职业和经济收入对乳腺癌妇女心理障碍影响的研究

像乳腺癌这样疾病的诊断与治疗 ,无疑会使人产生负性心理应激反应和精神障碍 ,因为患了乳腺癌 ,不但生命受到了威胁 ,而且女性所具有的典型特征也遭到了损害[1 ] 。然而 ,乳腺癌所造成的心理影响和冲击 ,却因人而异。依患者年龄、疾病性质和经济收入、以及接受的治疗措施和受教育程度、婚姻状况及人格特征和实际生活经历、社会与家庭关系和患者的心理及精神历史的不同而各异[2 ] ;与个人的应对能力和方式的不同而差别很大[3] ;与个体所接受的社会支持网络系统和医疗服务水平的不同而不同[4 ] 。据研究 ,在乳癌诊断治疗的头两年内 ,约有 1 / …     

乳腺癌患者“创伤后成长”的研究进展

近年来,乳腺癌的发病率不断上升,乳腺癌已逐渐成为危害女性健康的首位恶性肿瘤。手术给患者的身心带来很大伤害,但研究者发现,在与乳腺癌这一疾病做斗争的过程中患者会产生一种正向的心理变化,这就是积极心理学领域研究的创伤后成长。本文从创伤后成长内涵、国内外研究现状、测量工具、影响因素、干预方法等几方面对乳腺癌创伤后成长研究现状进行文献综述,为乳腺癌患者心理护理提供依据。     

异位妊娠保守治疗患者的心理特点和影响因素分析

观察异位妊娠保守治疗患者的心理特点及其影响因素。选取海南省三所医院中在妇科住院的异位妊娠保守治疗患者80例,采用一般情况问卷和状态特质焦虑量表(STAI)对患者的心理特点和影响因素进行分析。患者入院时的状态焦虑(S-AI)水平高于正常人(P0.05),多元线性回归分析结果显示,患者产生焦虑情绪与婚姻、生育史、有无子女、经济状况有关。异位妊娠保守治疗患者焦虑情绪的产生是生理、心理以及社会等方面的综合因素造成,而心理问题的准确评估是优选心理护理对策的前提,为心理干预的实施奠定了基础。     

心理韧性模型在乳腺癌患者中的构建及应用

根据Shift-Persist模型以及Kumpfer理论,探讨乳腺癌患者心理韧性模型(RM-BC)的构建。采用潜变量结构方程(SEM)对420名乳腺癌患者的心理韧性进行因子分析。RM-BC识别了3个主要的风险因子,分别是情绪困扰(焦虑、抑郁、疾病不确定感)、生理困扰(疼痛、呕吐、疲倦)以及侵入性想法;4个主要的保护因素是积极应对方式、自我效能、社会支持以及对未来的希望,共能解释乳腺癌患者67%的心理韧性变异以及54%的自我超越变异量,该模型增加了我们对乳腺癌患者心理韧性结构的理解,可以为今后其他的干预措施提供借鉴。     

异位妊娠保守治疗患者的心理特点和影响因素分析

观察异住妊娠保守治疗患者的心理特点及其影响因素.选取海南省三所医院中在妇科住院的异位妊娠保守治疗患者80例,采用一般情况问卷和状态特质焦虑量表(STAI)对患者的心理特点和影响因素进行分析.患者入院时的状态焦虑(S-AI)水平高于正常人(P＜0.05),多元线性回归分析结果显示,患者产生焦虑情绪与婚姻、生育史、有无子女、经济状况有关.异位妊娠保守治疗患者焦虑情绪的产生是生理、心理以及社会等方面的综合因素造成,而心理问题的准确评估是优选心理护理对策的前提,为心理干预的实施奠定了基础.     

早期乳腺癌患者术后心理状况研究

早期乳腺癌的检出率越来越高,关注治愈率同时,人们越来越关心患者术后的心理状态及生活质量.本文对保乳术及根治术后5年患者进行心理调查.保乳组患者术后心理障碍发生率明显低于根治组.保乳组患者术后心理状况影响因素主要为术后美容效果,而根治组患者心理障碍发生率与年龄、职业、家庭收入相关.两种手术方式对患者5年生存率及无病生存率的影响无明显差异,所以对于早期乳腺癌患者,在符合保乳原则的前提下,保乳手术是一种既安全又能提高生活质量的手术方式.     

性病诊治中医疗告知的伦理学因素探讨

随着我国社会的日趋开放,性病发病率逐年升高。性病是一组特殊的疾病,不仅是生物医学问题,更包含着复杂的社会心理问题,不但对患者本人造成伤害,还给社会和家庭带来许多问题。性病涉及患者的名誉、隐私、家庭关系等伦理因素,医师在临床诊治过程中,如何有效履行告知义务,既让患者充分了解病情,又不加重患者心理负担,不影响其人际关系是一个值得探讨的问题。     

综合医院常见心理问题的行为干预

综合医院常见心理问题的行为干预上海医科大学中山临床医学院（２０００３２）季建林在综合性医院工作的临床各科医师经常会遇到一些患躯体疾病的人同时伴有一定程度的心理或情绪问题（如焦虑和抑郁等）;另外,一定的心理社会因素往往对部分病人的躯体疾病发生、发展及预...     

