| [Object]The primary goal of the study was to describe the psychological status of cancerpatients treated with radiotherapy/chemotherapy, consider the relevant factors ofresilience; Research a cutoff value of the resilience-14, to identify the levels ofpatients’ resilience, in order to provide the basis for carry on clinical psychologicalcare and psychological intervention, and for reduce treatment side effects, improvingthe quality of life.[Method]Inpatients who were diagnosed as cancer and underwent treatment were recruitedin this study in the Fujian Provincial Cancer Hospital、Union Hospital、Fujianprovincial hospital、General Hospital、The first affiliate hospital of Fujian medicaluniversity from January,2009to October,2013. The demographic data (age, gender,educational, religious belief, social support) and clinical information (site of the tumor,clinical stage) were collected by questionnaires. Then reassessed at the point oftherapy3weeks later, measure comprised the14-Item Resilience Scale (RS-14),Hospital Anxiety and Depression Scale (HADS), the EORTC QLQ-C30as a measureof health related Quality of Life. Multiple linear regression analyses were used toanalyze resilience influencing factors. Partial correlation analyses were adopted todetermine the independent relationship between resilience with anxiety anddepression. Take HADS as a reference standard, Youden Index, Minkowski Distanceand the ROC Curve were used to find the optimal prediction cut-off point of RS-14.Divide patients into two groups respectively according to the three cut-off points,Independent Samples T Tests were used to compare the EF dimension scores in QoL.In order to evaluate the rationality of optimal cut-off points, anxiety and depression’s incidence differences were measured.[Results]1. There were1627patients collected. Multiple linear regression analysesrevealed that gender、educational, along with support, associated with resilience, evenafter controlling for the effects of illness severity.2. Partial correlation analysis shows that: by controlling for the age, gender, levelof education and the influence of religious belief, anxiety is negative related toresilience(r=0.643, P<0.001), depression is negative related to resilience(r=0.609, P<0.001), indicating that stronger resilience patients have lower incidence of anxietyand depression.3. Youden Index show that when resilience score was57, the cut-off point wasoptimal, the YI is0.529which attains its maximum, sensitivity and specificity were0.800and0.728respectively. The EF scores of the negative group were significantlyhigher than the positive ones.4. Minkowski Distance was used to discuss the RS-14’s appropriate criteriamargins:55to57. Patient could be diagnosed as a poor resilience one when his RS-14score is less than55points. The negative group’s EF scores of QoL were significantlyhigher than the positive ones.5. ROC curves combining with polynomial regression was used to determine thecut-off point is62, whose corresponding sensitivity is0.834.6. The maximal anxiety and depression’s incidence differences are shownbetween two groups dividing by the point measured through Minkowski Distance,shows a good ability of discrimination in patients with anxiety or depression.[Conclusion]1. Gender、educational and support associated with resilience.2. Resilience has a negative relationship with anxiety and depression, and itcould adjust psychological state.3. Youden index determined the cut-off point is57. The method most easy toimplement can determine the cutoff point which make the diagnostic tests havecomparatively high sensitivity and specificity, has certain limitation of application of continuous quantitative variables, however.4. A range from55to57is calculated as a reference test-treatment threshold ofRS-14through the Minkowski Distance. Taken the great overlap between positive andnegative population into consideration, the method give a definition of positive andnegative groups by using the concept of suspicious range of threshold andcomparatively reduce the rates of missed diagnosis and misdiagnosis.5. Those whose resilience score was less than62represent the poor resilience, isdetermined by ROC Curve combining with Polynomial Regression. The methodmeasure the influences of the incidence and the effectiveness of test-treatment, hascomparatively high sensitivity and is appropriate for continuous quantitative variables.The value of incidence and test-treatment’s effectiveness should be definedprofessionally, however. |
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