Trajectory And Function Research On Benefit Finding In Women With Breast Cancer

Objective:(1) The first aim of this study was to evaluate the reliability and validity of the Chinese version of Benefit Finding Scale (BFS-C) in women with breast cancer.(2) The second aim of the current study was to distinguish the specific trajectories of benefit finding from cancer diagnosis to early rehabilitation and compare the group differences in related factors.(3) The third aim of the study was to explore the role of benefit finding during the period of physical and mental adaptation in women with breast cancer.Methods:(1) In the psychometric study, a total of605women with breast cancer were assessed by BFS-C, CES-D and BAI. Four weeks later,100of the participants finished BFS-C again. The reliability was tested by the Cronbach’s a coefficient, mean inter-item correlation coefficient (MICC), test-retest reliability, and validity was evaluated by construct validity (exploratory factor analysis, and confirmatory factor analysis, EFA&CFA) and criterion validity.(2) A cohort of413women with breast cancer finished the six months follow-up study. In the initial assessment, all the participants finished BFS-C, CESD, Optimism-pessimism Scale (OPS), Multidimensional Scale of Perceived Social Support (MSPSS), Cognitive Emotion Regulation Questionnaire (CERQ), and Functional Assessment of Cancer Therapy scale-Breast cancer (FACT-B). The follow-up assessments were finished in the1、2、4、6months after initial assessment, and all participants finished BFS-C> CESD and FACT-B。Growth Mixture Model (GMM) and Multi-level Structural Equation Model (MSEM) were used in the data analysis.Results:(1) The scale was composed of five factors by EFA; the Cronbach’s alpha coefficient for the total scale was0.96and for the five factors ranged from0.77to0.90; the test-retest reliability of the total scale and five factors were over than0.70; the confirmatory factor analysis results confirmed the structure of five factors model; it also had satisfactory criterion validity.(2) Four specific trajectories were identified by using GMM:High stable, low stable, growth and decay groups. Demographic variables, such as age, resident place, education level, et al. and pathological stage influenced the trajectories of benefit finding significantly. Patients in high stable group of benefit finding got the highest scores on optimism, MSPSS and its three factors, adaptive cognitive emotion regulation strategies, acceptance, positive refocusing, refocus on planning and positive reappraisal among the four groups. Patients in low stable group of benefit finding gained the highest scores on pessimism, self-blame, rumination, putting into perspective, catastrophizing and maladaptive strategy among the four groups.(3) In the model of level-1, benefit finding and depressive symptoms affected quality of life in women with breast cancer directly, and benefit finding affected quality of life indirectly through depressive symptoms; In the model of level-2, benefit finding and depressive symptoms affected quality of life in women with breast cancer directly, and benefit finding affected quality of life indirectly through depressive symptoms. Meanwhile, optimism-pessimism traits and cognitive emotion regulation strategies affected benefit finding directly, and optimism-pessimism traits and cognitive emotion regulation strategies affected depressive symptoms and quality of life indirectly via benefit finding in women with breast cancer.Conclusion:(1) The BFS-C is a reliable and valid measure for Chinese women with breast cancer.(2) Four unique trajectories were identified, and patients in high stable group of benefit finding possessed more positive psychological characteristics.(3) The depressive symptoms mediated the relationship between benefit finding and quality of life partly in women with breast cancer.