Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy and Dental Medicine, Sidi Mohamed Ben Abdallah University, Fez, Morocco.
Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life, Faculty of Sciences Dhar El Mahraz, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
BMC Psychol. 2024 Nov 26;12(1):693. doi: 10.1186/s40359-024-02211-9.
The timing of a breast cancer (BC) diagnosis has a significant psychological impact on patients. However, it reported that those eligible for treatment regimens based on neoadjuvant chemotherapy may experience high levels of depression, anxiety and distress. To cope with this situation, patients deploy psychological coping strategies. The aim of this study is to explore effective and ineffective psychological adjustment mobilized by Moroccan patients newly diagnosed with BC and before receiving neoadjuvant chemotherapy, as well as to identify their associations to socio-demographic and clinical determinants.
A total of 209 patients were recruited in outpatient in oncology department in the public oncology hospital of Fez city, between 2021 and 2023. Ethics approval was obtained for this study and patients has signed an informed consent form. The questionnaire interview included socio-economic and clinical variables and the Arabic version of Mini-Mental Adjustment to Cancer (Mini-MAC) scale, which measures the strategies of mental adjustment to disease, as fighting spirit (FS), hopelessness/helplessness (HH), anxious preoccupations (AP), cognitive avoidance (CA), fatalism (FA), "maladaptive coping" and "adaptive coping". Bivariate analysis of psychological adjustment strategies and sociodemographic and clinical variables was carried out using statistical tests according to the nature of the variables, to their normality and the homogeneity of their variances. Univariate and multivariate linear regression modelling was carried out using a forward "enter" regression procedure.
A mean age of 47.43 ± 9.45 was found among participants. Assessment of mental adjustment to cancer using Mini-MAC scores revealed that psychological adjustment strategies with a higher mean score were FA, FS and "adaptive coping" strategies. Based mainly on multiple linear Regression, monthly family income was negatively associated with HH, and FS and positively linked to FA and "adaptive coping" strategies. Moreover, the left side as BC laterality was negatively associated with AP and "maladaptive coping" strategies. Furthermore, positive ER status was negatively associated with HH and "maladaptive coping" strategies and high Ki-67 levels were positively linked to AP.
Programs to strengthen psychological adjustment in patients with BC candidates for NACT, taking into consideration the determinants found associated in this study, are of great importance since the first oncology consultation.
乳腺癌 (BC) 的诊断时间会对患者产生重大的心理影响。然而，据报道，那些符合新辅助化疗治疗方案的患者可能会经历高水平的抑郁、焦虑和困扰。为了应对这种情况，患者会采用心理应对策略。本研究旨在探索摩洛哥新诊断为 BC 且在接受新辅助化疗前调动的有效和无效心理调整策略，并确定其与社会人口统计学和临床因素的关联。
2021 年至 2023 年期间，在费兹市公立肿瘤医院的肿瘤科门诊共招募了 209 名患者。本研究获得了伦理批准，患者已签署知情同意书。问卷调查包括社会经济和临床变量以及阿拉伯语版 Mini-Mental Adjustment to Cancer（Mini-MAC）量表，该量表用于衡量对疾病的心理调整策略，包括斗志（FS）、绝望/无助（HH）、焦虑关注（AP）、认知回避（CA）、宿命论（FA）、“适应不良应对”和“适应应对”。根据变量的性质、正态性和方差同质性，采用统计检验对心理调整策略与社会人口统计学和临床变量进行了单变量分析。采用正向“进入”回归程序进行单变量和多变量线性回归建模。
参与者的平均年龄为 47.43±9.45 岁。使用 Mini-MAC 评分评估对癌症的心理调整发现，心理调整策略的平均得分较高的是 FA、FS 和“适应应对”策略。主要基于多元线性回归，家庭月收入与 HH 呈负相关，与 FA 和“适应应对”策略呈正相关。此外，BC 侧的左侧与 AP 和“适应不良应对”策略呈负相关。此外，阳性 ER 状态与 HH 和“适应不良应对”策略呈负相关，高 Ki-67 水平与 AP 呈正相关。
对于符合 NACT 治疗方案的 BC 候选患者，考虑到本研究中发现的相关决定因素，加强心理调整的计划非常重要，因为这是第一次肿瘤学咨询。