变性术后患者心理状况的影响因素分析及对策

变性术后的患者是个特殊的弱势群体,心理问题非常突出,它是生理、个人、家庭、社会等多种因素交互影响的结果;因此,通过社会、家庭及个体的共同努力,帮助其建立良好的个体心理模式,稳定其心理状态,可促进其心理的健康发展,这对于变性手术的成功和帮助变性后患者重新走向社会有重要意义。     

中华医学会第十一届心身医学学术年会暨第六届全国心理、心身、整体护理学术研讨会征文通知

中华医学会第十一届心身医学学术年会暨第六届全国心理、心身、整体护理学术研讨会 ,根据中华医学会 2 0 0 2年学术计划 ,将于 2 0 0 2年 10月中旬在广州召开。会议主题为 :心身疾病的诊断、治疗、护理、预防研究。现将征文的有关事宜通知如下 :1 征文内容1 1　各种心身障碍与心身疾病流行病学调查与研究 ;1 2　亚健康或次健康发生原因及其心身问题和心身障碍的研究 ;1 3　各种心身疾病的致病因素与致病关系的共性和个性差异研究 ;1 4　各种疾病的病前心理问题与病后的心理问题对原发病和继发病的影响 ;1 5　心血管疾病的心身问题 (包括高血…     

Health-Related Quality of Life in Iranian Breast Cancer Survivors: A Qualitative Study

Women play the most important role in Iranian families. Therefore, it is necessary to pay attention to efforts to maintain and promote their health. The diagnosis and treatment of breast cancer have significant physical and psycho-social impacts on patients, families and friends. This qualitative study was designed to analyze the role of several social and cultural factors and their relationship to health-related quality of life among Iranian breast cancer survivors. In-depth semi-structured and unstructured face-to-face interviews were conducted with 39 breast cancer survivors. The results of the present study revealed that most prevalent physical problems that were reported by Iranian breast cancer survivors were fatigue, pain and lymphedema related to the adverse effects of mastectomy. We found that most participants have a strong sense of spirituality and used this as a source of psychological support to help them accept their disease. Spirituality has been found to be a strong source of psychological support among Iranian breast cancer survivors. Religious faith has provided this community the strength and motivation to seek medical treatment and to be patient and relax. These findings can help researchers to provide a framework for the development of appropriate and effective culturally sensitive health interventions.     

Negative support of significant others affects psychological adjustment in breast cancer patients

Significant others play an important role in providing support in patients’ lives, but some types of support negatively affect the patients. This study was conducted in early-stage breast cancer patients to examine the structure of support, which was provided by their significant others and assessed negatively by the patients, and to identify negative support relating to the psychological adjustment of these patients. Thus, we first conducted interviews among 28 breast cancer patients to identify these support items assessed as negative; next, we conducted a questionnaire survey using the resulting items in 109 postoperative patients who had early-stage breast cancer. We performed exploratory and confirmatory factor analyses and obtained a valid second-order factor structure, including superordinate factors (excessive engagement, avoidance of problems and underestimation) and subordinate factors (overprotection, encouragement and management). Among these factors, the avoidance of problems was the only factor to be negatively associated with psychological adjustment of the patients, suggesting that these patients receive problem-avoiding support. The results of our study suggest that such problem-avoiding support from significant others can be counter-productive and potentially worsen the psychological adjustment of breast cancer patients.     

Negative support of significant others affects psychological adjustment in breast cancer patients

Significant others play an important role in providing support in patients' lives, but some types of support negatively affect the patients. This study was conducted in early-stage breast cancer patients to examine the structure of support, which was provided by their significant others and assessed negatively by the patients, and to identify negative support relating to the psychological adjustment of these patients. Thus, we first conducted interviews among 28 breast cancer patients to identify these support items assessed as negative; next, we conducted a questionnaire survey using the resulting items in 109 postoperative patients who had early-stage breast cancer. We performed exploratory and confirmatory factor analyses and obtained a valid second-order factor structure, including superordinate factors (excessive engagement, avoidance of problems and underestimation) and subordinate factors (overprotection, encouragement and management). Among these factors, the avoidance of problems was the only factor to be negatively associated with psychological adjustment of the patients, suggesting that these patients receive problem-avoiding support. The results of our study suggest that such problem-avoiding support from significant others can be counter-productive and potentially worsen the psychological adjustment of breast cancer patients.     

