Watanabe Aki, Kawaguchi Takayuki, Nobematsu Ayumi, Sasada Satoshi, Kanari Nozomi, Maru Tatsuya, Kobayashi Takeshi
Faculty of Health and Social Work, School of Rehabilitation, Kanagawa University of Human Services, Yokosuka City 238-8522, Kanagawa, Japan.
Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira City 187-8553, Tokyo, Japan.
Healthcare (Basel). 2023 Jul 21;11(14):2082. doi: 10.3390/healthcare11142082.
The purpose of this study was to clarify the structural relationship of quality of life (QOL) in survivors of breast cancer, including difficulty in daily life and negative experiences in daily activities, as health-related indicators.
Participants were survivors of breast cancer for more than 2 years after primary breast cancer surgery and belonged to self-help groups. The assessment used FACT-B (QOL), HADS (anxiety and depression), SOC (sense of coherence), WHODAS 2.0 (difficulties in daily life), and CAOD (negative experiences in daily activities). Bayesian structural equation modeling (BSEM) was performed to analyze the hypothesized model. If the causal model was significant, multiplication of the path coefficient from emotional distress (anxiety and depression) to QOL, and from SOC to emotional distress, was considered a direct effect on QOL, and from SOC to difficulty in daily life, from difficulty in daily life to negative experiences in daily activities, and from negative experiences in daily activities to anxiety and depression were considered indirect effects on QOL.
The participants comprised 73 survivors of breast cancer. The goodness of fit of the model in the BSEM was satisfactory. The direct effect was 0.274, and the indirect effect was 0.164.
An additional finding of this study is that coping with difficulty in daily life and negative experiences in daily activities related to QOL may improve QOL.
本研究旨在阐明乳腺癌幸存者生活质量（QOL）的结构关系，包括日常生活中的困难和日常活动中的负面经历，作为与健康相关的指标。
参与者为原发性乳腺癌手术后2年以上的乳腺癌幸存者，且属于自助团体。评估使用了FACT-B（生活质量）、HADS（焦虑和抑郁）、SOC（连贯感）、WHODAS 2.0（日常生活困难）和CAOD（日常活动中的负面经历）。采用贝叶斯结构方程模型（BSEM）对假设模型进行分析。如果因果模型显著，从情绪困扰（焦虑和抑郁）到生活质量的路径系数，以及从连贯感（SOC）到情绪困扰的路径系数的乘积被视为对生活质量的直接影响，而从连贯感（SOC）到日常生活困难、从日常生活困难到日常活动中的负面经历、以及从日常活动中的负面经历到焦虑和抑郁的路径系数被视为对生活质量的间接影响。
参与者包括73名乳腺癌幸存者。BSEM中模型的拟合优度令人满意。直接效应为0.274，间接效应为0.164。
本研究的另一项发现是，应对与生活质量相关的日常生活困难和日常活动中的负面经历可能会改善生活质量。
