Alexithymie et créativité des patients cancéreux. Implémenter le modèle transactionnel, intégratif et multifactoriel (TIM)

IF 0.5 4区医学 Q4 PSYCHIATRY

Annales medico-psychologiques Pub Date : 2025-02-01 DOI:10.1016/j.amp.2024.03.007

Marie Lelièvre , Lionel Delpech , Jean-Luc Sudres

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引用次数: 0

Abstract

Background

The number of new cancer cases in France, between 1990 and 2023, has doubled. This disease, or rather a group of diseases, currently ranks as the leading cause of death in France. Nevertheless, ever-improving cancer therapies are prolonging life expectancy with relatively significant consequences for patients’ quality of life (QoL). This concept is defined as the subjective perception that the subject has of his or her own state of physical, psychological, and social health… Widely studied in the field of health psychology, it has been the subject of a number of models. The Transactional, Integrative and Multifactorial model (TIM) presents the links existing between the social and pathogenic (hostility, anxiety, depression…) or salutogenic (optimism, control…) antecedents, and the mediating processes (behavioral, psychophysiological and transactional) that can influence the QoL, but it neglects the impact of emotions and creativity.

Objective

By analyzing correlations, the objective of this exploratory study is to clarify not only the place, but also the nature of alexithymia and creativity within the TIM model in the particular case of the cancer population.

Method

The observed sample consists of 51 hospitalized patients (70.6% women) aged on average 59 years and 9 months (±11.92) in the outpatient oncology department for chemotherapy. The Functional Assessment Cancer Therapy-Fatigue (FACT-F) and the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire-Core 30 (EORTC QLQ-30) were used to assess the subjects’ QoL, fatigue, and pain. The State Trait Anxiety Inventory (STAI) reports their level of anxiety, while the Bermond-Vorst Alexithymia Questionnaire (BVAQ-A) evaluates their alexithymia. For creativity, the Revised Personality Inventory (NEO PI-R) provides an opening score, and the Torrance Test of Creative Thinking (TTCT) assesses divergent thinking (elaboration, fluidity, flexibility, and creativity respectively).

Results

The results reveal the negative and significant links of alexithymia with creativity and QoL as assessed by EORTC QLQ-30 (r = −.38, P = .003) or FACT-F (r = −.30, P = .015). The same phenomenon is observed between anxiety and QoL (r = −.47, P < .01; r = -.62, P < .01, respectively). Negative correlations between alexithymia and QoL (respectively r = −.30, P = .015; r = −.38, P = .003) lead us to consider alexithymia as a trait and thus to place it in the category of the history of disposition within the TIM model for the cancer population. While creativity would be a mediating process in terms of the positive links observed with QoL. These factors lead to the implementation of the expression of emotions through creativity, through therapeutic mediations (music therapy, drama therapy, art therapy) integrated into supportive care in oncology and to measure their impact through therapeutic evaluation with patients. All this while respecting the patient's temporality, his or her medical care, and their consequences in order to consider that an intervention can have a meaningful impact on his or her QoL.

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癌症患者的亚历山大症和创造力。实施交易、整合和多因素（TIM）模式

从1990年到2023年，法国的新癌症病例数翻了一番。这种疾病，或者说是一组疾病，目前是导致法国人死亡的主要原因。然而，不断改进的癌症治疗正在延长预期寿命，对患者的生活质量（QoL）产生相对显著的影响。这一概念被定义为主体对自己的身体、心理和社会健康状态的主观感知……在健康心理学领域得到广泛研究，它已成为许多模型的主题。交易、整合和多因子模型（TIM）呈现了社会和致病（敌意、焦虑、抑郁等）或健康（乐观、控制等）前因与影响生活质量的中介过程（行为、心理生理和交易）之间存在的联系，但忽略了情绪和创造力的影响。目的：通过分析相关性，本探索性研究的目的不仅是阐明在癌症人群的特定情况下，述情障碍和创造力在TIM模型中的位置，而且是性质。方法51例住院肿瘤门诊化疗患者（女性占70.6%），平均年龄59岁9个月（±11.92）。采用功能评估癌症治疗-疲劳量表（FACT-F）和欧洲癌症研究与治疗组织生活质量问卷- core 30量表（EORTC QLQ-30）评估受试者的生活质量、疲劳和疼痛。状态特质焦虑量表（STAI）报告他们的焦虑水平，而Bermond-Vorst述情障碍问卷（BVAQ-A）评估他们的述情障碍。在创造力方面，修订人格量表（NEO PI-R）提供了一个起始分数，托兰斯创造性思维测试（TTCT）评估发散性思维（分别是精细化、流动性、灵活性和创造力）。结果EORTC qq -30评价述情障碍与创造力和生活质量呈显著负相关（r =−）。38, P = .003)或FACT-F (r = -。30, p = .015)。焦虑与生活质量之间也存在同样的现象（r =−）。47、P <；. 01;r = -。62、P <；. 01)。述情障碍与生活质量呈负相关（r =−）。30, p = 0.015；r =−。38, P = .003)使我们将述情障碍视为一种特征，从而将其置于癌症人群的TIM模型中的倾向史类别中。而创造力将是一个中介过程，就与生活质量观察到的积极联系而言。这些因素导致通过创造性、通过治疗性调解（音乐疗法、戏剧疗法、艺术疗法）将情感表达融入肿瘤学的支持性护理，并通过对患者的治疗性评估来衡量其影响。所有这些都要尊重病人的暂时性、他或她的医疗护理及其后果，以便考虑干预措施可以对他或她的生活质量产生有意义的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annales medico-psychologiques 医学-精神病学

CiteScore

1.30

自引率

33.30%

发文量

196

审稿时长

4-8 weeks

期刊介绍： The Annales Médico-Psychologiques is a peer-reviewed medical journal covering the field of psychiatry. Articles are published in French or in English. The journal was established in 1843 and is published by Elsevier on behalf of the Société Médico-Psychologique. The journal publishes 10 times a year original articles covering biological, genetic, psychological, forensic and cultural issues relevant to the diagnosis and treatment of mental illness, as well as peer reviewed articles that have been presented and discussed during meetings of the Société Médico-Psychologique.To report on the major currents of thought of contemporary psychiatry, and to publish clinical and biological research of international standard, these are the aims of the Annales Médico-Psychologiques.