接受综合治疗的直肠癌患者心理困扰和创伤后成长的轨迹及预测因素：一项探索性前瞻性研究。

Trajectory and predictors of psychological distress and posttraumatic growth among rectal cancer patients undergoing combined modality treatment: An exploratory prospective study.

作者信息

Benfante Agata, Tesio Valentina, Franco Pierfrancesco, Romeo Annunziata, Arcadipane Francesca, Iorio Giuseppe Carlo, Bartoncini Sara, Castelli Lorys

机构信息

Department of Psychology, University of Turin.

Department of Translational Medicine, University of Eastern Piedmont.

出版信息

Psychol Trauma. 2025 Jan 9. doi: 10.1037/tra0001835.

DOI:10.1037/tra0001835

PMID:39786858

Abstract

OBJECTIVE

This exploratory prospective cohort study aimed to investigate the trajectory of psychological distress and posttraumatic growth (PTG) in rectal cancer patients from diagnosis to follow-up and to explore factors that could predict PTG and psychological distress at follow-up.

METHOD

We assessed psychological distress (anxiety and depression), PTG, physical symptoms, quality of life, cancer-related coping, state and trait affectivity, resilience, and alexithymia in 43 rectal cancer patients, ) age: 61.6 (12.6); 67.4% men, after diagnosis (T0), after preoperative radiochemotherapy (T1), after surgical resection (T2), and 1 year after surgery (T3, follow-up).

RESULTS

Psychological distress, especially anxiety symptoms, showed a significant reduction between T0 and T1 ( < .001), which increased again between T1 and T2 ( = .048). PTG showed a progressive increase, with a significant increase between T2 and T3 ( < .001). The exploratory hierarchical multiple regression analyses showed that low positive state affectivity ( = .005) and high health anxiety ( = .007) at T1 and high negative state affectivity ( = .012) at T3 were significant predictors of psychological distress at follow-up. Higher levels of PTG at T1 ( < .001) and greater use of adaptive coping styles of Fighting Spirit at T0 ( = .009) and Fatalism at T1 ( = .031) were significant predictors of PTG at follow-up.

CONCLUSIONS

The (fluctuating and linear, respectively) trajectories of psychological distress and PTG seem to be related to the psychological reactions to the different treatment phases, especially diagnosis and preoperative treatment. Data suggest the need to implement psychological screening and tailored support programs aimed at fostering PTG and reducing psychological distress from the earliest phases of cancer treatment. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

摘要

目的

这项探索性前瞻性队列研究旨在调查直肠癌患者从诊断到随访期间心理困扰和创伤后成长（PTG）的轨迹，并探索能够预测随访时PTG和心理困扰的因素。

方法

我们评估了43例直肠癌患者（年龄：61.6岁（12.6岁）；67.4%为男性）在诊断后（T0）、术前放化疗后（T1）、手术切除后（T2）以及术后1年（T3，随访）时的心理困扰（焦虑和抑郁）、PTG、身体症状、生活质量、癌症相关应对方式、状态和特质情感、心理韧性以及述情障碍。

结果

心理困扰，尤其是焦虑症状，在T0和T1之间显著降低（<.001），在T1和T2之间再次升高（=.048）。PTG呈逐渐上升趋势，在T2和T3之间显著增加（<.001）。探索性分层多元回归分析表明，T1时低积极状态情感（=.005）和高健康焦虑（=.007）以及T3时高消极状态情感（=.012）是随访时心理困扰的显著预测因素。T1时较高水平的PTG（<.001）以及T0时更多地使用“斗志”这种适应性应对方式（=.009）和T1时更多地使用“宿命论”应对方式（=.031）是随访时PTG的显著预测因素。