Trajectory and predictors of psychological distress and posttraumatic growth among rectal cancer patients undergoing combined modality treatment: An exploratory prospective study.

IF 2.3 2区 心理学 Q2 PSYCHIATRY
Agata Benfante, Valentina Tesio, Pierfrancesco Franco, Annunziata Romeo, Francesca Arcadipane, Giuseppe Carlo Iorio, Sara Bartoncini, Lorys Castelli
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Abstract

Objective: This exploratory prospective cohort study aimed to investigate the trajectory of psychological distress and posttraumatic growth (PTG) in rectal cancer patients from diagnosis to follow-up and to explore factors that could predict PTG and psychological distress at follow-up.

Method: We assessed psychological distress (anxiety and depression), PTG, physical symptoms, quality of life, cancer-related coping, state and trait affectivity, resilience, and alexithymia in 43 rectal cancer patients, M (SD) age: 61.6 (12.6); 67.4% men, after diagnosis (T0), after preoperative radiochemotherapy (T1), after surgical resection (T2), and 1 year after surgery (T3, follow-up).

Results: Psychological distress, especially anxiety symptoms, showed a significant reduction between T0 and T1 (p < .001), which increased again between T1 and T2 (p = .048). PTG showed a progressive increase, with a significant increase between T2 and T3 (p < .001). The exploratory hierarchical multiple regression analyses showed that low positive state affectivity (p = .005) and high health anxiety (p = .007) at T1 and high negative state affectivity (p = .012) at T3 were significant predictors of psychological distress at follow-up. Higher levels of PTG at T1 (p < .001) and greater use of adaptive coping styles of Fighting Spirit at T0 (p = .009) and Fatalism at T1 (p = .031) were significant predictors of PTG at follow-up.

Conclusions: The (fluctuating and linear, respectively) trajectories of psychological distress and PTG seem to be related to the psychological reactions to the different treatment phases, especially diagnosis and preoperative treatment. Data suggest the need to implement psychological screening and tailored support programs aimed at fostering PTG and reducing psychological distress from the earliest phases of cancer treatment. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

接受综合治疗的直肠癌患者的心理困扰和创伤后生长的轨迹和预测因素:一项探索性前瞻性研究。
目的:本探索性前瞻性队列研究旨在探讨直肠癌患者从诊断到随访期间心理困扰和创伤后生长(PTG)的发展轨迹,并探讨影响PTG和创伤后生长的因素。方法:我们评估43例直肠癌患者的心理困扰(焦虑和抑郁)、PTG、身体症状、生活质量、癌症相关应对、状态和特质情感、恢复力和述情障碍,M (SD)年龄:61.6 (12.6);67.4%男性,诊断后(T0)、术前放化疗后(T1)、手术切除后(T2)、术后1年(T3,随访)。结果:心理困扰,尤其是焦虑症状在T0和T1之间显著减少(p < 0.001),在T1和T2之间再次增加(p = 0.048)。PTG呈进行性升高,T2和T3间显著升高(p < 0.001)。探索性层次多元回归分析显示,T1时低积极状态情感(p = 0.005)、高健康焦虑(p = 0.007)和T3时高消极状态情感(p = 0.012)是随访时心理困扰的显著预测因子。T1时较高的PTG水平(p < 0.001),以及T1时更多使用斗志(p = 0.009)和宿命论(p = 0.031)的适应性应对方式是随访时PTG的显著预测因子。结论:心理困扰和PTG的轨迹(分别为波动和线性)似乎与不同治疗阶段,特别是诊断和术前治疗的心理反应有关。数据表明,需要实施心理筛查和量身定制的支持计划,旨在培养PTG,减少癌症治疗早期的心理困扰。(PsycInfo Database Record (c) 2025 APA,版权所有)。
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
CiteScore
11.20
自引率
3.20%
发文量
427
期刊介绍: Psychological Trauma: Theory, Research, Practice, and Policy publishes empirical research on the psychological effects of trauma. The journal is intended to be a forum for an interdisciplinary discussion on trauma, blending science, theory, practice, and policy. The journal publishes empirical research on a wide range of trauma-related topics, including: -Psychological treatments and effects -Promotion of education about effects of and treatment for trauma -Assessment and diagnosis of trauma -Pathophysiology of trauma reactions -Health services (delivery of services to trauma populations) -Epidemiological studies and risk factor studies -Neuroimaging studies -Trauma and cultural competence
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