Li Zimeng, Zhang Yening, Pang Ying, He Yi, Song Lili, Wang Yan, He Shuangzhi, Tang Lili
Department of Psycho-Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China.
Front Psychiatry. 2023 May 12;14:1076036. doi: 10.3389/fpsyt.2023.1076036. eCollection 2023.
We conducted this cross-sectional study to explore the mediating and predicting role of somatic symptom disorder (SSD) between psychological measures and quality of life (QOL) among Chinese breast cancer patients.
Breast cancer patients were recruited from three clinics in Beijing. Screening tools included the Patient Health Questionnaire-15 (PHQ-15), the Patient Health Questionnaire-9 (PHQ-9), the General Anxiety Disorder-7 scale (GAD-7), the Health Anxiety Scale (Whiteley Index-8, WI-8), the Somatic Symptom Disorder B-Criteria Scale (SSD-12), the Fear of Cancer Recurrence scale (FCR-4), the Brief Illness Perception Questionnaire (BIPQ-8), and the Functional Assessment of Cancer Therapy-Breast (FACT-B). Chi-square tests, nonparametric tests, mediating effect analysis, and linear regression analysis were used for the data analysis.
Among the 264 participants, 25.0% were screened positive for SSD. The patients with screened positive SSD had a lower performance status, and a greater number of patients with screened positive SSD received traditional Chinese medicine (TCM) ( < 0.05). Strong mediating effects of SSD were found between psychological measures and QOL among patients with breast cancer after adjusting for sociodemographic variables as covariates ( < 0.001). The range of the percentage mediating effects was 25.67% (independent variable = PHQ-9) to 34.68% (independent variable = WI-8). Screened positive SSD predicted low QOL in physical (B = -0.476, < 0.001), social (B = -0.163, < 0.001), emotional (B = -0.304, < 0.001), and functional (B = -0.283, < 0.001) well-being, as well as substantial concerns caused by breast cancer (B = -0.354, < 0.001).
Screened positive SSD had strong mediating effects between psychological factors and quality of life among breast cancer patients. Additionally, screened positive SSD was a significant predictor of lower QOL among breast cancer patients. Effective psychosocial interventions for improving QOL should consider the prevention and treatment of SSD or integrated SSD caring dimensions for breast cancer patients.
我们开展了这项横断面研究，以探讨躯体症状障碍（SSD）在中国乳腺癌患者心理测量指标与生活质量（QOL）之间的中介作用和预测作用。
从北京的三家诊所招募乳腺癌患者。筛查工具包括患者健康问卷-15（PHQ-15）、患者健康问卷-9（PHQ-9）、广泛性焦虑障碍-7量表（GAD-7）、健康焦虑量表（怀特利指数-8，WI-8）、躯体症状障碍B标准量表（SSD-12）、癌症复发恐惧量表（FCR-4）、简短疾病认知问卷（BIPQ-8）以及癌症治疗功能评估-乳腺癌（FACT-B）。数据分析采用卡方检验、非参数检验、中介效应分析和线性回归分析。
在264名参与者中，25.0%的人SSD筛查呈阳性。SSD筛查呈阳性的患者身体状况较差，且有更多SSD筛查呈阳性的患者接受了中药治疗（P<0.05）。在将社会人口统计学变量作为协变量进行调整后，发现SSD在乳腺癌患者心理测量指标与生活质量之间具有较强的中介作用（P<0.001）。中介效应百分比范围为25.67%（自变量=PHQ-9）至34.68%（自变量=WI-8）。SSD筛查呈阳性预测了身体（B=-0.476，P<0.001）、社会（B=-0.163，P<0.001）、情感（B=-0.304，P<0.001）和功能（B=-0.283，P<0.001）方面的低生活质量，以及乳腺癌引起的重大担忧（B=-0.354，P<0.001）。
SSD筛查呈阳性在乳腺癌患者心理因素与生活质量之间具有较强的中介作用。此外，SSD筛查呈阳性是乳腺癌患者生活质量较低的一个重要预测指标。改善生活质量的有效心理社会干预措施应考虑对SSD的预防和治疗或对乳腺癌患者综合的SSD照护维度。
