Investigation In Post-traumatic Growth Of Breast Cancer Patients Of Childbearing Age Undergoing Post-operative Chemotherapy And Its Influencing Factors

Objective:By conducting a survey on post-operative chemotherapy patients with breast cancer in their childbearing age,this study aims to understand their post-traumatic growth（PTG）status and analyze the influencing factors,providing a scientific and effective reference basis for developing intervention plans for such patients in clinical practice.Methods:This study adopted convenient sampling to conduct a descriptive cross-sectional study.210 patients of childbearing age who were hospitalized in the Department of Glandular Surgery of a tertiary grade A hospital in Guangxi from September2021 to November 2022 were selected as subjects.The general data questionnaire and the Chinese Post-traumatic Growth Inventory,Social Problem-Solving Inventory-Revised,Meaning in Life Questionnaire,Reproductive Concerns After Cancer scale were used to investgate the patients when they returned to the hospital for chemotherapy three months after surgery.A total of 210 questionnaires were sent out,210 were recovered,and 201 valid questionnaires were collected,with a valid questionnaire rate of 95.71%.The raw data were coded and double-entered into Epi Data3.1 software,and SPSS23.0 statistical software was used for data analysis.Enumeration data were described by frequency and constituent ratio.Measurement data of normal distribution were expressed by x±s,and those not meeting normal distribution were presented as M(P₂₅,P₇₅).Independent-samples t-test,one-way analysis of variance,Mann-Whitney U-test,and Kruskal-Wallis H test were applied to compare and analyze the differences in PTG scores of breast cancer patients of childbearing age undergoing post-operative chemotherapy.Moreover,the correlations of the sense of life meaning,social problem solving,and reproductive concerns after cancer with PTG were subjected to Spearman correlation analysis.Finally,multiple stepwise regression analysis was adopted for the effects of multiple factors on PTG.Results:（1）The total PTG score of breast cancer patients of childbearing age undergoing post-operative chemotherapy was（71.96±12.33）points.For the items of each dimension,the average PTG scores in descending order were（3.88±0.65）points for life perception,（3.86±0.70）points for personal power,（3.65±1.04）points for relationship with others,（3.43±0.85）points for self-transformation,and（3.10±0.78）points for new possibilities.（2）The results of univariate analysis indicated that there were statistically significant differences in the PTG level of breast cancer patients of childbearing age undergoing post-operative chemotherapy based on the fertility desire,conduction of breast-conserving surgery,disease stage,cancer type,educational level,employment status,family monthly income per capita,place of residence,and payment mode of medical expenses（p<0.05）.（3）It was manifested by correlation analysis that PTG was positively associated with social problem solving（r=0.164,p<0.05）and sense of life meaning（r=0.462,p<0.01）in breast cancer patients of childbearing age undergoing post-operative chemotherapy,but it had no relation to reproductive concerns after cancer（r=-0.002,p>0.05）.（4）According to the results of multivariate analysis,educational level of senior high school or special secondary school（Primary school and below for reference）,breast-conserving surgery performed,on-the-job status,presence of the sense of life meaning,search for the sense of life meaning,and rational problem-solving styles were independent influencing factors for the PTG level of breast cancer patients of childbearing age undergoing post-operative chemotherapy,which could explain 40.6%of the variance together,and the fitted regression equation was of statistical significance（R²=0.424,adjusted R²=0.406,F=23.797,p<0.001）.Conclusion:（1）In this study,patients with post-operative chemotherapy for breast cancer in childbearing age experienced the most growth in life perception and the least growth in new possibilities,and there is still room for improvement.Stimulating such patients to develop new interests and hobbies,opening up more new possibilities will be beneficial to improve their PTG levels.（2）Educational level,employment status,conduction of breast-conserving surgery,presence of the sense of life meaning,search for the sense of life meaning,and rational problem-solving styles were independent predictors of the PTG level of breast cancer patients of childbearing age undergoing post-operative chemotherapy.（3）The level of PTG was the lowest in patients of childbearing age with postoperative chemotherapy for breast cancer with education level below primary school.The PTG level of high school or secondary school patients was higher than that of primary school patients.There was no statistically significant difference in PTG levels between junior college students and primary school students.Due to the small number of cases of junior college students in this study,it is possible to increase the sample size to explore the influence of education level on post-traumatic growth in the future.In clinical work,medical staff should pay attention to patients with low education level,and explain the condition and educate them in a simple and understandable way.（4）The level of PTG in working patients was higher than that in non-working patients.It is suggested that medical staff should take the initiative to explain the relevant health care policies to patients,mobilize the social support system,and reduce their pressure.（5）The level of PTG in patients undergoing breast-conserving surgery was higher than that in patients without breast-conserving surgery.It is suggested that the patient’s confidence can be enhanced through the joint decision of doctors and patients to improve the breast preservation rate,breast reconstruction and wearing prosthetic milk.（6）The stronger the sense of life meaning and the more rational problem-solving style of patients with post-operative chemotherapy for breast cancer in childbearing age,the higher their PTG level.Such patients should be encouraged to perceive the meaning of life with optimism,and to think rationally when facing problems.