Purpose in life and mortality among breast cancer survivors.

IF 3.2 2区心理学 Q1 PSYCHOLOGY

Health Psychology Pub Date : 2025-09-22 DOI:10.1037/hea0001563

Juhua Luo, Stephanie A Hooker, Candyce H Kroenke, Michael Hendryx, Michelle J Naughton, Yu Du, Hilary A Tindle, Tarah J Ballinger, Su Yon Jung, Julie C Weitlauf, Roberto M Benzo, Lihong Qi, Dorothy S Lane, Karen L Margolis

{"title":"Purpose in life and mortality among breast cancer survivors.","authors":"Juhua Luo, Stephanie A Hooker, Candyce H Kroenke, Michael Hendryx, Michelle J Naughton, Yu Du, Hilary A Tindle, Tarah J Ballinger, Su Yon Jung, Julie C Weitlauf, Roberto M Benzo, Lihong Qi, Dorothy S Lane, Karen L Margolis","doi":"10.1037/hea0001563","DOIUrl":null,"url":null,"abstract":"Objective: Purpose in life (PIL), referring to an individual's sense of direction and meaning, may enhance well-being among cancer survivors. However, its relationship with survival remains unclear. This study investigates the association between PIL and mortality among breast cancer survivors and explores potential underlying pathways.Method: We analyzed 3,692 breast cancer survivors from the Women's Health Initiative, a cohort of postmenopausal women aged 50-79 recruited between 1993 and 1998. PIL was assessed in 2012 using a modified seven-item measure from Ryff and Keyes' Psychological Well-Being scale. Breast cancer cases and causes of death were confirmed through medical record review and death certificates. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs), with mediation analysis exploring underlying pathways.Results: Over 9.1 years of follow-up, 1,627 women (44.1%) died. Women in the highest PIL quartile had a 33% lower mortality risk than those in the lowest quartile (HR = 0.67, 95% CI = [0.58, 0.78], p for trend < .0001). Stronger associations were observed among women under 70 (HR = 0.34, 95% CI = [0.19, 0.63]) and those diagnosed within the past year (HR = 0.28, 95% CI = [0.13, 0.58]). Physical activity, low perceived stress, and social engagement mediated 14.2%, 18.3%, and 13.7% of the association, respectively, collectively explaining 51% of the association.Conclusion: Higher PIL is associated with improved survival in breast cancer survivors, with physical activity, stress reduction, and social engagement as key pathways. Goal-oriented interventions promoting PIL may improve survivorship outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).","PeriodicalId":55066,"journal":{"name":"Health Psychology","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Psychology","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1037/hea0001563","RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: Purpose in life (PIL), referring to an individual's sense of direction and meaning, may enhance well-being among cancer survivors. However, its relationship with survival remains unclear. This study investigates the association between PIL and mortality among breast cancer survivors and explores potential underlying pathways.

Method: We analyzed 3,692 breast cancer survivors from the Women's Health Initiative, a cohort of postmenopausal women aged 50-79 recruited between 1993 and 1998. PIL was assessed in 2012 using a modified seven-item measure from Ryff and Keyes' Psychological Well-Being scale. Breast cancer cases and causes of death were confirmed through medical record review and death certificates. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs), with mediation analysis exploring underlying pathways.

Results: Over 9.1 years of follow-up, 1,627 women (44.1%) died. Women in the highest PIL quartile had a 33% lower mortality risk than those in the lowest quartile (HR = 0.67, 95% CI = [0.58, 0.78], p for trend < .0001). Stronger associations were observed among women under 70 (HR = 0.34, 95% CI = [0.19, 0.63]) and those diagnosed within the past year (HR = 0.28, 95% CI = [0.13, 0.58]). Physical activity, low perceived stress, and social engagement mediated 14.2%, 18.3%, and 13.7% of the association, respectively, collectively explaining 51% of the association.

Conclusion: Higher PIL is associated with improved survival in breast cancer survivors, with physical activity, stress reduction, and social engagement as key pathways. Goal-oriented interventions promoting PIL may improve survivorship outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

查看原文本刊更多论文

乳腺癌幸存者的生活目标和死亡率。

目的：生活目的（PIL）是指个体的方向感和意义感，可能会提高癌症幸存者的幸福感。然而，它与生存的关系尚不清楚。本研究调查了PIL与乳腺癌幸存者死亡率之间的关系，并探讨了潜在的潜在途径。方法：我们分析了3,692名来自妇女健康倡议的乳腺癌幸存者，这是一个1993年至1998年间招募的年龄在50-79岁的绝经后妇女队列。PIL于2012年使用Ryff和Keyes心理健康量表修改的七项测量方法进行评估。通过医疗记录审查和死亡证明确认乳腺癌病例和死亡原因。Cox比例风险模型用于计算风险比（hr）和95%置信区间（ci），并通过中介分析探索潜在的途径。结果：在9.1年的随访中，1,627名女性（44.1%）死亡。PIL最高四分位数的妇女的死亡风险比最低四分位数的妇女低33% （HR = 0.67, 95% CI = [0.58, 0.78], p < 0.0001）。70岁以下的女性（HR = 0.34, 95% CI =[0.19, 0.63]）和过去一年内确诊的女性（HR = 0.28, 95% CI =[0.13, 0.58]）的相关性更强。体育活动、低感知压力和社会参与分别介导了14.2%、18.3%和13.7%的关联，共同解释了51%的关联。结论：高PIL与乳腺癌幸存者生存率的提高有关，体育活动、压力减轻和社会参与是关键途径。目标导向的干预促进PIL可能改善生存结果。（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。

求助全文

约1分钟内获得全文求助全文

来源期刊

Health Psychology 医学-心理学

CiteScore

4.90

自引率

2.40%

发文量

170

审稿时长

4-8 weeks

期刊介绍： Health Psychology publishes articles on psychological, biobehavioral, social, and environmental factors in physical health and medical illness, and other issues in health psychology.