护理学报 ›› 2021, Vol. 28 ›› Issue (14): 1-7.doi: 10.16460/j.issn1008-9969.2021.14.001
• 研究生园地 • 下一篇
刘瑾1, 路娜2, 张凤娃3, 牛晓丹1, 袁蓉敬1, 李雯艳1, 王叶同1, 王艳红1
LIU Jin1, LU Na2, ZHANG Feng-wa3, NIU Xiao-dan1, YUAN Rong-jing1, LI Wen-yan1, WANG Ye-tong1, WANG Yan-hong1
摘要: 目的 通过Meta分析,系统评价乳腺癌患者癌症复发恐惧的影响因素。方法 计算机检索PubMed、Web of Science、Cochrane Library、Embase、CINAHL Complete、CNKI、CBM、VIP、Wanfang 中外数据库,并辅助以人工检索,检索时限均从建库至2021年3月。由2位评价者独立筛选文献、提取资料和质量评价,采用R 4.0.2软件对符合纳入条件的文献进行Meta分析。结果 共纳入文献20篇,总样本量为6 374例,经Meta分析,影响因素合并r值分别为:年龄(r=-0.162,95%CI:-0.268~-0.057);确诊时年龄(r=-0.313,95%CI:-0.362~-0.264);家庭人均月收入(r=-0.174,95%CI:-0.229~-0.119);肿瘤分期(r=0.243,95%CI:0.156~0.330);负性情绪(r=0.609,95%CI: 0.494~0.724);情绪表征(r=0.492,95%CI:0.359~0.624);社会支持(r=-0.237,95%CI:-0.345~-0.128);屈服(r=0.529,95%CI:0.386~0.674)。结论 人口学特征(年龄、确诊时年龄、家庭人均月收入)、疾病相关因素(肿瘤分期)、负性情绪、情绪表征、社会支持、应对方式(屈服)是乳腺癌患者癌症复发恐惧的主要影响因素,今后要加强对乳腺癌患者进行上述有关恐惧等心理现状的筛查,以期为乳腺癌患者提供个性化的干预,减少癌症复发恐惧的发生,降低患者已有的癌症复发恐惧水平。
中图分类号:
[1] Lebel S, Ozakinci G, Humphris G, et al.From Normal Response to Clinical Problem: Definition and Clinical Features of Fear of Cancer Recurrence[J]. Supportive Care Cancer, 2016, 24(8):3265-3268. DOI:10.1007/s00520-016-3272-5. [2] Deniz O, Tas AF.An Investigation of the Relationship Between Social Support and Coping with Stress in Women with Breast Cancer[J]. Psycho-Oncology, 2018, 27(9):2214-2219. DOI:10.1002/pon.4798. [3] Lu Q, Yeung N, Man J, et al.Ambivalence Over Emotional Expression, Intrusive Thoughts, and Posttraumatic Stress Symptoms Among Chinese American Breast Cancer Survivors[J]. Supportive Care Cancer, 2017, 25(10):3281-3287. DOI:10.1007/s00520-017-3744-2. [4] Ellegaard M, Grau C, Zachariae R, et al.Fear of Cancer Recurrence and Unmet Needs among Breast Cancer Survivors in the First Five Years. A Cross-Sectional Study[J]. Acta Oncol, 2017, 56(2):314-320. DOI:10.1080/0284186X.2016.1268714. [5] Lisy K, Langdon L, Piper A, et al.Identifying The Most Prevalent Unmet Needs of Cancer Survivors in Australia: A Systematic Review[J].Asia Pac J Clin Oncol, 2019, 15(5):e68-e78. DOI:10.1111/ajco.13176. [6] 曾宪涛, 刘慧, 陈曦,等. Meta分析系列之四:观察性研究的质量评价工具[J]. 中国循证心血管医学杂志, 2012, 4(4):297-299. DOI:10.3969/j.1674-4055.2012.04.004. [7] Stang A .Critical Evaluation of the Newcastle-ottawa Scale for the Assessment of the Quality of Nonrandomized Studies in Meta-analyses[J]. Eur J Epidemiol, 2010, 25(9):603-605. DOI:10.1007/s10654-010-9491-z. [8] 李康,贺佳.医学统计学[M].7版.北京:人民卫生出版社,2018:121-122. [9] 叶春丽, 谢小玲, 罗美莲,等. 乳腺癌术后患者癌症复发恐惧与疾病不确定感,社会支持的相关性[J]. 解放军护理杂志, 2019,36(11):23-26.DOI:10.3969/j.issn.1008-9993.2019.11.006. [10] 胡泽伟, 王哲, 余丹妮,等. 乳腺癌术后患者癌症复发恐惧现状及影响因素分析[J]. 