乳腺癌患者身体意象与抑郁症状及创伤后成长的关联：社会支持的中介作用
Associations of body image with depressive symptoms and PTG among breast cancer patients: The mediating role of social support.
作者信息
Li Mengyao
机构信息
Department of Social Medicine, School of Health Management, China Medical University, Shenyang, China.
出版信息
Front Psychol. 2022 Oct 14;13:953306. doi: 10.3389/fpsyg.2022.953306. eCollection 2022.
BACKGROUND
Cancer diagnosis and treatment usually trigger positive and negative psychological health outcomes. Social support is a coping resource for psychological health outcomes. However, little research is available on the relationships between social support, body image, and overall psychological health outcomes in breast cancer (BC) patients. This study aimed to estimate the prevalence of depressive symptoms and post-traumatic growth (PTG) and examine the mediating roles of social support between body image and depressive symptoms and PTG among BC patients, respectively.
METHODS
A cross-sectional study was conducted in the Northeast China from December 2015 to August 2017. All the participants were diagnosed with BC and underwent surgery. This study was conducted with 405 BC patients from the First Affiliated Hospital of China Medical University. Participants completed the Center for Epidemiologic Studies Depression scale, Post Traumatic Growth Inventory, Body Image Scale, and Perceived Social Support Scale. The associations of social support, body image with depressive symptoms, and PTG were examined by hierarchical linear regression analysis. Asymptotic and resampling strategies were used to explore the mediating role of social support.
RESULTS
The prevalence of depressive symptoms was 88.1%, and 67.2% of the patients had moderate-high PTG, 52.84% of the patients had body concerns, and 264 (65.19%) patients had high-level social support. Body image was positively associated with depressive symptoms (β = 0.445, < 0.001) and social support was negatively associated with depressive symptoms (β = -0.219, < 0.001). Body image was negatively associated with PTG (β = -0.095, = 0.023), whereas social support was positively associated with PTG (β = 0.533, < 0.001). Social support significantly mediated the associations among body image, depressive symptoms (effect size = 0.057), and PTG (effect size = -0.304), respectively.
CONCLUSIONS
Social support played mediating role in the relationships between body image and depressive symptoms and PTG. The interventions based on social support and body image should be included in psychological health prevention.
背景
癌症的诊断和治疗通常会引发积极和消极的心理健康结果。社会支持是心理健康结果的一种应对资源。然而，关于乳腺癌（BC）患者的社会支持、身体意象和整体心理健康结果之间的关系，目前的研究较少。本研究旨在评估抑郁症状和创伤后成长（PTG）的患病率，并分别检验社会支持在身体意象与抑郁症状以及PTG之间的中介作用。
方法
2015年12月至2017年8月在中国东北地区进行了一项横断面研究。所有参与者均被诊断为BC并接受了手术。本研究对中国医科大学附属第一医院的405例BC患者进行。参与者完成了流行病学研究中心抑郁量表、创伤后成长问卷、身体意象量表和感知社会支持量表。通过分层线性回归分析检验社会支持、身体意象与抑郁症状以及PTG之间的关联。采用渐近和重抽样策略探讨社会支持的中介作用。
结果
抑郁症状的患病率为88.1%，67.2%的患者有中度至高度的PTG，52.84%的患者有身体担忧，264例（65.19%）患者有高水平的社会支持。身体意象与抑郁症状呈正相关（β = 0.445，P < 0.001），社会支持与抑郁症状呈负相关（β = -0.219，P < 0.001）。身体意象与PTG呈负相关（β = -0.095，P = 0.023），而社会支持与PTG呈正相关（β = 0.533，P < 0.001）。社会支持分别在身体意象、抑郁症状（效应量 = 0.057）和PTG（效应量 = -0.304）之间的关联中起显著中介作用。
结论
社会支持在身体意象与抑郁症状以及PTG之间的关系中起中介作用。基于社会支持和身体意象的干预措施应纳入心理健康预防。
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