| Objective:We aimed to explore the epidemiological characteristics of adjustment disorder(Aj D)in female breast cancer patients based on the reliability and validity analysis of the Chinese version of the Adjustment Disorder New Module-20(ADNM-20).We also tried to analyze the effects of exercise and social support on Aj D among female breast cancer patients.Methods:This study consisted of two stages.In stage one,a total of 214 colorectal cancer patients were recruited to participate from Tongji Hospital in Hubei,China.And183 questionnaires were valid.Confirmatory Factor Analysis(CFA)was used to evaluate the structure validity of the ADNM-20.Criterion validity was determined via correlations between the ADNM-20 and the Patient Health Questionnaire(PHQ-9),and the Generalized Anxiety Disorder 7-item Scale(GAD-7).The reliability of the ADNM-20was assessed via internal consistency and test-retest reliability.In stage two,400 newly diagnosed(<1 year)female breast cancer patients were recruited from Tongji Hospital and Hubei Cancer Hospital in Hubei,China.And 342 questionnaires were valid.The patients completed the self-report questionnaire including demographic characteristics,weekly exercise frequency,the scale ADNM-20 and the Multidimensional Scale of Perceived Social Support.The t-test was employed to analyze continuous variables,and the chi-square test was employed to compare the differences of categorical variables.Multivariate logistic regression was used to analyze the effect of exercise frequency and social support on Aj D and the interaction between them.Results:Stage one:The CFA suggested that the two-factor model of core symptoms fit the data well(χ~2/df=1.902,RMSEA=0.070,CFI=0.975,TLI=0.964,GFI=0.951).The ADNM-20 was positive associated with PHQ-9(r=0.682)and GAD-7(r=0.809)(P<0.05)respectively.The internal consistency of all subscales was from 0.610 to 0.887,and the test-retest reliability of all subscales was from 0.378 to 0.643.Stage two:The detection rate of Aj D in female breast cancer patients was 38.60%.Patients from rural areas were more likely to suffer from Aj D than those from urban areas(44.03%vs.33.33%,P<0.05).The detection rate of Aj D in female breast cancer patients who regard economic difficulties or work stress as the most sever life event was higher than that in patients who took breast cancer as the most sever life event(44.4%vs.33.9%,P<0.05).The results of multivariate logistic regression showed that the risk of Aj D in female breast cancer patients was significantly associated with moderate frequency of weekly exercise(1-2times/week),high level of total social support,middle and high level of social support from friends could reduce(P<0.05).High frequency of weekly exercise(≥3times/week)significantly interacted with high level of total social support(OR=0.417,95%CI=0.220-0.791),and social support from friends(OR=0.501,95%CI=0.252-0.996).Moderate frequency of weekly exercise significantly interacted with middle(OR=0.203,95%CI=0.044-0.932)and high(OR=0.122,95%CI=0.015-0.970)level of social support from friends.Conclusions:The prevalence of Aj D in female breast cancer patients in this study was very high and warranted more attention.Patients who were from rural areas and subjected to multiple stressors were more likely to suffer from Aj D.Moderate exercise,higher total social support and social support from friends can reduce the risk of Aj D in female breast cancer patients.The frequency of weekly exercise interacted with the level of total social support and social support from friends,and the interaction can significantly reduce the risk of Aj D in female breast cancer patients. |
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