护士进修杂志, 2019, 34(7):85-88. DOI:10.16821/j.cnki.hsjx.2019.07.023. [11] 张蓉, 张静. 乳腺癌术后化疗病人恐惧疾病进展心理及其影响因素分析[J].蚌埠医学院学报,2019, 44(11):1545-1548. DOI:10.13898/j.cnki.issn.1000-2200.2019.11.030. [12] 蔡建平, 郭冰洁, 江子芳. 乳腺癌患者复发恐惧现状及影响因素分析[J]. 护理学报, 2018, 25(21):5-8. DOI:10.16460/j.issn1008-9969.2018.21.005. [13] 张阳, 程春燕, 崔盼盼,等. 乳腺癌患者癌症复发恐惧现状及其影响因素分析研究[J]. 中国全科医学,2018,575(20):2479-2483.DOI:10.3969/j.issn.1007-9572.2018.00.075. [14] 张阳, 田丽, 王盼盼,等. 乳腺癌患者癌症复发恐惧及影响因素分析[J]. 广东医学, 2017, 38(23):3658-3661. DOI:10.13820/j.cnki.gdyx.2017.23.024. [15] 张贤贤, 张利霞, 贾智慧,等. 康复期青年乳腺癌患者复发恐惧现状及影响因素研究[J]. 护理学杂志, 2019, 34(18):80-83. DOI:10.13820/j.cnki.gdyx.2017.23.024. [16] 江丽玲, 王建宁, 李立群,等. 110例乳腺癌女性患者健康素养与癌症复发恐惧的相关性研究[J]. 护理学报, 2020(14):26-29. DOI:10.16460/j.issn1008-9969.2020.14.026. [17] 张洪莉, 赵雅玲, 郝正玮,等. 乳腺癌术后患者应对方式与其自我管理行为及复发恐惧的相关性[J].现代临床护理, 2016, 15(12):1-4. DOI:10.3969/j.issn.1671-8283.2016.12.001. [18] 王佳佳,方艳春,王蓉,等.心理资本在乳腺癌患者知觉压力与癌症复发恐惧间的中介效应[J].护理学杂志,2021,36(1):76-79.DOI:10.3870/j.issn.1001-4152.2021.01.076. [19] 吕展杨,蔡建平,江子芳,等.乳腺癌患者恐惧疾病进展及影响因素研究[J].护理管理杂志,2020,20(7):466-470. DOI:10.3969/j.issn.1671-315x.2020.07.003. [20] Ziner KW, Sledge GW, Bell CJ, et al.Predicting Fear of Breast Cancer Recurrence and Self-efficacy in Survivors by Age at Diagnosis[J]. Oncology Nursing Forum, 2012, 39(3):287-295. DOI:10.1188/12.ONF.287-295. [21] Thewes B, Bell ML, Butow P,et al.Psychological Morbidity and Stress But Not Social Factors Influence Level of Fear of Cancer Recurrence in Young Women with Early Breast Cancer:Results of a Cross-sectional Study[J]. Psychooncology, 2013, 22(12):2797-2806. DOI:10.1002/pon.3348. [22] Niu LS, Liang YC, Niu M, Factors Influencing Fear of Cancer Recurrence in Patients with Breast Cancer: Evidence from a Survey In Yancheng, China[J]. J Obstet Gynaecol, 2019, 45(7):1319-1327. DOI:10.1111/jog.13978. [23] Liu Y, Pérez M, Schootman M, et al.Correlates of Fear of Cancer Recurrence in Women with Ductal Carcinoma in Situ and Early Invasive Breast Cancer[J]. Breast Cancer Res Treat, 2011, 130(1):165-173. DOI:10.1007/s10549-011-1551-x. [24] van den Beuken-van Everdingen MH,Peters ML, de Rijke JM, et al. Concerns of Former Breast Cancer Patients About Disease Recurrence: A Validation and Prevalence Study[J]. Psychooncology,2008,17(11):1137-1145. DOI:10.1002/pon.1340. [25] Freeman-Gibb LA, Janz NK, Katapodi MC, et al.The Relationship Between Illness Representations, Risk Perception and Fear of Cancer Recurrence in Breast Cancer Survivors[J]. Psycho-Oncology, 2017, 26(9):1270-1277. DOI:10.1002/pon.4143. [26] Gormley M, Knobf T, Vorderstrasse A, et al.Exploring the Effects of Genomic Testing on Fear