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乳腺癌幸存者的心理赋能:创伤后成长及相关因素

Psychological Empowerment in Breast Cancer Survivors: Posttraumatic Growth and Related Factors.

作者信息

Çamlı Nevzat, Varma Gülfizar Sözeri, Topak Osman Zülkif, Doğu Gamze Gököz, Toker Uğurlu Tuğçe, Özhan Nail, Gündüz Muhammet

机构信息

Department of Psychiatry, Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Bursa Türkiye.

Department of Psychiatry, Faculty of Medicine, Pamukkale University, Denizli, Türkiye.

出版信息

Noro Psikiyatr Ars. 2025 Aug 18;62(3):234-240. doi: 10.29399/npa.28818. eCollection 2025.

Abstract

INTRODUCTION

Diagnosis and treatment of breast cancer is traumatic for both patients and their relatives. It is crucial to understand the factors that enhance the psychological resilience of breast cancer survivors. This study aims to investigate posttraumatic growth following breast cancer and its relationship with psychiatric disorders, social support, and stigma.

METHODS

The study included 100 female breast cancer patients and 100 relatives. Patients underwent a DSM-5-based structured psychiatric interview and were assessed with the Posttraumatic Growth Inventory (PTGI), the Hospital Anxiety-Depression Scale (HADS), the Cancer Patient Perceived Social Support Scale (CPPSSS), and Cancer-related Attitudes Measurement Questionnaire (CRAMQ)-patient version. The patient's relatives were administered the PTGI, HADS, and CRAMQ-community versions.

RESULTS

Psychiatric disorders were diagnosed in 40% of individuals with breast cancer, most commonly major depressive disorder (22%). Posttraumatic growth demonstrated a negative correlation with age and a positive association with being employed. The presence of psychiatric disorders and elevated anxiety levels are associated with reduced personal growth. Perceived emotional/confidence social support were associated with increased growth. A subscale of stigma 'impossibility of recovery', led to a positive shift in life philosophy and interpersonal relationships. Additionally, both patients' age and the level of growth in their relatives were found to predict posttraumatic growth in the patients (B=-0.499, p=0.021; B=0.211, p=0.044, logistic regression).

CONCLUSION

Posttraumatic growth is negatively associated with age and the presence of a psychiatric disorder, and positively associated with employment and social support. Additionally, relatives' posttraumatic growth and patients' age predict posttraumatic growth in patients. Stigmatising the perception of "impossibility of recovery" is associated with positive psychological change, possibly reflecting a more traumatic perception of the cancer diagnosis, a reduction in denial, and increased acceptance of the illness. This acceptance of mortality may lead to deeper personal transformation for a more meaningful life and improved interpersonal relationships.

摘要

引言

乳腺癌的诊断和治疗对患者及其亲属来说都是痛苦的。了解增强乳腺癌幸存者心理复原力的因素至关重要。本研究旨在调查乳腺癌后的创伤后成长及其与精神障碍、社会支持和耻辱感的关系。

方法

该研究纳入了100名女性乳腺癌患者和100名亲属。患者接受了基于《精神疾病诊断与统计手册》第5版的结构化精神科访谈,并使用创伤后成长量表(PTGI)、医院焦虑抑郁量表(HADS)、癌症患者感知社会支持量表(CPPSSS)和癌症相关态度测量问卷(CRAMQ)患者版进行评估。患者的亲属接受了PTGI、HADS和CRAMQ社区版的评估。

结果

40%的乳腺癌患者被诊断出患有精神障碍,最常见的是重度抑郁症(22%)。创伤后成长与年龄呈负相关,与就业呈正相关。精神障碍的存在和焦虑水平升高与个人成长减少有关。感知到的情感/信心社会支持与成长增加有关。耻辱感的一个子量表“无法康复”导致生活哲学和人际关系出现积极转变。此外,发现患者的年龄和亲属的成长水平都能预测患者的创伤后成长(B=-0.499,p=0.021;B=0.211,p=0.044,逻辑回归)。

结论

创伤后成长与年龄和精神障碍的存在呈负相关,与就业和社会支持呈正相关。此外,亲属的创伤后成长和患者的年龄可预测患者的创伤后成长。对“无法康复”的耻辱感认知与积极的心理变化有关,这可能反映出对癌症诊断的创伤感更强、否认减少以及对疾病的接受度增加。这种对死亡的接受可能会导致更深刻的个人转变,以实现更有意义的生活并改善人际关系。

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