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COVID-19大流行期间肿瘤患者的创伤后成长

Post-traumatic growth in oncological patients during the COVID-19 pandemic.

作者信息

Lafuenti Letizia, Dinapoli Loredana, Mastrilli Ludovica, Savoia Vezio, Linardos Marinella, Masetti Riccardo, Tortora Giampaolo, Valentini Vincenzo, Scambia Giovanni, Chieffo Daniela P R

机构信息

UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Università Cattolica del Sacro Cuore, Rome, Italy.

出版信息

Health Psychol Rep. 2023 Sep 18;12(2):142-153. doi: 10.5114/hpr/169165. eCollection 2024.

Abstract

BACKGROUND

Post-traumatic growth (PTG) is defined as "positive psychological change experienced as a result of the struggle with highly challenging life circumstances". Diagnosis of cancer leads to many psychological challenges. The recent pandemic forced oncological patients to face other multiple stressors. Resilience is a target of interest for PTG. The aim of this study is to analyze relationships between cancer trauma, COVID-19 pandemic stress, PTG and resilience over time.

PARTICIPANTS AND PROCEDURE

One hundred forty-six patients (124 females, 22 males) in active oncological treatment were enrolled from September 2020: 45.2% ( = 66) diagnosed with gynecological cancer, 23.3% ( = 34) with breast cancer, 15.1% ( = 22) with lung cancer, 16.5% ( = 24) with other cancers. We conducted a prospective longitudinal study on oncological patients evaluated at: diagnosis (T0), 6 (T1) and 12 months (T2) by means of the following self-administered tests: Distress Thermometer (DT), Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale Revised (IES-R), Post-traumatic Growth Inventory (PTGI), Perceived Stress Scale (PSS), Connor-Davidson Resilience Scale (CD-RISC).

RESULTS

DT decreased over time (T0 vs. T2, < .001). HADS decreased from T0 to T2 ( < .001). The PTG subscales regarding new possibilities and appreciating life improved comparing T0 vs. T2 ( = .029; = .013), as well as the total index of PTG ( = .027). The IES avoidance subscale score decreased over time (T0 vs. T1, = .035).

CONCLUSIONS

For some patients, the cancer experience is characterized not only by psychological distress but also by the presence and growth of positive aspects, such as the tendency to positively reconsider the value and importance of life, health and social relationships.

摘要

背景

创伤后成长(PTG)被定义为“因与极具挑战性的生活境遇抗争而经历的积极心理变化”。癌症诊断会带来诸多心理挑战。近期的疫情迫使肿瘤患者面对其他多重压力源。复原力是创伤后成长关注的一个目标。本研究的目的是分析癌症创伤、新冠疫情压力、创伤后成长和复原力随时间的关系。

参与者与程序

2020年9月招募了146名正在接受肿瘤治疗的患者(124名女性,22名男性):45.2%(n = 66)被诊断为妇科癌症,23.3%(n = 34)为乳腺癌,15.1%(n = 22)为肺癌,16.5%(n = 24)为其他癌症。我们对肿瘤患者进行了一项前瞻性纵向研究,通过以下自我管理测试在诊断时(T0)、6个月(T1)和12个月(T2)进行评估:痛苦温度计(DT)、医院焦虑抑郁量表(HADS)、事件影响量表修订版(IES - R)、创伤后成长量表(PTGI)、感知压力量表(PSS)、康纳 - 戴维森复原力量表(CD - RISC)。

结果

DT随时间下降(T0与T2相比,P <.001)。HADS从T0到T2下降(P <.001)。与T0相比,关于新可能性和珍惜生活的创伤后成长分量表有所改善(P =.029;P =.013),创伤后成长总指数也有所改善(P =.027)。IES回避分量表得分随时间下降(T0与T1相比,P =.035)。

结论

对于一些患者来说,癌症经历不仅以心理困扰为特征,还以积极方面的存在和成长为特征,比如积极重新审视生活、健康和社会关系的价值与重要性的倾向。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e36/11016944/14b988ab8b5c/HPR-12-169165-g001.jpg

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