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患有癌症的青少年和青年的决策冲突与生理失调。

Decisional conflict and physiological dysregulation among adolescents and young adults with cancer.

作者信息

Darabos Katie, Barakat Lamia P, Schwartz Lisa A

机构信息

Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA.

Behavioral Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

出版信息

J Psychosoc Oncol. 2025 Jun 6:1-11. doi: 10.1080/07347332.2025.2515064.

Abstract

PURPOSE

Adolescents and young adults with cancer (AYA) are faced with making several cancer-related decisions daily (e.g. managing pain/fatigue). Many of these decisions involve uncertainty (e.g. feeling uninformed about alternatives, feeling unsupported about making a choice), even under ideal conditions that have implications for health (e.g. wear and tear on the body). The present study examined relationships between decisional conflict within cancer-related decision-making and physiological responding.

METHODS

Participants included 18 AYAs on active cancer treatment, diagnosed within the past 2 years. Participation included two days of salivary samples (assessing cortisol) followed by a 7-day collection of decisional conflict within cancer-related decision-making. Associations between decisional conflict and the cortisol awakening response (CAR) were examined.

RESULTS

Decisional conflict was significantly associated with a smaller (i.e. blunted) cortisol awakening response, reflecting cortisol dysregulation.

CONCLUSION

Results from this study add to an emerging body of literature focused on the role of decisional conflict and physiological stress responding enhancing our understanding of decisional processes that may impact stress systems among AYAs undergoing cancer treatment.

摘要

目的

患有癌症的青少年和青年(AYA)每天都要做出多项与癌症相关的决定(例如应对疼痛/疲劳)。即使在对健康有影响的理想条件下(例如身体的损耗),这些决定中的许多都涉及不确定性(例如对替代方案了解不足、在做出选择时感到缺乏支持)。本研究探讨了与癌症相关决策中的决策冲突与生理反应之间的关系。

方法

参与者包括18名正在接受积极癌症治疗的AYA,他们在过去两年内被诊断出患有癌症。参与过程包括采集两天的唾液样本(评估皮质醇),随后进行为期7天的与癌症相关决策中的决策冲突收集。研究了决策冲突与皮质醇觉醒反应(CAR)之间的关联。

结果

决策冲突与较小的(即钝化的)皮质醇觉醒反应显著相关,反映出皮质醇失调。

结论

本研究结果为专注于决策冲突和生理应激反应作用的新兴文献增添了内容,增强了我们对可能影响接受癌症治疗的AYA应激系统的决策过程的理解。

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本文引用的文献

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Day-to-Day Decision Making by Adolescents and Young Adults with Cancer.青少年和青年癌症患者的日常决策。
J Pediatr Hematol Oncol Nurs. 2022 Sep-Oct;39(5):290-303. doi: 10.1177/27527530211068718. Epub 2022 Jan 15.
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The Adolescent and Young Adult with Cancer: A Developmental Life Course Perspective.患癌青少年及青年:发展生命历程视角
Semin Oncol Nurs. 2015 Aug;31(3):186-96. doi: 10.1016/j.soncn.2015.05.006. Epub 2015 May 7.

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