【作者】 李诗晨； 朱熊兆；

【Author】 Shichen Li;Xiongzhao Zhu;Department of Physical Education,Hunan Normal University;Medical Psychological Institute,Second Xiangya Hospital,Central South University;

【机构】 湖南师范大学体育学院； 中南大学湘雅二医院医学心理中心；

【摘要】 目的:随着诊疗技术的发展,女性乳腺癌患者的生存率得到了大幅提升,生存期延长。女性乳腺癌患者生存期生存质量的提高日益受到关注。既往研究发现,女性乳腺癌患者术后正性情绪与其生存质量相关,但提高正性情绪能否改善患者的生存质量尚不清楚。探究提高乳腺癌患者的正性情绪能否改善其生存质量对优化乳腺癌患者现有心理干预方案具有指导意义和临床价值。因此,本研究通过采用情绪应对联结干预对乳腺癌患者进行心理干预提高其正性情绪,检验正性情绪水平的提高能否改善乳腺癌患者的生存质量。方法:105例接受手术治疗2周内的女性乳腺癌患者被随机分为干预组与等待组。干预组接受乳腺癌健康知识教育和每月1次为期5个月的情绪应对联结干预,等待组仅接受乳腺癌健康知识教育。两组患者在干预前完成正负性情绪量表(PANAS)与生存质量测定量表(FACT-B)的测评,在干预第1、2、3、4次后完成PANAS测评,在干预第5次后完成PANAS与FACT-B测评。采用重复测量的混合线性模型比较干预前以及干预后不同时间点患者的正性情绪、负性情绪及生存质量,采用阶层回归分析法分析正、负性情绪的变化对患者生存质量的影响。结果:在接受干预后,患者的正性情绪水平和生存质量显著提高,负性情绪水平显著降低(p <0.05);干预前、后患者正、负性情绪水平的变化对患者的生存质量都有显著的影响(p <0.05),但正性情绪水平的变化对生存质量的影响更大。结论:情绪应对联结干预能有效提高患者术后的正性情绪、生存质量,降低患者术后的负性情绪。正性情绪的提高与负性情绪的降低均对女性乳腺癌患者的生存质量有影响,但正性情绪对生存质量的作用更大。更多还原

【Abstract】 Objectives: With the development of diagnosis and treatment, the survival rate and duration have been improved for women with breast cancer. Improving the quality of life(QoL) among women with breast cancer has become an increasing concern. Previous studies have found that positive affect was closely related to the QoL of women with breast cancer. However, the effect of improvement of positive affect on QoL of women with breast cancer remains unclear. Investigation of the influence of improving positive affect on the QoL is of guiding significance and clinical value for optimizing current psychological intervention programs for women with breast cancer. As a result, the current study used Lessons in Linking Affect and Coping(LILAC) to improve the positive affect of women with breast cancer and to examine the effect of improving positive affect on QoL. Methods:One hundred and five women with breast cancer who received surgery within two weeks were randomly assigned to intervention group and wait-list group. The intervention group received health education of breast cancer and LILAC for five months with a session per month. The wait-list group only received health education of breast cancer. The two groups completed the Positive and Negative Affect Scale(PANAS) and Functional Assessment of Cancer Therapy for Breast Cancer(FACT-B) before intervention. They also completed the PANAS after the 1 st to the 4 th sessions and received test of PANAS, FACT-B after the fifth session. The mixed linear model of repeated measures was used to compare the change of PA, NA and QoL prior and post intervention. The hierarchical regression analysis was used to analyze the impact of change in PA and NA on QoL of women with breast cancer. Results: The positive affect and QoL of women with breast cancer significantly increased after intervention, while negative affect significantly decreased after intervention(p < 0.05). Both change of positive affect and negative affect prior and post intervention had significant effect on the QoL of women with beast cancer(p < 0.05), but the influence of change of positive affect was greater. Conclusions: LILAC effectively improved positive affect and QoL and decreased negative affect among women with breast cancer. Improved positive affect and decreased negative affect have effect on QoL among women with breast cancer, but the influence of improved positive affect was stronger.更多还原