of Cancer Recurrence among Breast Cancer Survivors[J]. Psycho-Oncology, 2021, 48(2):11-12. DOI:10.1002/pon.5679. [27] Mehnert A, Berg P, Henrich G, et al.Fear of Cancer Progression and Cancer-related Intrusive Cognitions in Breast Cancer Survivors[J]. Psycho-oncology, 2010, 18(12):1273-1280. DOI:10.1002/pon.1481. [28] Halbach SM, Enders A, Kowalski C, et al.Health Literacy and Fear of Cancer Progression in Elderly Women Newly Diagnosed with Breast Cancer—A Longitudinal Analysis[J]. Patient Educ Couns, 2016, 99(5):855-862. DOI:10.1016/j.pec.2015.12.012. [29] Nakata H, Halbach S, Geiser F, et al.Health Literacy, Mental Disorders and Fear of Progression and Their Association with a Need for Psycho-oncological Care Over The Course of a Breast Cancer Treatment[J]. Psychol Health Med,2020(40):1-14.DOI:10.1080/13548506.2020.1772987. [30] Simard S, Savard J.Screening and Comorbidity of Clinical Levels of Fear of Cancer Recurrence[J]. [J] Cancer Surviv. 2015, 9(3):481-491. DOI:10.1007/s11764-015-0424-4. [31] Soylu C, Babacan T, Sever AR, et al.Patients'; Understanding of Treatment Goals and Disease Course and Their Relationship with Optimism, Hope, and Quality of Life: A Preliminary Study Among Advanced Breast Cancer Outpatients Before Receiving Palliative Treatment[J]. Supportive Care in Cancer,2016,24(8):3481-3488.DOI:10.1007/s00520-016-3182-6. [32] Okubo R, Kinoshita T, Katsumata N, et al.Impact of Chemotherapy on the Association Between Fear of Cancer Recurrence and the Gut Microbiota in Breast Cancer Survivors-Science Direct[J]. Brain Behav Immun, 2020, 85:186-191. DOI:10.1016/j.bbi.2019.02.025. [33] Soriano EC, Pasipanodya EC, Losavio ST, et al.Social Constraints and Fear of Recurrence in Couples Coping with Early Stage Breast Cancer[J]. Health Psychol, 2018, 37(9):874-884. DOI:10.1037/hea0000649. [34] 徐华. 复发转移乳腺癌患者住院期间心理情绪变化的研究[J]. 中国民康医学, 2013, 25(22):64. DOI:10.3969/j.issn.1672-0369.2013.22.050. [35] Rozema H, Völlink T, Lechner L.The Role of Illness Representations in Coping and Health of Patients Treated for Breast Cancer[J]. Psychooncology, 2009,18(8):849-857. DOI:10.1002/pon. [36] Yang L, Song WP, Chen ZL, et al.Correlation Between Social Support and Quality of Life in Patients with Breast Cancer at Different Periods of Treatment[J]. Zhonghua zhong liu za zhi, 2017, 39(3):202-206. DOI:10.3760/cma.j.issn.0253-3766.2017.03.009. [37] Kizuki M, Fujiwara T.Adult Attachment Patterns Modify the Association Between Social Support and Psychological Distress[J]. Front Public Health, 2018,6:249.DOI:10.3389/fpubh.2018.00249. |
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