应对副作用：接受辅助内分泌治疗的乳腺癌女性的日常日记研究。

Coping With Side Effects: A Daily Diary Study in Women With Breast Cancer Living With Adjuvant Endocrine Therapy.

机构信息

Applied Social and Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland.

URPP Dynamics of Health Aging, University of Zurich, Zurich, Switzerland.

出版信息

Psychooncology. 2024 Oct;33(10):e70006. doi: 10.1002/pon.70006.

DOI:10.1002/pon.70006

PMID:39450894

Abstract

OBJECTIVE

Adjuvant endocrine therapy (AET) is increasingly being prescribed for up to 10 years to people diagnosed with hormone receptor-positive breast cancer. AET intake is often accompanied by side effects that significantly impact the well-being of people. The way individuals cope with medication-related side effects might play a pivotal role in their emotional adaption.

METHODS

This intensive-longitudinal study investigated the association between self-reported coping strategies (Brief COPE) and psychological well-being (Patient Health Questionnaire-4) among women undergoing AET. A multilevel factor analysis resulted in the identification of four coping factors, namely, problem-focused, support-focused, meaning-focused, and avoidance-focused coping. Daily coping efforts and experienced side effects were analyzed as predictors of psychological well-being using multilevel modeling.

RESULTS

A total of 215 women (M = 56.5 ± 10.9 years) participated, resulting in a total of n = 2080 daily surveys (M = 9.67 ± 1.08). On average, women reported 3.7 ± 2.2 different side effects per day. Days characterized by an elevated frequency of side effects and increased burden were associated with diminished well-being. Using more problem- and meaning-focused strategies than usual to cope with side effects correlated positively with well-being. Conversely, employing more support- and avoidance-focused coping strategies than usual was linked to reduced psychological well-being. Exploratory analyses focusing on individual coping strategies provided nuanced insights into coping behaviors.

CONCLUSION

The present findings underscore the relationship between women's coping efforts concerning medication-related side effects during AET and their daily well-being. Psychosocial education (e.g., cognitive behavioral therapy) may offer valuable benefits for patients by helping them develop adaptive coping strategies to manage side effects.

摘要

目的

辅助内分泌治疗（AET）越来越多地被规定用于诊断为激素受体阳性乳腺癌的患者长达 10 年。AET 的摄入常常伴随着严重影响人们幸福感的副作用。个体应对与药物相关副作用的方式可能在他们的情绪适应中起着关键作用。

方法

本密集纵向研究调查了接受 AET 的女性中自我报告的应对策略（Brief COPE）与心理幸福感（Patient Health Questionnaire-4）之间的关联。多级因素分析确定了四种应对因素，即问题聚焦、支持聚焦、意义聚焦和回避聚焦应对。使用多级建模分析每日应对努力和经历的副作用作为心理幸福感的预测指标。

结果

共有 215 名女性（M=56.5±10.9 岁）参与，共获得 2080 份每日调查（M=9.67±1.08）。平均而言，女性每天报告 3.7±2.2 种不同的副作用。副作用频率升高和负担增加的日子与幸福感降低有关。与平时相比，更多地使用问题和意义聚焦策略来应对副作用与幸福感呈正相关。相反，与平时相比，更多地使用支持和回避聚焦应对策略与心理幸福感降低有关。关注个体应对策略的探索性分析提供了应对行为的细致见解。