乳腺癌患者诊断早期负性情绪与创伤后成长的纵向研究

摘要

Objectives To investigate the dynamic changes in negative mood and posttraumatic growth (PTG) in early-stage breast cancer (BC) survivors over a 6-month period. Methods Twenty-seven BC patients were selected using a purposive sampling method and completed the follow-up investigation by the Mood and Anxiety Symptom Questionnaire(MASQ) and Posttraumatic Growth Inventory(PTGI) after 1 month, 3 month and 6 months diagnosis. Results Twenty-seven BC patients receiving chemotherapy were selected after 1 month and 3 months, of the total, 19 BC patients completed the final investigation after 6 month diagnosis. The total score of MASQ was 53.03±7.51 in BC survivors at baseline, 57.04±9.09 3 months after diagnosis and 55.84±9.49 half year after diagnosis. The PTGI scores were 58.74±12.56, 58.92±12.35 and 59.68±7.87 at 1 month, 3, and 6 months after diagnosis, respectively. MASQ-AD positively predicted PTGI [Time(2-1)Coefficient=1.53, P<0.01; Time(3-1)Coefficient=1.23, P<0.01]. Conclusion The level of negative mood of BC patients shows an increasing tendency 3 month after diagnosis, but downward trend 6 months after diagnosis. BC survivors experience a low PTG within 6 months after diagnosis. Anhedonia benefits PTG of BC patients to a certain extent.%目的：调查诊断早期（确诊后半年内）乳腺癌患者的负性情绪和创伤后成长心理变化的趋势，并探讨其相互关系，为循证护理提供依据。方法采用心境和焦虑症状问卷-D30和创伤后成长量表，对27例乳腺癌患者于诊断后1个月、3个月和6个月3个时间点进行追踪调查。结果在1个月、3个月时收集了27例患者的信息，而在6个月时收集了19例患者信息，丢失了8例。本组患者心境和焦虑症状总分在1个月、3个月、6个月时总分为（53.03±7.51）分、（57.04±9.09）分、（55.84±9.49）分，3个时间点得分差异无统计学意义（P>0.05）。本组患者创伤后成长评分在1个月、3个月、6个月时分别为（58.74±12.56）分、（58.92±12.35）分、（59.68±7.87）分，3个时间点得分差异无统计学意义（P>0.05）。多层线性分析结果显示：负性情绪的抑郁性快感缺失维度对乳腺癌患者的创伤后成长有正向预测作用[时间点（2-1）系数=1.53，P<0.01；时间点（3-1）系数=1.23，P<0.01]。结论乳腺癌患者在确诊后半年内明显存在痛苦、抑郁和焦虑情绪，创伤后成长不明显。一定程度抑郁性快感缺失对患者的创伤后成长有促进作用。