Pathways for psychological adjustment in breast cancer: A longitudinal study on coping strategies and posttraumatic growth

This longitudinal study examined the role of coping strategies and posttraumatic growth (PTG) on the psychological adjustment to breast cancer trajectory. The participants were 50 women assessed at the time of surgery (T1), during adjuvant treatment (T2) and six months after the end of treatment (T3). Women completed questionnaires assessing coping strategies, PTG and psychological adjustment (psychological quality of life, anxiety and depression). Results showed that the greatest impact of breast cancer on women's adjustment occurred at T1, when patients were significantly more anxious than in the other phases of the disease. The type of surgery and adjuvant treatment did not account for the course of PTG and adjustment. Coping through seeking social support and using cognitive strategies at T1 were linked to psychological quality of life and depression at T3 via PTG dimension of personal resources and skills at T2. Findings emphasise the value of promoting adaptive coping strategies and PTG in order to improve psychological adjustment in breast cancer patients.     

Pathways for psychological adjustment in breast cancer: A longitudinal study on coping strategies and posttraumatic growth

This longitudinal study examined the role of coping strategies and posttraumatic growth (PTG) on the psychological adjustment to breast cancer trajectory. The participants were 50 women assessed at the time of surgery (T1), during adjuvant treatment (T2) and six months after the end of treatment (T3). Women completed questionnaires assessing coping strategies, PTG and psychological adjustment (psychological quality of life, anxiety and depression). Results showed that the greatest impact of breast cancer on women's adjustment occurred at T1, when patients were significantly more anxious than in the other phases of the disease. The type of surgery and adjuvant treatment did not account for the course of PTG and adjustment. Coping through seeking social support and using cognitive strategies at T1 were linked to psychological quality of life and depression at T3 via PTG dimension of personal resources and skills at T2. Findings emphasise the value of promoting adaptive coping strategies and PTG in order to improve psychological adjustment in breast cancer patients.     

The interface between physical and mental disorders: The need to dismantle the biopsychosocialneuroimmunological model of disease

This article argues for the necessity of cognitive-behavioral assessment for a thorough understanding of how psychological factors mediate disease process across a wide range of diseases including coronary artery disease, breast cancer, and human immunodeficiency disease. Based on empirical data presented as part of the APA Presidential miniconvention, “To Your Health: Psychology through the Life Span,” the conclusion is that psychological treatment can help extend life. Stress management programs can positively influence adherence to treatment regimens and positively influence the human immune system response during the course of treatment and recovery from illness. Even in the face of life-threatening circumstances such as liver transplantation, Stage II and III breast cancer, and after HIV infection has been diagnosed, the quality of life can be remarkably improved. Physicians and psychologists must work together to produce the beneficial effects of the synergy between mind-body processes.     

Breast Cancer in Men: Emasculation by Association?

The occurrence of breast cancer in men is rare in comparison to women. Public knowledge that men can get breast cancer and of male breast self-examination are lacking. Research in the course and treatment of breast cancer in men is needed. Men generally present in more advanced stages of breast cancer than women, and have a poorer prognosis. In this article, the epidemiology, common symptoms, diagnostic methods, and current treatment of breast cancer in men are described. Gender differences in presentation and course of illness are discussed. Additionally, the psychological implications of breast cancer for male gender roles and masculine identity are explored. Directions for further investigation are given. Treatment providers are encouraged to educate themselves and their male patients on breast cancer in men and male breast examination techniques so that this disease may be identified earlier in its course and survival rates improved.     

Body image issues in women with breast cancer

Diagnosis and treatment of breast cancer affects women physically as well as psychologically. There are many obvious and real factors that are related to psychological distress in women coping with breast cancer, such as facing a life-threatening illness, painful and impairing treatments, and significant role changes. Although these factors are clearly important, issues related to body image in women faced with breast cancer can also add to psychological distress. Women, in general, are concerned with their appearance, their weight, and their body, with recent studies suggesting 89% of women reported concerns with weight. Such premorbid concerns are often deeply ingrained and can contribute to psychological distress in women treated for breast cancer. The present article is a summary of the literature that has examined body image issues and related psychological adjustment in women with breast cancer. Implications for clinical practice and recommendations for future investigations are discussed.     

Breast cancer: a manual for a proposed group treatment integrating evidence based resilience factors

The paper presents the structure and content of a manual for a proposed treatment of breast cancer patients in groups. The proposed treatment is structured, time limited, and integrates elements from 1995 work of Spiegel and the Yalom 1995 theory of group therapy as well as empirically derived resilience factors. Addressing the psychological specificity of breast cancer, the overall treatment goals are to help patients to acquire new coping skills for relieving stress, to increase their personal and social competence and their use of available social support, to increase family coherence, to enhance optimism and quality of life, and to help patients develop new values and priorities that comply with their current and future life situation.