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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

乳腺癌患者癌症复发恐惧影响因素的Meta分析

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   

  1. 1.兰州大学护理学院,甘肃 兰州 730000;
    2.平凉市华亭市第二人民医院,甘肃 平凉 744100;
    3.甘肃省人民医院妇科,甘肃 兰州 730000
  • 收稿日期:2021-04-23 出版日期:2021-07-25 发布日期:2021-08-05
  • 通讯作者: 王艳红(1979-),女,甘肃武威人,博士学历,副教授,硕士研究生导师。E-mail:yanhongwang@lzu.edu.cn
  • 作者简介:刘瑾(1997-),女,甘肃庆阳人,本科学历,硕士研究生在读,护士。
  • 基金资助:
    国家自然科学基金项目(71804064)

Influence Factors of Cancer Recurrence Fear in Breast Cancer Patients:A Meta-analysis

LIU Jin1, LU Na2, ZHANG Feng-wa3, NIU Xiao-dan1, YUAN Rong-jing1, LI Wen-yan1, WANG Ye-tong1, WANG Yan-hong1   

  1. 1. School of Nursing, Lanzhou University, Lanzhou 730000, China;
    2. The Second Hospital of Huating City, Pingliang 744100,China;
    3. Dept. of Gynecology, Gansu Provincial People';s Hospital, Lanzhou 730000, China
  • Received:2021-04-23 Online:2021-07-25 Published:2021-08-05

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。

关键词: 乳腺癌, 复发恐惧, 影响因素, Meta分析

Abstract: Objective To systematically evaluate the influence factors of fear of cancer recurrence in breast cancer patients through Meta-analysis. Methods We searched databases of PubMed, Web of Science, Cochrane Library, Embase, CINAHL Complete, CNKI, CBM, VIP, Wanfang by computer and with manual retrieval from the inception to March 2021. Two reviewers independently screened the literature, extracted the data, and evaluated the quality. R 4.0.2 software was used to perform meta-analysis on the literature that met the inclusion criteria. Results A total of 20 pieces of literature were included, with a total sample size of 6,374 cases. Through meta-analysis, the combined R-value of influence factors was age (r=-0.162, 95%CI: -0.268~-0.057); age at diagnosis (r=-0.313, 95%CI: -0.362~-0.264); per capita of family income (monthly)(r=-0.174,95%CI:-0.229~-0.119); tumor stage (r=0.243, 95%CI: 0.156~0.330); negative emotion (r=0.609, 95%CI: 0.494~0.724); emotional representation (r=0.492, 95%CI: 0.359~0.624);social support(r=-0.237, 95%CI: -0.345~-0.128); resignation(r=0.529, 95%CI:0.386~0.674). Conclusion Demography characteristics [age, age at diagnosis, per capita of family income (monthly)], disease-related factors (tumor stage), negative emotion, emotional representation, social support, coping style ( resignation) are the main influencing factors of fear of cancer recurrence in breast cancer patients. It is necessary to strengthen the screening of the above-mentioned psychological factors in breast cancer patients, so as to provide personalized intervention, and reduce the occurrence of fear of cancer recurrence and the level of fear of cancer recurrence in patients.

Key words: breast cancer, fear of recurrence, influencing factor, Meta-analysis

中图分类号: 

  • R473.73
[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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