Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany.
National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany.
BMC Psychol. 2024 Sep 27;12(1):507. doi: 10.1186/s40359-024-02018-8.
Systematic reviews and meta-analyses reveal the importance of an accepting attitude towards cancer for mental health and functional coping. The aim of this study was to examine the psychometric properties of the German translation of the Peace, Equanimity, and Acceptance in the Cancer Experience (PEACE) questionnaire (Mack et al., 2008) and to investigate its associations with mental health, health-related quality of life (HRQoL) and related constructs.
The German version of the PEACE (PEACE-G) was created and validated with cancer patients in a cross-sectional two center questionnaire study. Construct validity was tested with confirmational factor analyses (CFA); Cronbach's alpha was used to determine internal consistency of items. We further examined associations with depression (PHQ-8), anxiety (GAD-7), distress (NCCN distress thermometer), HRQoL (SF-12), psychological flexibility (AAQ-II), resilience (RS-11) and acceptance scales, to evaluate concurrent and divergent validity.
N = 213 cancer patients with different tumor entities participated in this study. Results of the CFA replicated the two-factor solution of the original PEACE (peaceful acceptance and struggle with illness) with satisfactory psychometric properties. Peaceful acceptance showed negative associations with depression, anxiety, distress, psychological inflexibility, and positive associations with HRQoL, acceptance, resilience, and mindfulness. Results of sensitivity analyses indicate a third factor (injustice/anger).
The results demonstrate the validity and reliability of PEACE-G in cancer patients and point to the essential role of acceptance- and mindfulness-based interventions in psycho-oncology. Further studies are needed to investigate the different facets of struggle with the cancer illness.
系统评价和荟萃分析揭示了对癌症的接受态度对于心理健康和功能应对的重要性。本研究的目的是检验德国翻译版癌症经历中的平静、平衡和接受（Peace, Equanimity, and Acceptance in the Cancer Experience，PEACE）问卷（Mack 等人，2008 年）的心理测量学特性，并研究其与心理健康、健康相关生活质量（health-related quality of life，HRQoL）和相关结构的关系。
使用横断面两项中心问卷调查研究，对癌症患者进行了德国版 PEACE（PEACE-G）的创建和验证。验证性因子分析（confirmational factor analysis，CFA）用于测试结构效度；使用 Cronbach's alpha 来确定项目的内部一致性。我们进一步检查了与抑郁（PHQ-8）、焦虑（GAD-7）、痛苦（NCCN 痛苦温度计）、HRQoL（SF-12）、心理灵活性（AAQ-II）、韧性（RS-11）和接受量表的关联，以评估同时和发散效度。
共有 213 名患有不同肿瘤实体的癌症患者参加了这项研究。CFA 的结果复制了原始 PEACE 的双因素解决方案（平和接受和与疾病抗争），具有令人满意的心理测量学特性。平和接受与抑郁、焦虑、痛苦、心理不灵活性呈负相关，与 HRQoL、接受、韧性和正念呈正相关。敏感性分析的结果表明存在第三个因素（不公平/愤怒）。
结果表明，PEACE-G 在癌症患者中的有效性和可靠性，指出了基于接受和正念的干预在心理肿瘤学中的重要作用。需要进一步研究来探讨与癌症疾病抗争的不同方面。
