Psychosocial factors associated with the recurrence of breast cancer survivors after treatments

• Main Authors: Ya-Hsin Cheng, 鄭雅心
• Other Authors: Yung-Yuan Chang
• Format: Others
• Language: zh-TW
• Published: 2012
• Online Access: http://ndltd.ncl.edu.tw/handle/91856360856614424067

碩士 === 高雄醫學大學 === 公共衛生學研究所 === 100 === Objective：The purpose of this study was to assess the psychosocial factors significantly associated with the recurrence of breast cancer survivors after finish surgical treatment and adjuvant therapy. Methods：A retrospective case-control study is designed, and the patients diagnosed as breast cancer were reviewed retrospectively from Dec. 31, 2010 to Jan. 01, 1996. The study sample consisted of 219 breast cancer patients, and 31 case had recurrence in follow-up at OPD（out-patient）. All of the data concerned with biological factors, socio-demographic characteristics, and psychosocial factors had been extracted from the structured questionnaire. Then semi-structured interview was used to gather more complete mental status information before patients were recurrence of the case group. We used two sample t-test and Chi-square test to compare the difference between the case group and control group. Kaplan-Meier method was used to estimate 5-years recurrent rate. Cox Proportional Hazards Model was used to explore the role of psychosocial factors for recurrence after controlling for biological and genetic factors. Results：219 breast cancer patients were analyzed with a median age of 48. The median recurrent time was 36 months. 5-years and 10-years recurrent rate were 13.1% and 21%. According to Cox Proportional Hazards Model we found, young (HR=0.96；95%C.I. =0.91~1.00), and none acceptance of hormone therapy (HR=2.4；95%C.I. =0.20~0.87) were significantly predicted breast cancer recurrence. Psychosocial factors, including depression, anxiety, impact of events, and emotional expressivity were not found significantly as the predictors of recurrence. Conclusion：The psychosocial factors were not significantly different between case group and control group in this study. Using in-depth interview technique, we found four of the five patients were not expressing negative emotions, and no appropriate ways to coping with those emotions. They understand how to express negative emotions after recurrence. In addition, we found that the effect of stress was an important factor association with breast cancer recurrence.