| ObjectivesTo understand the cancer adjustment status of young breast cancer patients after operation,and analyze the influencing factors of cancer adjustment,to provide reference for improving the cancer adjustment level of young breast cancer patients after operation.MethodsUsing a convenient sampling method,292 young patients with breast cancer who were treated in two Grade 3A general hospitals in Qingdao from February to October 2018 were selected as the subjects.The general information questionnaire,M.D.anderson symptom inventor(MDASI-C),social impact scale(SIS),medical coping style questionnaire(MCMQ)and psychosocial adjustment questionnaire for breast cancer were used to investigate the symptom burden,stigma,coping-style and cancer adjustment of 292 patients.The Statistical software of SPSS 21.0 and AMOS 21.0 were used to analyze data.The main statistical analysis methods included: descriptive analysis,independent sample t test,one-way analysis of variance(ANOVA),Pearson correlation analysis,Multivariate linear regression analysis and structural equation model.Results(1)The symptom burden was(2.65±0.34),fatigue(5.32±2.78),numbness(5.21±2.33)and sadness(5.01±2.19)were the most frequent symptoms and had the most serious influence on patients’ general life(3.56±2.47),work or housework(3.21±2.18)and emotion(3.06±1.91).(2)The stigma was(2.52±0.53).The scores from high to low were economic discrimination(3.53±1.05),social isolation(2.55±0.76),internal shame(2.42±0.75)and social exclusion(2.21±0.64).(3)The coping-style score was(2.31±0.27).The scores of each dimension from high to low were yielding coping(2.52±0.58),avoidance coping(2.31±0.57)and confrontation coping(2.17±0.51).(4)The cancer adjustment was(2.83±0.57).The scores from high to low were self-control and self-efficacy(3.21±0.86),attitude(2.98±0.77),belonging(2.90±0.73),anxiety and depression(2.75±0.92),self-esteem and self-acceptance(2.38±0.79).(5)Correlation analysis results show: symptom burden,stigma,avoidance and yield coping were negative correlated with cancer adjustment(r=-0.557~-0.493,P<0.01),there was a positive correlation between confrontation and cancer adjustment(r=0.524,P<0.01).(6)Multivariate regression analysis show: stigma,symptom burden,marital status,surgical method,medical expense payment method,monthly income,living condition,coping-style,fertility demand,pathological stage,sexual life were the influencing factors of cancer adjustment in young breast cancer patients after operation.(7)Structural equation model display: the symptom burden,stigma,avoidance and yield had a direct positive effect on cancer adjustment(β=-0.365~-0.191,P<0.05),confrontation may predict cancer adjustment directly forward positive way(β=0.199,P<0.05).Coping-styles can be used as intermediate variables to regulate the effects of symptom burden and stigma on cancer adjustment,the indirect effects ranged from 37.82%~47.09%.Conclusions1 The cancer adjustment of young breast cancer patients after operation is affected by many factors,such as stigma,symptom burden,marital status,surgical method,medical expense payment method,monthly income,living condition,coping-style,fertility demand,pathological stage,sexual life and so on.2 Symptom burden and stigma of young breast cancer patients after operation have a direct negative effect on cancer adjustment,coping style can be used as an intermediate variable to regulate the effect of symptom burden and stigma on cancer adjustment. |
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