Wang Deju, Li Bin, Xin Hongmei, Wu Xiaofei, Xia Jieqiong
International Nursing School, Hainan Medical University, Haikou, China.
Department of Nursing Management, Hainan General Hospital, Haikou, China.
Front Psychol. 2024 Oct 15;15:1437025. doi: 10.3389/fpsyg.2024.1437025. eCollection 2024.
Depression seriously affects the quality of life of breast cancer patients and even hinders treatment and recovery after diagnosis. Subthreshold depression should be worthy of attention, and the risk of subthreshold depression developing into depression increases if timely intervention is not available. However, there is limited research on interventions for subthreshold depression, especially for newly diagnosed breast cancer patients.
Exploring the efficacy of a PERMA-based positive psychological intervention programme in newly diagnosed breast cancer patients with subthreshold depression.
Using PERMA as a framework, we constructed the intervention programme through a literature review and expert discussion approach, and revised the programme using the Delphi method. Then we selected 84 newly diagnosed breast cancer patients for a randomised controlled trial. The control group received conventional care (primary care, specialist care, psychological care, etc.), and the observation group received a PERMA-based positive psychological intervention programme. Patient data were collected before and after the intervention, and the dataset consisted of patient responses to general information, the Depression Screening Scale (CES-D), the Hamilton Depression Inventory (HAMD-17), and the Questionnaire on Psychosocial Adjustment in Breast Cancer Patients.
A total of 79 patients completed the study (38 patients in the observation group and 41 patients in the control group), and before the intervention, there were no statistical differences in the comparison of general information, subthreshold depression scores, and psychosocial adaptation scores between the two groups ( 0.05). After the intervention, the subthreshold depression (CES-D and HAMD-17 scores) scores of the observation group were lower than those of the control group ( < 0.01), and the psychosocial adaptation scores were significantly higher than those of the control group ( < 0.01).
A positive psychological intervention programme using PERMA as a framework was more effective in reducing subthreshold depression levels and promoting levels of psychosocial adjustment in newly diagnosed breast cancer patients.
Interventions for subthreshold depression are not limited to the traditional aftercare model, but rather from a positive psychology perspective. Especially for patients newly diagnosed with breast cancer, this is a new endeavour that has important implications for them. Because, instead of focusing on their negative emotions, we help them gradually adapt to their new identity and treatment process from a positive aspect during their most difficult period, thus reducing their subthreshold depression level and preventing it from developing into a more severe depression.
抑郁症严重影响乳腺癌患者的生活质量，甚至阻碍诊断后的治疗和康复。阈下抑郁应引起重视，若不及时干预，阈下抑郁发展为抑郁症的风险会增加。然而，针对阈下抑郁干预措施的研究有限，尤其是针对新诊断乳腺癌患者。
探讨基于积极情绪、投入、人际关系、意义和成就（PERMA）的积极心理干预方案对新诊断的阈下抑郁乳腺癌患者的疗效。
以PERMA为框架，通过文献回顾和专家讨论构建干预方案，并采用德尔菲法对方案进行修订。然后选取84例新诊断的乳腺癌患者进行随机对照试验。对照组接受常规护理（初级护理、专科护理、心理护理等），观察组接受基于PERMA的积极心理干预方案。在干预前后收集患者数据，数据集包括患者对一般信息、抑郁筛查量表（CES-D）、汉密尔顿抑郁量表（HAMD-17）以及乳腺癌患者心理社会适应问卷的回答。
共有79例患者完成研究（观察组38例，对照组41例），干预前，两组在一般信息、阈下抑郁评分和心理社会适应评分比较上无统计学差异（P>0.05）。干预后，观察组的阈下抑郁（CES-D和HAMD-17评分）得分低于对照组（P<0.01），心理社会适应得分显著高于对照组（P<0.01）。
以PERMA为框架的积极心理干预方案在降低新诊断乳腺癌患者的阈下抑郁水平和促进心理社会适应水平方面更有效。
对阈下抑郁的干预不限于传统的后续护理模式，而是从积极心理学角度出发。特别是对于新诊断的乳腺癌患者，这是一项新的尝试，对他们具有重要意义。因为，在他们最困难的时期，我们不是关注他们的负面情绪，而是从积极的方面帮助他们逐渐适应新的身份和治疗过程，从而降低他们的阈下抑郁水平，防止其发展为更严重的抑郁症。
