Wojtyna Ewa, Pasek Małgorzata, Nowakowska Aleksandra, Goździalska Anna, Jochymek Małgorzata
Institute of Psychology, University of Silesia in Katowice, 40-007 Katowice, Poland.
Department of Nursing, Faculty of Health, University of Applied Sciences in Tarnów, 33-100 Tarnów, Poland.
Healthcare (Basel). 2023 Aug 4;11(15):2203. doi: 10.3390/healthcare11152203.
Self-esteem is an important factor determining QoL after surgical procedures leading to bodily deformities associated with cancer treatment. However, there are few data on which components of self-esteem are most closely related to QoL. The article presents two studies that aim to fill this gap. Study 1 concerns changes in global self-esteem and QoL in patients treated surgically for oral cancer ( = 35); Study 2 concerns changes in explicit and implicit self-esteem and QoL in women with breast cancer undergoing mastectomy ( = 96). The study was longitudinal with two measurements: before and after surgery. Both studies used the EORTC QLQ-C30 and Rosenberg's SES questionnaires. In Study 2, the Implicit Association Test (IAT) was additionally performed. The patients' global QoL and self-esteem deteriorated after surgery. In Study 1, patients with higher initial self-esteem showed a greater range of decreased self-esteem and QoL than patients with initially low self-esteem. In Study 2, the largest decreases in various dimensions of QoL and explicit self-esteem were observed in women with fragile self-esteem. A group of women with high explicit and implicit self-esteem showed the best QoL after mastectomy. Cancer patients with high, fragile self-esteem are at risk of the greatest deterioration in QoL and self-image after cancer surgery. These people should be given special psycho-oncological care.
自尊是决定因癌症治疗导致身体畸形的手术后生活质量的一个重要因素。然而，关于自尊的哪些组成部分与生活质量最密切相关的数据却很少。本文介绍了两项旨在填补这一空白的研究。研究1关注口腔癌手术患者（n = 35）的总体自尊和生活质量的变化；研究2关注接受乳房切除术的乳腺癌女性（n = 96）的显性和隐性自尊及生活质量的变化。该研究为纵向研究，进行了两次测量：手术前和手术后。两项研究均使用了欧洲癌症研究与治疗组织生活质量核心问卷（EORTC QLQ-C30）和罗森伯格自尊量表（Rosenberg's SES）。在研究2中，还额外进行了内隐联想测验（IAT）。手术后患者的总体生活质量和自尊下降。在研究1中，初始自尊较高的患者比初始自尊较低的患者自尊和生活质量下降的幅度更大。在研究2中，自尊脆弱的女性在生活质量和显性自尊的各个维度上下降幅度最大。一组显性和隐性自尊都较高的女性在乳房切除术后生活质量最佳。自尊高且脆弱的癌症患者在癌症手术后生活质量和自我形象恶化的风险最大。这些人应给予特殊的心理肿瘤护理。
