Nelson D V, Friedman L C, Baer P E, Lane M, Smith F E
Department of Anesthesiology, University of Texas-Houston Health Science Center 77030.
J Behav Med. 1994 Apr;17(2):127-41. doi: 10.1007/BF01858101.
By means of cluster analytic techniques, four subtypes of psychosocial adjustment were identified in a sample of 122 breast cancer patients who completed the Psychosocial Adjustment to Illness Scale. Internal consistency and internal validity of the derived typology were suggested by the finding that two different hierarchical agglomerative clustering methods (average linkage between groups, Ward's) produced similar solutions. Three of the derived subtypes reported normal affect levels but different patterns of relative strengths and dysfunctions, while the fourth subtype appeared to be highly distressed and globally maladjusted. External validation was demonstrated by differentiating the subtypes on variables of negative affect, avoidance coping, and fighting spirit. The clinical and heuristic implications of these findings are discussed. The findings highlight the need for comprehensive assessment of psychosocial functioning of cancer patients. They demonstrate that even non-emotionally distressed patients can have very different profiles of adjustment and may benefit from correspondingly individually tailored psychosocial interventions.
通过聚类分析技术，在122名完成疾病心理社会适应量表的乳腺癌患者样本中确定了四种心理社会适应亚型。两种不同的层次凝聚聚类方法（组间平均连锁、沃德法）产生了相似的结果，这表明所推导类型学的内部一致性和内部效度。所推导的四种亚型中有三种报告了正常的情感水平，但相对优势和功能障碍的模式不同，而第四种亚型似乎高度痛苦且整体适应不良。通过在消极情感、回避应对和斗志等变量上区分这些亚型，证明了外部效度。讨论了这些发现的临床和启发意义。这些发现凸显了对癌症患者心理社会功能进行全面评估的必要性。它们表明，即使是非情绪困扰的患者，其适应情况也可能有很大差异，可能会从相应的个性化心理社会干预中受益。
