Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain; Osakidetza Basque Health Service, Araba Integrated Health Organisation, Vitoria-Gasteiz, Spain; Vitoria-Gasteiz School of Nursing, University of the Basque Country, Vitoria-Gasteiz, Spain.
Department of Basic Psychological Processes and Development, Faculty of Psychology, University of the Basque Country, San Sebastian, Spain.
Eur J Oncol Nurs. 2024 Aug;71:102620. doi: 10.1016/j.ejon.2024.102620. Epub 2024 May 20.
This study investigated the role of resilience and coping strategies on breast cancer patients' well-being using a structural equation model. To achieve this objective, a model previously developed by Mayordomo's group was partially replicated using a longitudinal study design in an oncological sample.
The study was a longitudinal observational survey. Patients with breast cancer were recruited (N = 166). Resilience was measured with the Mexican Resilience Measurement Scale, coping strategies with the Forms of Coping and Dimensions Scale and perception of the psychological well-being with a short-form of Ryff's Scales of Psychological Well-Being at the start and end of adjuvant chemotherapy (T1 and T2 respectively).
The results showed stability in the variables over time and revealed differences with respect to Mayordomo's model. The best predictor of well-being at T2 was well-being at T1. In addition, the model indicated that resilience had a direct impact on well-being through problem-focused coping. Indeed, resilience and problem-focused coping best explained well-being at T2.
Both at the start and end of adjuvant chemotherapy for breast cancer, problem-focused coping positively predicted resilience, which in turn was a positive predictor of well-being. On the other hand, emotion-focused coping showed no association with resilience or well-being. As part of the multidisciplinary cancer team, oncology nurses have a key role to play in promoting resilience and problem-focused coping as an important goal of psychosocial interventions in breast cancer patients.
本研究通过结构方程模型，探讨了韧性和应对策略对乳腺癌患者健康状况的作用。为了实现这一目标，使用纵向研究设计，在肿瘤学样本中部分复制了 Mayordomo 小组之前开发的模型。
该研究为纵向观察性调查。招募了乳腺癌患者（N=166）。在辅助化疗开始时（T1）和结束时（T2），使用墨西哥韧性测量量表、应对方式形式和维度量表以及 Ryff 的心理幸福感量表短表测量韧性、应对策略和心理幸福感。
结果显示，变量在时间上具有稳定性，并显示出与 Mayordomo 模型的差异。T2 时幸福感的最佳预测因子是 T1 时的幸福感。此外，该模型表明，韧性通过问题聚焦应对直接影响幸福感。事实上，韧性和问题聚焦应对可以很好地解释 T2 时的幸福感。
在乳腺癌辅助化疗开始和结束时，问题聚焦应对均能正向预测韧性，而韧性又能正向预测幸福感。另一方面，情绪聚焦应对与韧性或幸福感没有关联。作为多学科癌症团队的一员，肿瘤护士在促进乳腺癌患者的韧性和问题聚焦应对方面发挥着关键作用，这是心理社会干预的一个重要目标。
