是 QOL 的影响因素;中介效应显示,用药依从性在 PSA 和 QOL 之间起部分中介作用。

结论

PSA 直接影响 AET 乳腺癌女性的 QOL。用药依从性在 PSA 对 QOL 的间接影响中具有较弱的中介作用。今后临床护理工作应采取有针对性的措施,提高患者 PSA 水平,有效提高患者用药依从性,从而更好地提高乳腺癌女性的 QOL。

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