| Objecties:To understand the current situation of menopausal symptoms in breast cancer patients within 1 year after chemotherapy,and to analyze the physiologicalpsychological/envviromeental factors related to menopausal symptoms,and the relationship between menopausal symptoms and quality of life;and to discuss the path of physiological/psychological/environmental factors-menopausal symptoms-quality of life in order to provide the theoretical basis of improving the menopausal symptoms.Methods:Two hundred and eight breast cancer patients from one tertiary hospital of Shandong Province were selected.The survey tools indluded General Informati,on Questionnaire,Menopaushe Rating Scale,Insomnia Severity Index,indfulness Attention Awareness Scale,Positive and Negative Affect Scales,Illness Perception Questionnaire,Perceived Social Support Scale and Eight-Item Short-Form Health Survey.SPSS25.0 software was used for data analysis.The statistical methods included descriptive statistics,Students’t tests,one-way ANOVA analysis,Pearson correlation analysis.And AMOS25.0 software was used for the construction of structural equation model.Results1.Basic information on breast cancer patients within one year after chemo-therapyThe age distribution of 208 breast cancel patients after chemotherapy in this study was 30～70 years,with an average age of(46.27±9.62)years.Among them,41.3%were<45 years old,58.7%were>45 years old;92.8%were married;55.3%lived in towns;37.0%were farming;51.0%had upper secondary education and above;68.8%had a balanced income;40.9%patients’ BMI was<24;76.4%patients’waist-to-hip ratio was<0.85;54.3%had no/less exercise;51.9%of lesions were located on the right side;pathological stage for Ⅰ-Ⅱ accounted for 69.2%,and 30.8%for the Ⅲ-Ⅳ period;the course of 63.5%was<12 months,and 36.5%was>12 months;66.8%was within 3 months after chemotherapy;42.3%received three treatments;The average menstrual cycle was(28.58±2.47)days;79.3%had menarche aged from 13 to 16 years;53.8%did not have treatment-induced menopause;77.9%were in peri-menopausal period.2.The status of menopausal symptoms in breast cancer patients within one year after chemotherapyThe total scores of menopaus.al symptoms in breast cancer patients was(6.15±5.75),and the incidence rate was 50.0%according to a score of>5 as a cut-off value for having menopausal symptoms.The average scores of the three sub-dimensions of menopausal symptoms were physical symptoms(2.75 ± 2.25),psychological symptoms(2.37±3.16),and urogenital symptoms(1.02±1.70)in descending order.The results of independent sample t-test and one-way analysis of variance showed that the total scores of menopausal symptoms and its three sub-dimensions were not statistically different in the sociodemographic and clinical characteristics of patients(Ps>0.05).3.Analysis of physiological/psychological/environm ental factors associated with menopausal symptoms in breast cancer patients within one year after chemotherapy The scores of insomnia symptom,positive affect,negative affect,illness perception and social support in breast cancer patients within 1 year after chemotherapy were(2.5±2.60),(30.42±6.07),(21.59±5.92),(35.14±10.73),(66.51±10.73),respectively,and family support,friend support,and other support srcores were(23.48±3.64)、(21.22±4.63)、(21.82±3.93),respectively.As for quality of life,the scores were(70.10±17.20)in the physical health dimension and(67.30±14.83)in the mental health dimension.Pearson correlation analysis showed that menopausal symptoms and its sub-dimensions(physical symptoms,psychological symptoms.urogenital symptoms)scores were all positively correlated with insomnia symptoms(r=0.19～0.694,Ps<0.001),illness perception(r=0.194,P<0.01),and negative affect(r=0.267,P<0.001).There was a negative association with mindfulness,social support,family support,and friend support(r=-0.139～0.247,Ps<0.05).Menopausal symptom scores were not correlated with positive affect or other suplport(P>0.05).All variables except general information were cenntralized,and then menopausal symptoms were taken as the dependent variable in regression analysis;and six physiological-psycho-social factors including insomnia symptoms,illness perception,mindfulness,positive affect,negative affect and social support were put into the first layer;all the two-two interactions of these six factors were put into the second layer,and all the three-three interactions were put into the third layer.The results showed that insomnia symptoms could positively predict menopausal symptoms(β=0 390,P<0.001),additionally,mindfulness and insomnia symptoms×sociial support could negatively predict menopausal symptoms(β=-0.18.3,-0.186,Ps<0.0.001).4.Analysis of the relationship between menopausal symptoms and quality of life in breast cancer patients within one year after chemotherapyThe physical and mental health dimensions of qualty of life wre negatively correlated with menopausal symptoms(r=-0.202,-0.227,P<0.001).Linear regression showed that the total score of menopausal symptoms had a negative predictive effect on quality of life(β=-0.202,-0.227,P<0.05).5.Analysis of physiologi cal/psychological/environmental factors-menopanse symptoms-quality of life by using structural equation model in breast.cancer patients based on unpleasant symptoms theoryThe structural equation model of physiological/psychological/environm ental factors-menopausal symptoms-quality-of-life based on unpleasant symptoms theory was fit in breast cancer patients(fitting inde×es:χ2/df=2.163,GFI=0.961,AGFI=0.887、TLI=0.889、CFI=0.953、RMSEA=0.075).The results showed that insomnia symptoms could positively predict menopausal symptoms(β=0.712,P<0.001)and mindfulness,insomnia × social support,negative affect × social support could predict menopausal symptoms negatively(β=-0.115,-0.712,-0.712,Ps<0.05),and menopausal symptoms could negatively predict quality of life(β=-0.287,P<0.05).Conelnuion:1.The incidence of menopausal symptoms in breast cancer patients within one year aftter chemotherapy is higher,reaching 50%,of which physical symptoms were most obvious;2.Insomnia,mindfulness,social support,insomnia symptoms × social support,mindfulness,negative affect × social support were predictors of menopausal symptoms in breast cancer patients within one year after chemotherapy;3.Menopausal symptoms of breast cancer patients within one year after chemotherapy were an important predictor of quality of life;4.The structural equation model of physiological/psychological/environmental factors-menopausal symptoms-quality of life based on unpleasant symptoms theory was applicable in breast cancer population within one year after chemotherapy,which could provide a theoretical basis for improving the menopausal symptoms of this population. |
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