School of Nursing, Sun Yat-Sen University, No. 74, Zhongshan II Road, Guangzhou, Guangdong Province, China.
School of Nursing, Sun Yat-Sen University, No. 74, Zhongshan II Road, Guangzhou, Guangdong Province, China.
J Psychosom Res. 2023 Jul;170:111344. doi: 10.1016/j.jpsychores.2023.111344. Epub 2023 May 1.
To identify longitudinal trajectories of illness perception (IP) regarding breast cancer-related lymphedema (BCRL) in the first six months after surgery among women with breast cancer and to explore the predictive effects of demographics and clinical factors on IP trajectories.
From August 2019 to August 2021, a total of 352 patients participated in this study, 328 of whom were included in the data analysis. Demographic and clinical characteristics were collected at baseline (1-3 days after surgery). The BCRL-specific revised illness perception questionnaire was used to measure IP regarding BCRL at baseline and 1 month, 3 months and 6 months post-surgery. A multilevel model was conducted to analyze the data.
Over the first six months post-surgery, the "timeline acute/chronic" and "illness coherence" dimensions showed positive growth trajectories; the "personal control" and "treatment control" dimensions presented negative growth trajectories; and the trajectories of identity, consequences, cyclicality and emotional influence perceptions regarding BCRL showed no significant changes. Age, education level, marital status, employment status, family monthly income per person, cancer stage and status of removed lymph nodes were indicated to be predictive factors of IP trajectories.
The present study determined significant changes over the first six months post-surgery in four IP dimensions and predictive effects of some demographics and clinical details on IP trajectories. These findings may help healthcare providers know more about the dynamic characteristics of IPs regarding BCRL in patients with breast cancer and assist them in identifying patients with a tendency toward improper IP regarding BCRL.
在乳腺癌手术后的头 6 个月内，识别乳腺癌相关淋巴水肿（BCRL）患者的疾病感知（IP）纵向轨迹，并探讨人口统计学和临床因素对 IP 轨迹的预测作用。
2019 年 8 月至 2021 年 8 月，共有 352 名患者参与了这项研究，其中 328 名患者纳入数据分析。在基线（手术后 1-3 天）时收集人口统计学和临床特征。使用乳腺癌特异性修订疾病感知问卷在基线以及手术后 1 个月、3 个月和 6 个月时测量 BCRL 的 IP。采用多水平模型进行数据分析。
在手术后的头 6 个月内，“时间线急慢性”和“疾病一致性”维度呈现出积极的增长轨迹；“个人控制”和“治疗控制”维度呈现出负向的增长轨迹；而对 BCRL 的身份、后果、周期性和情绪影响感知的轨迹则没有明显变化。年龄、教育水平、婚姻状况、就业状况、家庭人均月收入、癌症分期和淋巴结切除情况被认为是 IP 轨迹的预测因素。
本研究确定了乳腺癌患者在手术后的头 6 个月内，四个 IP 维度出现了显著变化，以及一些人口统计学和临床特征对 IP 轨迹的预测作用。这些发现可能有助于医疗保健提供者了解乳腺癌患者对 BCRL 的 IP 动态特征，并帮助他们识别出对 BCRL 有不当 IP 倾向的患者。
